Meeting physical activity guidelines in conjunction with higher protein intake: associations with appendicular lean soft tissue index in middle aged adults with cancer.

Meeting vigorous physical activity guidelines combined with higher protein intake was not significantly associated with ALSTI in fully adjusted models.

• Vigorous physical activity group result: β = 0.08, SE 0.12, p = 0.53
• Physical activity threshold defined as vigorous ≥ 75 min/week
• Protein intake categorized as > 0.8 vs. ≤ 0.8 g/kg/day
• Models adjusted for demographic, clinical, and dietary covariates

Meeting moderate physical activity guidelines combined with higher protein intake was not significantly associated with ALSTI in fully adjusted models.

• Moderate physical activity group result: β = -0.05, SE 0.15, p = 0.76
• Physical activity threshold defined as moderate ≥ 150 min/week
• Protein intake assessed via two interviewer-administered 24-h dietary recalls
• ALSTI calculated using dual-energy X-ray absorptiometry (kg/m²)

Meeting both vigorous and moderate physical activity guidelines in combination with higher protein intake was significantly and positively associated with ALSTI.

• β = 0.40, SE 0.02, p < 0.01
• This was the only combination showing a statistically significant association with ALSTI
• The finding suggests a potential additive benefit of meeting combined physical activity guidelines with higher protein intake

The study sample consisted of 169 middle-aged adults with cancer drawn from the National Health and Nutrition Examination Survey.

• Mean age was 51.0 ± 5.6 years
• 69% of participants were women
• Mean ALSTI was 7.74 ± 1.66 kg/m²
• Age range was 40–59 years
• Protein intake was assessed using two interviewer-administered 24-h dietary recalls