A cross-sectional study of the relationship between physical activity, diet quality, and high-sensitivity C-reactive protein in US adults

Background and aims: High-sensitivity C-reactive protein (hs-CRP) is associated with many diseases, especially cardiovascular disease (CVD). Research into the independent and integrated relationships of physical activity and diet quality with hs-CRP across sex-specific cohorts is lacking. Methods and results: National Health and Nutrition Examination Survey data (2015-2018) was used to examine the relationship between physical activity and diet quality with hs-CRP and hs-CRP classified CVD risk using multiple multinormal logistic regression adjusted for covariates including demographics. Physical activity was measured using a self-reported survey and further categorized to those who met (MPAR) or did not meet (NPAR) national recommendations. Diet quality was measured using the Healthy Eating Index-2015, and further categorized to higher (HDQ) and lower (LDQ) diet quality. hs-CRP was also categorized as low, average, and high CVD risk using established cut-points. Physical activity was inversely related to hs-CRP in males (p < 0.001) whereas diet quality was inversely related to hs-CRP in females (p = 0.031). Compared to those with NPAR and LDQ, the hs-CRP for males with NPAR and HDQ and females with MPAR and HDQ was 1.18 mg/L and 0.75 mg/L lower respectively. Although, diet quality was inversely associated with high CVD risk in both sexes (p < 0.05), the lowest proportion of high and average CVD risk was observed in males and females with MPAR and HDQ. Conclusion: Physical activity and diet-quality lowered CVD risk regardless of sex. However, the independent effects of physical activity and diet quality on hs-CPR differs between sexes. (c) 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.