Resistance Exercise Training in Individuals With and Without Cardiovascular Disease: 2023 Update: A Scientific Statement From the American Heart Association.

Resistance training not only can improve or maintain muscle mass and strength, but also has favorable physiological and clinical effects on cardiovascular disease and risk factors. This scientific statement is an update of the previous (2007) American Heart Association scientific statement regarding resistance training and cardiovascular disease. Since 2007, accumulating evidence suggests resistance training is a safe and effective approach for improving cardiovascular health in adults with and without cardiovascular disease. This scientific statement summarizes the benefits of resistance training alone or in combination with aerobic training for improving traditional and nontraditional cardiovascular disease risk factors. We also address the utility of resistance training for promoting cardiovascular health in varied healthy and clinical populations. Because less than one-third of US adults report participating in the recommended 2 days per week of resistance training activities, this scientific statement provides practical strategies for the promotion and prescription of resistance training.

Increasing Equity of Physical Activity Promotion for Optimal Cardiovascular Health in Adults: A Scientific Statement From the American Heart Association.

Fewer than 1 in 4 adults achieves the recommended amount of physical activity, with lower activity levels reported among some groups. Addressing low levels of physical activity among underresourced groups provides a modifiable target with the potential to improve equity in cardiovascular health. This article (1) examines physical activity levels across strata of cardiovascular disease risk factors, individual level characteristics, and environmental factors; (2) reviews strategies for increasing physical activity in groups who are underresourced or at risk for poor cardiovascular health; and (3) provides practical suggestions for physical activity promotion to increase equity of risk reduction and to improve cardiovascular health. Physical activity levels are lower among those with elevated cardiovascular disease risk factors, among certain groups (eg, older age, female, Black race, lower socioeconomic status), and in some environments (eg, rural). There are strategies for physical activity promotion that can specifically support underresourced groups such as engaging the target community in designing and implementing interventions, developing culturally appropriate study materials, identifying culturally tailored physical activity options and leaders, building social support, and developing materials for those with low literacy. Although addressing low physical activity levels will not address the underlying structural inequities that deserve attention, promoting physical activity among adults, especially those with both low physical activity levels and poor cardiovascular health, is a promising and underused strategy to reduce cardiovascular health inequalities.

Short-term hot water immersion results in substantial thermal strain and partial heat acclimation; comparisons with heat-exercise exposures.

OBJECTIVE: To examine the effectiveness of hot water immersion (HWI) as a heat acclimation strategy in comparison to time and temperature matched, exercise-heat acclimation (EHA). METHODS: 8 males performed heat stress tests (HST) (45 min of cycling at 50% of VO2max in 40 °C, 40% RH) before and after heat acclimation sessions. Acclimation sessions were either three consecutive bouts of HWI (40 min of submersion at 40 °C) or EHA (40 min of cycling at 50% VO2max in 40 °C, 40% RH). RESULTS: Average change in tympanic temperature (TTympanic) was significantly higher following HWI (2.1 °C ± 0.4) compared to EHA (1.5 °C ± 0.4) (P < 0.05). Decreases in peak heart rate (HR) (HWI: -10 bpm ± 8; EHA: -6 ± 7), average HR (-7 bpm ± 6; -3 ± 4), and average core temperature (-0.4 °C ± 0.3; -0.2 ± 0.4) were evident following acclimation (P < 0.05), but not different between interventions (P > 0.05). Peak rate of perceived exertion (RPEPeak) decreased for HWI and EHA (P < 0.05). Peak thermal sensation (TSPeak) decreased following HWI (P < 0.05) but was not different between interventions (P > 0.05). Plasma volume increased in both intervention groups (HWI: 5.9% ± 5.1; EHA: 5.4% ± 3.7) but was not statistically different (P > 0.05). CONCLUSION: HWI induced significantly greater thermal strain compared to EHA at equivalent temperatures during time-matched exposures. However, the greater degree of thermal strain did not result in between intervention differences for cardiovascular, thermoregulatory, or perceptual variables. Findings suggest three HWI sessions may be a potential means to lower HR, TCore, and perceptual strain during exercise in the heat.

Associations between mental distress and physical activity in US adults: a dose-response analysis BRFSS 2011.

Background: To examine the associations between levels of severity of mental distress (MD) and meeting the 2008 physical activity (PA) recommendations using the MD Severity Index (MDSI). Methods: Participants (n = 431 313) were adults (≥18 years of age) who responded to the 2011 Behavioral Risk Factor Surveillance System (BRFSS). MD was categorized into five levels of severity: 0-4, 5-10, 11-16, 17-22 and ≥23 days/month. The dependent variable was self-reported PA volume of at least 150 min/wk (or vigorous equivalent, 75 min/wk). Results: Following adjustment for age, gender, race/ethnicity, education and body mass index, the odds of reporting meeting the PA recommendations were significantly lower among those reporting the following days per month of MD: 5-10 (odds ratio [OR] = 0.92, 95% confidence interval [CI]: 0.87-0.96), 11-16 (OR = 0.76, 95% CI: 0.71-0.82), 17-22 (OR = 0.69, 95% CI: 0.62-0.76) and ≥23 (OR = 0.64, 95% CI: 0.60-0.67). An inverse dose-response (P < 0.01) was observed between the severity of MD and meeting the current PA recommendations. Conclusions: An inverse dose-response relationship was found between the severity of MD and volumes of PA meeting the 2008 recommendation. These findings lend support for the epidemiological utility of the MDSI when examining the relationship between MD and PA.

Use of population-referenced total activity counts percentiles to assess and classify physical activity of population groups.

OBJECTIVES: Population-referenced total activity counts per day (TAC/d) percentiles provide public health practitioners a standardized measure of physical activity (PA) volume obtained from an accelerometer that can be compared across populations. The purpose of this study was to describe the application of TAC/d population-referenced percentiles to characterize the PA levels of population groups relative to US estimates. METHODS: A total of 679 adults participating in the 2011 NYC Physical Activity Transit survey wore an ActiGraph accelerometer on their hip for seven consecutive days. Accelerometer-derived TAC/d was classified into age- and gender-specific quartiles of US population-referenced TAC/d to compare differences in the distributions by borough (N=5). RESULTS: Males in Brooklyn, Manhattan, and Staten Island had significantly greater TAC/d than US males. Females in Brooklyn and Queens had significantly greater levels of TAC/d compared to US females. The proportion of males in each population-referenced TAC/d quartile varied significantly by borough (χ(2)(12)=2.63, p=0.002), with disproportionately more men in Manhattan and the Bronx found to be in the highest and lowest US population-referenced TAC/d quartiles, respectively. For females, there was no significant difference in US population-reference TAC/d quartile by borough (χ(2)(12)=1.09, p=0.36). CONCLUSIONS: These results demonstrate the utility of population-referenced TAC/d percentiles in public health monitoring and surveillance. These findings also provide insights into the PA levels of NYC residents relative to the broader US population, which can be used to guide health promotion efforts.

Accelerometer-Derived Total Activity Counts, Bouted Minutes of Moderate to Vigorous Activity, and Insulin Resistance: NHANES 2003-2006.

INTRODUCTION: The objective of this study was to compare the associations of accelerometer-derived total activity counts per day and minutes of bouted moderate to vigorous physical activity (MVPA) with insulin resistance. METHODS: The sample included 2,394 adults (aged ≥20 y) from the 2003-2006 National Health and Nutrition Examination Survey. Time spent in MVPA, measured by using 2 cutpoints (≥2,020 counts/min [MVPA2,020] and ≥760 counts/min [MVPA760]), was calculated for bouts of at least 8 to 10 minutes. Total activity counts per day reflects the total amount of activity across all intensities. Insulin resistance was measured via the homeostatic model assessment of insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI). Two nested regression models regressed HOMA-IR and QUICKI, respectively, on minutes of bouted MVPA and total activity counts per day. We used an adjusted Wald F statistic to illustrate strength of association. RESULTS: After adjustment for covariates, total activity counts per day was more strongly associated with both HOMA-IR (adjusted Wald F = 36.83 , P < .001) and QUICKI (adjusted Wald F = 29.44, P < .001) compared with MVPA2,020 (HOMA-IR, adjusted Wald F = 4.00, P = .06; QUICKI, adjusted Wald F = 1.08, P = .31).Total activity counts per day was more strongly associated with both HOMA-IR (adjusted Wald F = 13.64, P < .001) and QUICKI (adjusted Wald F = 12.10, P < .001) compared with MVPA760 (HOMA-IR, adjusted Wald F = 1.13, P = .30; QUICKI, adjusted Wald F = 0.97, P = .33). CONCLUSION: Our study indicated that total activity counts per day has stronger associations with insulin resistance compared with minutes of bouted MVPA. The most likely explanation is that total activity counts per day captures data on light physical activity and intermittent MVPA, both of which influence insulin resistance.

The Physical Activity Guidelines and Diabetes-Related Mortality: National Health and Nutrition Examination Survey 1999-2006.

Background: Previous studies have indicated an inverse relationship between aerobic physical activity (PA) and risk of diabetes-related mortality (DRM). However, the contribution of aerobic PA across multiple domains, while also considering the contribution of muscle-strengthening activity (MSA), in reduction of risk for DRM has yet to be examined. Purpose: The aim of this study is to examine the individual and combined associations of aerobic PA and MSA with DRM. Methods: The study sample (n = 13,350) included adult (20-79 years of age) participants from the 1999 to 2006 National Health and Nutrition Examination Survey. PA was categorized into 6 categories based around the 2018 PA guidelines: category 1 (inactive), category 2 (insufficient aerobic PA and no MSA), category 3 [active (aerobic) and no MSA], category 4 (no aerobic PA and sufficient MSA), category 5 (insufficient aerobic PA and sufficient MSA), and category 6 (meeting both recommendations). The dependent variable in this study was DRM, which includes those who had diabetes as the primary cause of death as well as those with diabetes listed as an underlying cause of death. Cox proportional hazards models were used for all analyses. Results: Following adjustment for covariates, significant risk reductions for DRM were found only in category 3 (HR = 0.57; 95% confidence interval: 0.37-0.88). Conclusions: Results suggest that meeting the aerobic PA guidelines significantly reduces the risk for DRM. Those meeting versus not meeting the MSA guidelines seem to have no difference in risk for DRM independent of aerobic PA.

Caffeine has no effect on submaximal running in hypoxia in low caffeine consuming males and females.

BACKGROUND: Exposure to hypoxia immediately challenges a variety of physiologic systems that limit exercise capacity. Under normoxia, caffeine (CAFF) increases ventilation and subsequent oxygenation of hemoglobin (SpO2) and skeletal muscle (SmO2). CAFF improves exercise performance at altitude. However, little attention has been given to submaximal exercise in hypoxia, particularly regarding low CAFF consumers and female participants. The aim of this study was to determine the effect of CAFF on pulmonary, metabolic, and perceptual variables in response to submaximal running in hypoxia in low CAFF consuming males and females. METHODS: In a double blinded, counterbalanced design, 14 (6 females) individuals (24.1±5.1 years; VO2max: 40.6±5.6 mL × kg-1 × min-1; 20.8±8.0% body fat), who habitually consumed ≤150 mg/day of CAFF performed treadmill running at workloads of 25%, 40%, 60%, and 75% of sea level VO2max in normobaric hypoxia (FIO2=0.15) on two separate occasions: 1) 60 minutes after 6 mg/kg of CAFF; or 2) placebo. RESULTS: CAFF had no effect on any variable measured. Specifically, VE (condition: P=0.12; interaction: P=0.19), VT (condition: P=0.16; interaction: P=0.57), and Ve:VO2 (condition: P=0.07; interaction: P=0.69) were similar between groups. Further, CAFF had no effect on relative VO2 (condition: P=0.84; interaction: P=0.95), HR (condition: P=0.28; interaction: P=0.35), SmO2 (condition: P=0.66; interaction: P=0.82), or SpO2 (condition: P=0.16; interaction: P=0.97). Finally, rating of perceived exertion (RPE; P=0.92) and acute mountain sickness scores (P=0.29) were similar across conditions. CONCLUSIONS: These data demonstrate that CAFF provides no physiologic advantage to submaximal exercise in acute, normobaric hypoxia with low CAFF consuming males and females.

Accelerometer-Measured Physical Activity and Cardiometabolic Risk Factors by Race-Ethnicity: 2003-2006 NHANES.

Previous studies suggest that the magnitude of morbidity/mortality reduction may differ between race-ethnic groups despite equated dose of physical activity (PA). The purpose of this study was to compare the potential racial-ethnic differences in cardiometabolic risk factors (CMRF) across quartiles of accelerometer-derived total activity counts/day (TAC/d) among US adults. The final sample (n=4144) included adults who participated in the 2003-2006 National Health and Nutrition Examination Survey (NHANES). CMRF included fasting glucose (FG), fasting insulin (FI), HOMA-IR, resting systolic (SBP) and diastolic blood pressure (DBP), waist circumference (WC), BMI, CRP, HDL-C, LDL-C, and triglycerides. Race-ethnic groups examined included non-Hispanic white (NHW), non-Hispanic black (NHB), and Mexican American (MA). In the highest quartile, NHW had significantly lower values of HOMA-IR, FI, SBP, BMI, WC, and HDL-C when compared to NHB. Compared to MA in the highest quartile, NHW had significantly lower values of HOMA-IR, FI, BMI, and triglycerides. Significant race-ethnic differences were found for several CMRF, especially among those who were in the top quartile of PA (e.g., the most active adults). It is probable that the protective effect of higher volumes of PA on CMRF is moderated by other non-PA factors distinct to NHB and MA.

Leisure-time aerobic physical activity and the risk of diabetes-related mortality: An analysis of effect modification by race-ethnicity.

AIMS: To examine the relationship between aerobic moderate-to-vigorous intensity leisure-time physical activity (LTPA) and the risk of diabetes-related mortality in the NHANES III (1988-1994) while considering potential effect modification by race-ethnicity. METHODS: The study sample (n = 14,006) included adults, 20-79 years of age, with Mobile Examination Center (MEC) data. An age-standardized physical activity score (PAS) was calculated from the self-reported frequency and intensity of 12 leisure-time aerobic activities. Three categories of PA were examined: inactive (PAS = 0), insufficiently active (PAS >0-<10), and active (PAS ≥10). Diabetes-related mortality was defined as death from diabetes mellitus. Cox Proportional Hazard models were used all analyses. RESULTS: A statistically significant reduction in risk was found for insufficiently active (HR 0.59, 95% CI 0.40-0.90) and active non-Hispanic black (NHB) (HR 0.54, 95% CI 0.34-0.88). Among active non-Hispanic white (NHW), a similar pattern of risk reduction was found, however, this relationship was borderline significance (HR 0.59, 95% CI 0.35-1.02, p = 0.06). CONCLUSIONS: Any volume of aerobic LTPA is beneficial in terms of reducing the risk of diabetes-related mortality. However, these benefits may differ by racial-ethnic group, with further research on health disparities in the area of PA being warranted.

Protective role of physical activity on type 2 diabetes: Analysis of effect modification by race-ethnicity.

BACKGROUND: It is well known physical activity (PA) plays a role in the prevention of type 2 diabetes (T2D). However, the extent to which PA may affect T2D risk among different race-ethnic groups is unknown. Therefore, the aim of the present study was to systematically examine the effect modification of race-ethnicity on PA and T2D. METHODS: The PubMed and Embase databases were systematically searched through June 2016. Study assessment for inclusion was conducted in three phases: title review (n = 13 022), abstract review (n = 2200), and full text review (n = 265). In all, 27 studies met the inclusion criteria and were used in the analysis. Relative risks (RRs) and 95% confidence intervals (CIs) were extracted and analyzed using Comprehensive Meta-Analysis software. All analyses used a random-effects model. RESULTS: A significant protective summary RR, comparing the most active group with the least active PA group, was found for non-Hispanic White (RR 0.71, 95% CI 0.60-0.85), Asians (RR 0.76, 95% CI 0.67-0.85), Hispanics (RR 0.75, 95% CI 0.64-0.89), and American Indians (RR 0.73, 95% CI 0.60-0.88). The summary effect for non-Hispanic Blacks (RR 0.91, 95% CI 0.76-1.08) was not significant. CONCLUSIONS: The results of the present study indicate that PA (comparing most to least active groups) provides significant protection from T2D, with the exception of non-Hispanic Blacks. The results also indicate a need for race-ethnicity-specific reporting of RRs in prospective cohort studies that incorporate multiethnic samples.

Assessing Energy Level as a Marker of Aerobic Exercise Readiness: A Pilot Investigation.

Energy ratings have been used as a marker of exercise readiness (i.e. pre-exercise physical/mental state indicating ability to perform) within flexible nonlinear periodization (FNLP)-based resistance training interventions. However, empirical data is lacking regarding the utility of this approach for aerobic exercise. The purpose of this study was to examine the ability of pre-exercise energy level to predict affective and behavioral responses to prescribed aerobic exercise. Participants consisted of 19 women and 8 men (N=27, age=20±4 years, estimated maximal oxygen uptake=37±6). Participants performed two 30-min bouts of treadmill exercise under an imposed moderate intensity (70-75% of age-predicted maximal heart rate; %HRmax) condition and a self-selected intensity condition. Pre-exercise energy level was assessed using the Energy Index (EI) score derived from the Profile of Mood States. Feeling Scale (FS) was the dependent variable in the imposed bout and average intensity (%HRmax) was the dependent variable during the self-selected bout. Multiple regression analyses were used to determine if EI predicted mean FS and %HRmax. After controlling for potential confounders, EI significantly predicted mean FS (ß=.499, p=.037) during imposed exercise. No significant relationship existed between EI and overall intensity (ß =-121, p=.554) during self-selected exercise. While EI predicted in-task core affect it was unrelated to self-selected intensity. It is premature to suggest EI as an optimal predictor of exercise readiness in regards to aerobic exercise for aerobically untrained young adults. More research is needed to determine an evidence-based marker of readiness that can be used for aerobic exercise prescribed within the context of FNLP.

Accuracy of Consumer Monitors for Estimating Energy Expenditure and Activity Type.

INTRODUCTION: Increasing use of consumer-based physical activity (PA) monitors necessitates that they are validated against criterion measures. Thus, the purpose of this study was to examine the accuracy of three consumer-based PA monitors for estimating energy expenditure (EE) and PA type during simulated free-living activities. METHODS: Twenty-eight participants (mean ± SD: age, 25.5 ± 3.7 yr; body mass index, 24.9 ± 2.6 kg·m) completed 11 activities ranging from sedentary behaviors to vigorous intensities. Simultaneous measurements were made with an Oxycon portable calorimeter (criterion), a Basis Peak and Garmin Vivofit on the nondominant wrist, and three Withings Pulse devices (right hip, shirt collar, dominant wrist). Repeated-measures ANOVA were used to examine differences between measured and predicted EE. Intraclass correlation coefficients were calculated to determine reliability of EE predictions between Withings placements. Paired samples t tests were used to determine mean differences between observed minutes and Basis Peak predictions during walking, running, and cycling. RESULTS: On average, the Basis Peak was within 8% of measured EE for the entire PA routine (P > 0.05); however, there were large individual errors (95% prediction interval, -290.4 to +233.1 kcal). All other devices were significantly different from measured EE for the entire PA routine (P < 0.05). For activity types, Basis Peak correctly identified ≥92% of actual minutes spent walking and running (P > 0.05), and 40.4% and 0% of overground and stationary cycling minutes, respectively (P < 0.001). CONCLUSIONS: The Basis Peak was the only device that did not significantly differ from measured EE; however, it also had the largest individual errors. Additionally, the Basis Peak accurately predicted minutes spent walking and running, but not cycling.

The Associations Between Increasing Degrees of HOMA-IR and Measurements of Adiposity Among Euglycemic U.S. Adults.

BACKGROUND: The purpose of this study was to examine the associations between increasing degrees of insulin resistance (using the homeostatic model assessment of insulin resistance [HOMA-IR]) and two measures of adiposity in a nationally representative sample of euglycemic U.S. adults. MATERIALS AND METHODS: Sample included adult participants (≥ 20 years of age) [N = 1586 (body mass index, BMI model), N = 1577 (waist circumference, WC model)] from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). HOMA-IR was categorized into quartiles. BMI and WC were examined continuously as the dependent variables. RESULTS: Following adjustment for covariates, those with HOMA-IR values in the second, third, and fourth quartiles had significantly higher BMIs (P < 0.001) compared with subjects in the first quartile. In the model using WC, significantly higher WCs were found in subjects in the second, third, and fourth quartiles of HOMA-IR (P < 0.001) compared with those in the first quartile. A significant moderate correlation was found between HOMA-IR and BMI (R(2) = 0.4171, P < 0.001), as well as HOMA-IR and WC (R(2) = 0.4826, P < 0.001). CONCLUSIONS: Having a higher HOMA-IR value is associated with higher BMI and WC values in euglycemic subjects.

Vigorous Intensity Physical Activity and C-Reactive Protein in U.S. Adults.

BACKGROUND: Several studies have revealed inverse associations between physical activity (PA) and C-reactive protein (CRP). However, few studies have examined associations between vigorous intensity PA (VIPA) and CRP using nationally representative samples. METHODS: The sample (n = 14,461) included adults (≥20 years of age) who participated in the 1999-2006 National Health and Nutrition Examination Survey. Reported VIPA was categorized into none, insufficient (<500 MET·min·wk(-1)), and meeting the 2008 Department of Health and Human Services PA recommendation (≥500 MET·min·wk(-1)). The dependent variable was elevated CRP (3

The associations between increasing degrees of homeostatic model assessment for insulin resistance and muscular strengthening activities among euglycaemic US adults.

PURPOSE: To examine the associations between the homeostatic model assessment for insulin resistance and self-reported muscular strengthening activity in a nationally representative sample of euglycaemic US adults. METHODS: Sample included euglycaemic adults (⩾20 years of age (n = 2009)) from the 1999 to 2004 National Health and Nutrition Examination Survey. Homeostatic model assessment for insulin resistance was categorized into quartiles and was the primary independent variable of interest. No reported muscular strengthening activity was the dependent variable. RESULTS: Following adjustment for covariates, those with homeostatic model assessment for insulin resistance values in fourth (odds ratio: 2.04, 95% confidence interval: 1.35-3.06, p < 0.001) quartile were found to have significantly greater odds of reporting no muscular strengthening activity. Following further adjustment for non-muscular strengthening activity specific aerobic leisure-time physical activity, results remained significant for the fourth (odds ratio: 2.30, 95% confidence interval: 1.50-3.52, p < 0.001) quartile. A significant trend was seen across quartiles of homeostatic model assessment for insulin resistance for increasing prevalence of no muscular strengthening activity (p < 0.001). CONCLUSION: Having a higher homeostatic model assessment for insulin resistance value is associated with greater odds of reporting no muscular strengthening activity among euglycaemic US adults. This implies that subjects with an increasing degree of insulin resistance are more likely to not engage in muscular strengthening activity, an exercise modality that has been shown to reduce the risk of several cardiometabolic diseases and improve glycaemic status.

Gender Differences in C-Reactive Protein and Muscle Strengthening Activity.

BACKGROUND: Few studies have examined the gender differences between C-reactive protein (CRP) and muscle strengthening activity (MSA). METHODS: The sample (n = 7533) included U.S. adult (≥20 years of age).participants in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). Created categories of MSA participation included no MSA (referent group), some MSA (≥1 to <2 days/week), and meeting the 2008 Department of Health and Human Services (DHHS) recommendation (≥2 days/week). The dependent variable was elevated CRP (>3 to 10 mg/L). RESULTS: Analysis revealed significantly lower odds of having elevated CRP for women reporting some MSA (OR 0.64; 95% CI 0.44-0.93, P = .0191). Significantly lower odds of men having elevated CRP was observed in those reporting MSA volumes meeting the DHHS recommendation (OR 0.72; 95% CI 0.59-0.88, P = .0019). Following adjustment for waist circumference (WC) these odds remained significant in men but not women. CONCLUSIONS: These results suggest that WC may mediate the associations between MSA and CRP and this relationship may be stronger in women.

Association between alcohol consumption patterns and metabolic syndrome.

AIMS: Examine associations between self-reported alcohol consumption patterns and metabolic syndrome. MATERIALS AND METHODS: Sample (N=7432) included adult (≥20 years) participants in the 1999-2006 National Health and Nutrition Examination Survey. RESULTS: Above moderate alcohol consumption (AMAC) was negatively associated with waist circumference among those in the 20-29, 40-49, and 70-79 age groups (ß=-6.21, ß=-8.34, and ß=-6.60, respectively) and moderate alcohol consumption (MAC) was negatively associated with waist circumference among those in the 30-39, 40-49, and 70-79 age groups (ß=-4.60, ß=-5.69, and ß=-2.88, respectively). AMAC was negatively associated with triglycerides among those in the 70-79 and 80+ age groups (ß=-23.62 and ß=-34.18, respectively) and positively associated with HDL-C levels in all groups (ß range 8.96-18.25). MAC was positively associated with HDL-C in the age groups spanning 20-69 years (ß range 3.05-5.34) and those over 80 (ß=5.26). AMAC and MAC were negatively associated with fasting glucose levels in the 20-29 and 70-79 age groups (ß=-3.38 and -15.61, respectively). MAC was negatively associated with fasting glucose levels among those 70-79 and those over 80 years of age (ß=-7.06 and ß=-5.00, respectively). CONCLUSION: MAC and AMAC may favorably impact metabolic health.