LAUSR

Background: Although physical inactivity, obesity, and low serum vitamin D [25-hydroxyvitamin D, 25(OH)D] are common among women, joint associations among these biomarkers are not well-described. Materials and Methods: A total of 7553 healthy women received a comprehensive examination (2006-2018), including self-reported physical activity (PA), body mass index (BMI), waist circumference (WC), waist:height ratio (W:HT), percent body fat (%Fat), and 25(OH)D. Participants were divided into four categories of PA based on current guidelines: <500 (not meeting guidelines), 500-1000 (meeting guidelines), 1001-2500 (>1-2.5 times guidelines), and >2500 (>2.5 times guidelines) metabolic equivalent-minutes/week (MET-Min/wk), and were also classified by clinical cut points for adiposity measures and 25(OH)D. We examined trends of 25(OH)D and adiposity exposures across PA categories and calculated odds ratios (ORs) of vitamin D deficiency across categories of each adiposity exposure. We examined joint associations among PA and adiposity with 25(OH)D. Results: A positive trend was observed for 25(OH)D across PA categories (p < 0.001). Compared with normal weight status, the odds for 25(OH)D deficiency were significantly higher for overweight women within adiposity exposures (p for all <0.001). When examining joint associations, 25(OH)D was higher across PA categories within each stratum of BMI, WC, W:HT, and %Fat (p trend <0.007 for all). When examining PA and BMI as continuous variables, OR for vitamin D deficiency were 0.95 (95% confidence interval [CI]: 0.93-0.96) per 250 MET-minutes/week increment in PA, and 1.20 (95% CI: 1.17-1.23) per 2 kg/m2 increment in BMI. Conclusions: 25(OH)D levels are positively associated with PA and negatively associated with different measures of adiposity. Higher levels of PA attenuate the association between adiposity and 25(OH)D.