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Llamas-Saez C, Saez-Vaquero T, Jiménez-García R, López-de-Andrés A, Carabantes-Alarcón D, Zamorano-León JJ, Cuadrado-Corrales N, Pérez-Farinos N, Wärnberg J. Cross Sectional and Case-Control Study to Assess Time Trend, Gender Differences and Factors Associated with Physical Activity among Adults with Diabetes: Analysis of the European Health Interview Surveys for Spain (2014 & 2020). J Clin Med 2023; 12:jcm12062443. [PMID: 36983443 PMCID: PMC10057052 DOI: 10.3390/jcm12062443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
(1) Background: We aim to assess the time trend from 2014 to 2020 in the prevalence of physical activity (PA), identify gender differences and sociodemographic and health-related factors associated with PA among people with diabetes, and compare PA between people with and without diabetes. (2) Methods: We conducted a cross-sectional and a case-control study using as data source the European Health Interview Surveys for Spain (EHISS) conducted in years 2014 and 2020. The presence of diabetes and PA were self-reported. Covariates included socio-demographic characteristics, health-related variables, and lifestyles. To compare people with and without diabetes, we matched individuals by age and sex. (3) Results: The number of participants aged ≥18 years with self-reported diabetes were 1852 and 1889 in the EHISS2014 and EHISS2020, respectively. The proportion of people with diabetes that had a medium or high frequency of PA improved from 48.3% in 2014 to 52.6% in 2020 (p = 0.009), with 68.5% in 2014 and 77.7% in 2020 being engaged in two or more days of PA (p < 0.001). Males with diabetes reported more PA than females with diabetes in both surveys. After matching by age and gender, participants with diabetes showed significantly lower engagement in PA than those without diabetes. Among adults with diabetes, multivariable logistic regression showed confirmation that PA improved significantly from 2014 to 2020 and that male sex, higher educational level, and better self-rated health were variables associated to more PA. However, self-reported comorbidities, smoking, or BMI > 30 were associated to less PA. (4) Conclusions: The time trend of PA among Spanish adults with diabetes is favorable but insufficient. The prevalence of PA in this diabetes population is low and does not reach the levels of the general population. Gender differences were found with significantly more PA among males with diabetes. Our result could help to improve the design and implementation of public health strategies to improve PA among people with diabetes.
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Affiliation(s)
- Carlos Llamas-Saez
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | | | - Rodrigo Jiménez-García
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Ana López-de-Andrés
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - David Carabantes-Alarcón
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - José J Zamorano-León
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Natividad Cuadrado-Corrales
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, IdISSC, 28040 Madrid, Spain
| | - Napoleón Pérez-Farinos
- Epi-PHAAN Research Group, School of Medicine, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain
| | - Julia Wärnberg
- Epi-PHAAN Research Group, School of Health Sciences, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), 29071 Málaga, Spain
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Mondal R, Banik PC, Zaman MM. Low physical activity among middle-aged type-2 diabetic outpatients of two peripheral hospitals in Bangladesh. PLoS One 2023; 18:e0284392. [PMID: 37053202 PMCID: PMC10101379 DOI: 10.1371/journal.pone.0284392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
Physical activity (PA) is an important lifestyle recommendation for managing type-2 diabetes mellitus (T2DM). However, low PA among them is a global public health concern, including Bangladesh. We aimed to investigate the prevalence of low PA levels and its associated sociodemographic factors particularly among middle-aged T2DM subjects, which is quite limited globally and unknown in Bangladesh. In this cross-sectional study, we conveniently recruited 356 T2DM subjects (aged 40-60 years) from outpatient departments of the corresponding diabetic hospitals from Pirojpur and Dinajpur, the southern and northern districts, respectively. The primary outcome was low PA (via metabolic equivalents <600), using the Global Physical Activity Questionnaire. Univariable and multivariable binary logistic regression analyses were used to identify the factors associated with low PA. Among the participants (mean age 51.0±6.9 years), men and women were with almost equal proportions (48.9% and 51.1%, respectively). The prevalence (95% Confidence Intervals [CI]) of low PA was 34.8% (29.9-39.7). The median sitting or reclining time was 6 hours on a typical day. The odds (OR [95% CI]; P) of low PA was found to be significantly higher in respondents with primary or no education compared to the above-primary level, in unadjusted (1.6 [1.1-2.6]; 0.029) and adjusted (2.0 [1.1-3.7]; 0.028) associations both. In conclusion, over one-third of the middle-aged study subjects had a low PA level, which was associated with education. There is a high demand for designing and implementing PA enhancing interventions among them.
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Affiliation(s)
- Rajib Mondal
- Department of Public Health, Hamdard University Bangladesh, Gazaria, Munshiganj, Bangladesh
| | - Palash Chandra Banik
- Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh
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López Sánchez GF, López-Bueno R, Villaseñor-Mora C, Pardhan S. Comparison of Diabetes Mellitus Risk Factors in Mexico in 2003 and 2014. Front Nutr 2022; 9:894904. [PMID: 35845804 PMCID: PMC9280272 DOI: 10.3389/fnut.2022.894904] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/13/2022] [Indexed: 11/24/2022] Open
Abstract
Objective The prevalence of diabetes mellitus in Mexico is very high. This study aimed to compare the risk factors of diabetes mellitus in Mexican adults in 2003 and in 2014. Methods This study had a repeated cross-sectional design. Data from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) from Mexico (Wave 0, 2003, and Wave 2, 2014) were compared. Self-reported diabetes mellitus (outcome) was evaluated with the yes/no question: "Have you ever been diagnosed with diabetes mellitus (high blood sugar)?" Bivariate analyses and multivariable logistic regression analyses adjusted for potential risk factors were conducted. Results In 11 years (2003-2014), the prevalence of self-reported diabetes mellitus in Mexican adults increased by 2.6 times in those younger than 50 years (2003: 2.1%; 2014: 5.5%) and by 1.9 times in those ≥50 years (2003: 12.7%; 2014: 24.2%). In 2003, the risk factors associated with diabetes mellitus were female sex (OR 1.344, 95% CI 1.176-1.536), age ≥50 years (OR 6.734, 95% CI 5.843-7.760), being overweight (OR 1.359, 95% CI 1.175-1.571), obesity (OR 1.871, 95% CI 1.583-2.211), and lower physical activity of <600 MET-minutes/week (OR 1.349, 95% CI 1.117-1.630). In 2014, the exposure characteristics significantly associated with diabetes mellitus were female sex (OR 1.244, 95% CI 1.025-1.511), older age ≥50 years (OR 4.608, 95% CI 3.260-6.515), being overweight (OR 1.649, 95% CI 1.305-2.083), obesity (OR 1.778, 95% CI 1.398-2.261), and in those who had not attended/completed primary school (OR 1.360, 95% CI 1.042-1.773). Conclusion The prevalence of diabetes mellitus in Mexico significantly increased from 2003 to 2014. Female sex, age older than 50 years, and being overweight or obese were significant risk factors in both 2003 and 2014. Not having completed primary school was a new significant risk factor in 2014. Public health policies and strategies should prioritize decreasing the high levels of overweight and obesity, and improve health literacy in Mexico.
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Affiliation(s)
- Guillermo F. López Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Rubén López-Bueno
- Department of Physical Medicine and Nursing, University of Zaragoza, Zaragoza, Spain
| | | | - Shahina Pardhan
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, United Kingdom
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López Sánchez GF, Smith L, Jacob L, Shin JI, Koyanagi A, Pardhan S. Gender Differences in the Association Between Cataract and Mental Health in Adults With Diabetes: A Cross-Sectional Analysis From the Spanish National Health Survey 2017. Front Public Health 2021; 9:769155. [PMID: 34950629 PMCID: PMC8688691 DOI: 10.3389/fpubh.2021.769155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to explore gender differences in the associations between cataracts and self-reported depression and chronic anxiety in Spanish adults with diabetes. Methods: Cross-sectional data from the Spanish Health Survey 2017 were analyzed. Inclusion criterion was a positive response to the question “Have you ever been diagnosed with diabetes?” Diabetes, cataracts, depression and chronic anxiety were based on self-reported lifetime diagnosis. Multivariable logistic regression was conducted to assess the association between cataracts and depression or anxiety among respondents with diabetes, stratifying by gender. Results: Out of a total 23,089 respondents, 2,266 people self-reported suffering from diabetes (50.2% women; average age 69.7 ± 12.7 years; age range 15-98 years). In people with diabetes, the presence of cataracts was associated with significantly higher odds for depression (OR = 1.655; 95% CI = 1.295-2.115). Gender-stratified analyses showed that only women with cataracts were significantly associated with higher odds for depression (OR = 1.762; 95% CI = 1.307-2.374) and chronic anxiety (OR = 1.519; 95% CI = 1.067-2.163). Conclusion: Cataracts are a significant risk factor for depression and chronic anxiety in Spanish women with diabetes, but not in men. Women with both diabetes and cataracts require assessment for depression and chronic anxiety, and possibly earlier interventions in order to reduce the potential risk of further mental health complications.
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Affiliation(s)
- Guillermo F López Sánchez
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Boi de Llobregat, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Sant Boi de Llobregat, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Shahina Pardhan
- Faculty of Health, Education, Medicine and Social Care, School of Medicine, Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, United Kingdom
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Pardhan S, Smith L, Davis A, Bourne R, Barnett Y, Jacob L, Koyanagi A, Radzimiński Ł, Skalska M, Jastrzębska J, Jastrzębski Z, López-Sánchez GF. Gender differences in the association between physical activity and obesity in adults with vision and hearing losses. Eur J Public Health 2021; 31:835-840. [PMID: 33970269 DOI: 10.1093/eurpub/ckab077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Physical inactivity is strongly associated with obesity, which in turn is a major risk factor for many non-communicable diseases. We examined associations between physical inactivity and obesity in Spanish adults with vision and hearing difficulties and explored differences between men and women. METHODS Data from the Spanish National Health Survey 2017 were analyzed [n = 23 089 adults (15-103 years, mean age 53.4 ± 18.9 years, 45.9% men)]. Participants self-reported difficulties in seeing and hearing. Physical inactivity (exposure) was evaluated with the International Physical Activity Questionnaire Short Form. Obesity (outcome) was defined as body mass index ≥30 kg m-2 based on self-reported weight and height. The association between physical inactivity and obesity was assessed with multivariable logistic regression in people with difficulties seeing and hearing, adjusting for significant covariates. RESULTS Multivariable logistic regression analyses showed that the association between physical inactivity and obesity was stronger in those with difficulty hearing (OR 1.778, 95% CI 1.215-2.602) compared with difficulty seeing (OR 1.375, 95% CI 1.076-1.756). Gender-stratified analyses showed significant association between physical inactivity and obesity in men who reported difficulty hearing (OR 2.319, 95% CI 1.441-3.735) and difficulty seeing (OR 1.556, 95% CI 1.079-2.244), but not in women. CONCLUSIONS A significant association between physical inactivity and obesity was observed in Spanish men with vision and hearing difficulties. Physical activity has an important role in the prevention of obesity in men with seeing and hearing difficulties. Active steps should be taken to encourage physical activity to reduce the risk of obesity in people with sensory impairments.
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Affiliation(s)
- Shahina Pardhan
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Adrian Davis
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK.,ENT and Audiology, Imperial College London, London, UK
| | - Rupert Bourne
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- School of Life Sciences, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain.,ICREA, Lluis Companys, Barcelona 08010, Spain
| | - Łukasz Radzimiński
- Department of Health and Life Sciences, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Maria Skalska
- Department of Pediatrics, Diabetology and Endocrinology, Gdansk Medical University, Gdansk, Poland
| | - Joanna Jastrzębska
- Department of Pediatrics, Diabetology and Endocrinology, Gdansk Medical University, Gdansk, Poland
| | - Zbigniew Jastrzębski
- Department of Health and Life Sciences, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, UK
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Jacob L, Smith L, Koyanagi A, Pardhan S, Allen P, Yang L, Grabovac I, Shin JI, Tully MA, López‐Sánchez GF. Associations between obesity and ocular health in Spanish adults. LIFESTYLE MEDICINE 2020. [DOI: 10.1002/lim2.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Louis Jacob
- Faculty of Medicine University of Versailles Saint‐Quentin‐en‐Yvelines Montigny‐le‐Bretonneux France
- Research and Development Unit Parc Sanitari Sant Joan de Déu Barcelona Spain
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences Anglia Ruskin University Cambridge UK
| | - Ai Koyanagi
- Research and Development Unit Parc Sanitari Sant Joan de Déu Barcelona Spain
- ICREA Barcelona Spain
| | - Shahina Pardhan
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care Anglia Ruskin University–Cambridge Campus Cambridge UK
| | - Peter Allen
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care Anglia Ruskin University–Cambridge Campus Cambridge UK
| | - Lin Yang
- Cancer Epidemiology and Prevention Research Alberta Health Services Calgary Alberta Canada
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Center of Public Health Medical University of Vienna Vienna Austria
| | - Jae Il Shin
- Department of Pediatrics Yonsei University College of Medicine Seoul Republic of Korea
| | - Mark A. Tully
- School of Health Sciences, Institute of Mental Health Sciences Ulster University Newtownabbey UK
| | - Guillermo F. López‐Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care Anglia Ruskin University–Cambridge Campus Cambridge UK
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