The association between metabolic equivalent and visceral adiposity index among children and adolescents: Ten-cycle cross-sectional study on NHANES (1999–2018)

Metabolic disorder is globally prevalent in children and adolescents, and physical activity may have a protective role against metabolic disorder. However, the association between metabolic equivalent (MET) and visceral adiposity index (VAI) among children and adolescents remains unclear. This study aimed to address this concern. Data were retrieved from the National Health and Nutrition Examination Survey (NHANES), which used the Global Physical Activity Questionnaire to assess the physical activity levels. VAI was calculated according to body mass index (BMI), waist circumference (WC), triglyceride (TG), and high-density lipoprotein (HDL). Linear regression was adopted to assess the association between MET and VAI. Restricted cubic spline regression was used to further explore the nonlinear relationship, Interaction effect analysis was conducted to identify whether the sample characteristic could modify the effect of MET on VAI. After data cleansing, a total of 3402 participants aged <18 years were enrolled. In the fully adjusted linear regression model, the β for VAI was 0.01 (95% confidence interval [CI]: −0.08, 0.09) for the second tertile and −0.11 (95% CI: −0.20, −0.03) for the third tertile. A linear downward trend was found in the restricted cubic spline regression (overall P < .05). Interaction effect analysis revealed no significant effects of age, gender, race, income poverty ratio, and insurance (all P for interaction >0.05). High physical activity intensity is associated with decreased VAI scores in children and adolescents.