The study sample consisted of 1,421 women and 1,505 men with a mean age of 50 ± 10 years (), with the exception of the dietary analysis, which was limited to only 925 participants.
Characteristics of study participants
SAT, VAT, and dietary quality
In women, higher DGAI (i.e., a diet more adherent to healthy guidelines) was associated with lower SAT (232 cm3 lower per 1 SD of DGAI, P = 0.002) and lower VAT (139 cm3 lower, P = 0.001) (). Similar results were obtained in men. The difference between the magnitude of the association between DGAI and VAT versus SAT was not significant (P = 0.19 for women and P = 0.78 for men).
Sex-specific multivariable-adjusted mean difference in volumes of SAT and VAT per 1-SD increment in DGAI and PAI and least-squares mean volumes of SAT and VAT by smoking and alcohol categories
SAT, VAT, and physical activity
Higher PAI (i.e., more physical activity) was inversely associated with SAT in both women (P < 0.0001) and men (P = 0.0001) (), although the association was more pronounced in women (P for sex interaction = 0.0002). For VAT, similar results were obtained (P < 0.0001 for women and P = 0.0006 for men), although the sex interaction did not reach statistical significance (P = 0.05). No difference was observed in the strength of the association of PAI with SAT versus VAT (P = 0.21 for women, P = 0.27 for men).
SAT, VAT, and smoking
In women, former smokers tended to have the highest mean SAT compared with current or never smokers, although the difference did not meet statistical significance (P = 0.06) (). Similar results were observed in men, with a significant difference observed among the three groups (P = 0.02). In women, mean VAT was higher in current smokers and former smokers compared with those who never smoked (P = 0.03 for both pairwise comparisons), whereas in men, mean VAT was higher in former smokers (P = 0.001 for pairwise comparison) but not in current smokers.
SAT, VAT, and alcohol consumption
In women, participants with light-to-moderate alcohol intake had higher mean SAT compared with those with high alcohol intake (P = 0.006), whereas there was no difference in mean VAT (P = 0.18) (). In contrast, SAT did not differ according to alcohol intake in men (P = 0.91), whereas men with light-to-moderate alcohol intake had lower mean VAT compared with those with high alcohol intake (P = 0.04).
SAT, VAT, and number of healthy lifestyle factors
In both women and men, practicing a higher number of healthy lifestyle habits was significantly associated with lower mean SAT (P < 0.0001 for women and P < 0.01 for men) and VAT (P < 0.0001) ().
Figure 1 Age-adjusted mean (± 1 SE) volumes of SAT and VAT in women (A) and men (B) associated with practicing zero, one, two, or three healthy lifestyle habits. Age-adjusted P values for trend are presented. *P < 0.01; ** (more ...)
The additional inclusion of physical activity as a covariate did not materially change the associations between the lifestyle factors and SAT and VAT (data not shown). When the general estimating equation procedure was used to repeat the analyses, the results did not substantially differ from the findings reported above (data not shown). Significant effect modification of BMI on the association between DGAI and SAT and PAI and VAT was observed (supplemental Table A1, available in an online appendix at http://dx.doi.org/10.2337/dc08-1382
). The strongest association between DGAI and SAT was in overweight individuals, whereas the strongest association between PAI and VAT was observed in normal-weight individuals.