Physical Activity, Gut Microbiota, and the Risk of Dyslipidemia in a Community-Based Cohort Study

Whether moderate-to-vigorous physical activity (MVPA) mitigates the detrimental association between sedentary behavior and dyslipidemia remains unclear, as does the link between MVPA and gut microbiota.

We prospectively evaluated the joint association between MVPA and sedentary time on dyslipidemia risk in a cohort of 2942 Chinese adults, where PA was measured by a validated self-reported questionnaire. In a subcohort (n=754), 1-year gut microbial changes associated with MVPA were assessed via fecal samples collected twice at 1-year intervals for 16S ribosomal RNA sequencing, with PA intensively assessed by 4 quarterly 3-day PA diaries (2 weekdays and 1 weekend day) during the year.

From 2020 to 2025, 306 dyslipidemia were newly diagnosed. Prolonged sedentary hours increased dyslipidemia risk by 63% (highest versus lowest tertile: adjusted hazard ratio [HR], 1.63 [95% CI, 1.19-2.22], P_trend=0.002). Compared with participants with long sedentary hours and low MVPA levels (ie, long-low group), HRs of dyslipidemia for those in short-high, short-low, and long-high groups were 0.70 (95% CI, 0.50-0.98), 0.99 (95% CI, 0.71-1.37), and 0.83 (95% CI, 0.60-1.16), respectively. The microbial α-diversity declined in the low MVPA group (P=0.024), and β-diversity shifted in both low/high MVPA groups (all P≤0.005). We identified 7 MVPA-associated and 13 sedentary time-associated genera (all P_{FALSE DISCOVERY RATE}<0.05). Among these genera, Eggerthella and Desulfovibrio correlated positively with MVPA levels but inversely with sedentary time, and Desulfovibrio was inversely associated with dyslipidemia (odds ratio, 0.78 [95% CI, 0.606-0.997]).

MVPA attenuates the positive association between sedentary time and dyslipidemia risk and modulates gut microbial diversity and richness, suggesting microbiota-mediated pathways for dyslipidemia prevention.