The Role of Physical Activity Status in the Relationship between Obesity and Carotid Intima-Media Thickness (CIMT) in Urban South African Teachers: The SABPA Study

Globally, the prevalence of physical inactivity and obesity are on the rise, which may increase carotid intima-media thickness (CIMT) as a marker of subclinical atherosclerosis. This study assessed the association between physical activity (PA), obesity, and CIMT. A cross-sectional study design was used, including a sub-sample (n = 216) of teachers who participated in the Sympathetic Activity and Ambulatory Blood Pressure in Africans (SAPBA) study. Measurements included the following: physical activity status (measured with ActiHeart devices over 7 consecutive days), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), CIMT (measured by SonoSite Micromax ultrasound), blood pressure (BP), fasting C-reactive protein (CRP), and cholesterol and glucose levels. Data were analysed using the Statistical Package for Social Science. One-third of the teachers were physically inactive (33%) and had low-grade inflammation CRP ≥ 3 mg/L (41%). Males were more sedentary and had higher BP and CIMT (p < 0.05). Independent of age and sex, WC or central obesity was 2.63 times more likely (p = 0.02) to contribute to atherosclerosis, especially in females (OR: 4.23, p = 0.04). PA levels were insignificantly and negatively (β −0.034; 0.888; 0.240) related to subclinical atherosclerosis. The cardiovascular disease risk profiles and limited PA status may have curbed the beneficial impact of PA on the obesity and atherosclerosis.