1
|
An X, Zhang Y, Sun W, Kang X, Ji H, Sun Y, Jiang L, Zhao X, Gao Q, Lian F, Tong X. Early effective intervention can significantly reduce all-cause mortality in prediabetic patients: a systematic review and meta-analysis based on high-quality clinical studies. Front Endocrinol (Lausanne) 2024; 15:1294819. [PMID: 38495794 PMCID: PMC10941028 DOI: 10.3389/fendo.2024.1294819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/19/2024] [Indexed: 03/19/2024] Open
Abstract
Background Reducing the occurrence of diabetes is considered a primary criterion for evaluating the effectiveness of interventions for prediabetes. There is existing evidence that early lifestyle-based interventions can significantly decrease the incidence of diabetes. However, whether effective interventions can reduce long-term outcomes in patients, including all-cause mortality, cardiovascular risks, and the occurrence of microvascular complications, which are the most concerning issues for both patients and clinicians, remains a subject of inconsistent research findings. And there is no direct evidence to answer whether effective intervention has long-term benefits for prediabetic patients. Therefore, we conducted a systematic review and meta-analysis to assess the relationship between early effective intervention and macrovascular and microvascular complications in prediabetic patients. Methods PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for the randomized controlled trials of lifestyle or/and drugs intervention in prediabetes from inception to 2023.9.15. Two investigators independently reviewed the included studies and extracted relevant data. Random or fixed effects model meta-analysis to derive overall relative risk (RR) with 95% CI for all-cause mortality, cardiovascular events, and microvascular complications. Results As of September 15, 2023, a total of 7 effective intervention studies were included, comprising 26 articles out of 25,671 articles. These studies involved 26,389 patients with a total follow-up duration of 178,038.6 person-years. The results indicate that effective intervention can significantly reduce all-cause mortality in prediabetic patients without a history of cardiovascular disease by 17% (RR 0.83, 95% CI 0.70-0.98). Additionally, effective intervention reduced the incidence of retinopathy by 38% (RR 0.62, 95% CI 0.70-0.98). Furthermore, the study results suggest that women and younger individuals have lower all-cause mortality and cardiovascular mortality. Subsequently, we conducted an in-depth analysis of patients without a history of cardiovascular disease. The results revealed that prediabetic patients with a 10-year cardiovascular risk >10% experienced more significant benefits in terms of all-cause mortality (P=0.01). When comparing the results of all-cause mortality and cardiovascular mortality from the Da Qing Diabetes Prevention Outcome Study longitudinally, it was evident that the duration of follow-up is a key factor influencing long-term benefits. In other words, the beneficial effects become more pronounced as the intervention duration reaches a certain threshold. Conclusion Early effective intervention, which significantly reduces the incidence of diabetes, can effectively lower all-cause mortality in prediabetic patients without a history of cardiovascular disease (especially those with a 10-year cardiovascular risk >10%), with women and younger individuals benefiting more significantly. Additionally, the duration of follow-up is a key factor influencing outcomes. The conclusions of this study can provide evidence-based guidance for the clinical treatment of prediabetic patients to prevent cardiovascular and microvascular complications. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier CRD42020160985.
Collapse
Affiliation(s)
- Xuedong An
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuehong Zhang
- Fangshan Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Wenjie Sun
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaomin Kang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hangyu Ji
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuting Sun
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Linlin Jiang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xuefei Zhao
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qing Gao
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fengmei Lian
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaolin Tong
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
2
|
Boonpor J, Parra‐Soto S, Gore J, Talebi A, Lynskey N, Raisi A, Welsh P, Sattar N, Pell JP, Gill JMR, Gray SR, Ho FK, Celis‐Morales CA. Association between walking pace and incident type 2 diabetes by adiposity level: A prospective cohort study from the UK Biobank. Diabetes Obes Metab 2023; 25:1900-1910. [PMID: 36951683 PMCID: PMC10947435 DOI: 10.1111/dom.15053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/24/2023]
Abstract
AIMS To investigate the combined association of adiposity and walking pace with incident type 2 diabetes. METHODS We undertook a prospective cohort study in 194 304 White-European participants (mean age 56.5 years, 55.9% women). Participants' walking pace was self-reported as brisk, average or slow. Adiposity measures included body mass index (BMI), waist circumference (WC) and body fat percentage (BF%). Associations were investigated using Cox proportional hazard models, with a 2-year landmark analysis. A four-way decomposition analysis was used for mediation and additive interaction. RESULTS The median (interquartile range) follow-up was 5.4 (4.8-6.3) years. During the follow-up period, 4564 participants developed type 2 diabetes. Compared to brisk-walking participants with normal BMI, those with obesity who walked briskly were at an approximately 10- to 12-fold higher risk of type 2 diabetes (hazard ratio [HR] 9.64, 95% confidence interval [CI] 7.24-12.84, in women; HR 11.91, 95% CI 8.80-16.12, in men), whereas those with obesity and walked slowly had an approximately 12- to 15-fold higher risk (HR 12.68, 95% CI 9.62-16.71, in women; HR 15.41, 95% CI 11.27-21.06, in men). There was evidence of an additive interaction between WC and BF% and walking pace among women, explaining 17.8% and 47.9% excess risk respectively. Obesity mediated the association in women and men, accounting for 60.1% and 44.9%, respectively. CONCLUSIONS Slow walking pace is a risk factor for type 2 diabetes independent of adiposity. Promoting brisk walking as well as weight management might be an effective type 2 diabetes prevention strategy given their synergistic effects.
Collapse
Affiliation(s)
- Jirapitcha Boonpor
- School of Cardiovascular and Metabolic HealthUniversity of GlasgowGlasgowUK
- Faculty of Public HealthKasetsart University, Chalermphrakiat Sakon Nakhon Province CampusSakon NakhonThailand
| | - Solange Parra‐Soto
- School of Cardiovascular and Metabolic HealthUniversity of GlasgowGlasgowUK
- Department of Nutrition and Public HealthUniversidad del Bío‐BíoChillanChile
| | - Jasunella Gore
- School of Cardiovascular and Metabolic HealthUniversity of GlasgowGlasgowUK
| | - Atefeh Talebi
- School of Cardiovascular and Metabolic HealthUniversity of GlasgowGlasgowUK
| | - Nathan Lynskey
- School of Cardiovascular and Metabolic HealthUniversity of GlasgowGlasgowUK
| | - Andrea Raisi
- School of Cardiovascular and Metabolic HealthUniversity of GlasgowGlasgowUK
- Center for Exercise Science and Sport, Department of Neuroscience and RehabilitationUniversity of FerraraFerraraItaly
| | - Paul Welsh
- School of Cardiovascular and Metabolic HealthUniversity of GlasgowGlasgowUK
| | - Naveed Sattar
- School of Cardiovascular and Metabolic HealthUniversity of GlasgowGlasgowUK
| | - Jill P. Pell
- School of Health and WellbeingUniversity of GlasgowGlasgowUK
| | - Jason M. R. Gill
- School of Cardiovascular and Metabolic HealthUniversity of GlasgowGlasgowUK
| | - Stuart R. Gray
- School of Cardiovascular and Metabolic HealthUniversity of GlasgowGlasgowUK
| | - Frederick K. Ho
- School of Health and WellbeingUniversity of GlasgowGlasgowUK
| | - Carlos A. Celis‐Morales
- School of Cardiovascular and Metabolic HealthUniversity of GlasgowGlasgowUK
- Research Group on Education, Physical Activity and Health (GEEAFyS)University Católica del MauleTalcaChile
| |
Collapse
|
3
|
Mähs M, Pithan JS, Bergmann I, Gabrys L, Graf J, Hölzemann A, Van Laerhoven K, Otto-Hagemann S, Popescu ML, Schwermann L, Wenz B, Pahmeier I, Teti A. Activity tracker-based intervention to increase physical activity in patients with type 2 diabetes and healthy individuals: study protocol for a randomized controlled trial. Trials 2022; 23:617. [PMID: 35907864 PMCID: PMC9338482 DOI: 10.1186/s13063-022-06550-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND One relevant strategy to prevent the onset and progression of type 2 diabetes mellitus (T2DM) focuses on increasing physical activity. The use of activity trackers by patients could enable objective measurement of their regular physical activity in daily life and promote physical activity through the use of a tracker-based intervention. This trial aims to answer three research questions: (1) Is the use of activity trackers suitable for longitudinal assessment of physical activity in everyday life? (2) Does the use of a tracker-based intervention lead to sustainable improvements in the physical activity of healthy individuals and in people with T2DM? (3) Does the accompanying digital motivational intervention lead to sustainable improvements in physical activity for participants using the tracker-based device? METHODS The planned study is a randomized controlled trial focused on 1642 participants with and without T2DM for 9 months with regard to their physical activity behavior. Subjects allocated to an intervention group will wear an activity tracker. Half of the subjects in the intervention group will also receive an additional digital motivational intervention. Subjects allocated to the control group will not receive any intervention. The primary outcome is the amount of moderate and vigorous physical activity in minutes and the number of steps per week measured continuously with the activity tracker and assessed by questionnaires at four time points. Secondary endpoints are medical parameters measured at the same four time points. The collected data will be analyzed using inferential statistics and explorative data-mining techniques. DISCUSSION The trial uses an interdisciplinary approach with a team including sports psychologists, sports scientists, health scientists, health care professionals, physicians, and computer scientists. It also involves the processing and analysis of large amounts of data collected with activity trackers. These factors represent particular strengths as well as challenges in the study. TRIAL REGISTRATION The trial is registered at the World Health Organization International Clinical Trials Registry Platform via the German Clinical Studies Trial Register (DRKS), DRKS00027064 . Registered on 11 November 2021.
Collapse
Affiliation(s)
- M Mähs
- Institute of Gerontology, Vechta University, Vechta, Germany.
| | - J S Pithan
- Sport Science, Vechta University, Vechta, Germany
| | - I Bergmann
- Institute of Gerontology, Vechta University, Vechta, Germany
| | - L Gabrys
- University of Applied Sciences for Sport and Management Potsdam, Potsdam, Germany
| | - J Graf
- Institute of Gerontology, Vechta University, Vechta, Germany
| | - A Hölzemann
- Research group Ubiquitous Computing, University of Siegen, Siegen, Germany
| | - K Van Laerhoven
- Research group Ubiquitous Computing, University of Siegen, Siegen, Germany
| | - S Otto-Hagemann
- Diabetologische Schwerpunktpraxis Dr. Silke Otto-Hagemann (diabetes center) Vechta, Vechta, Germany
| | - M L Popescu
- Diabetologische Schwerpunktpraxis Dr. Silke Otto-Hagemann (diabetes center) Vechta, Vechta, Germany
| | - L Schwermann
- Diabetologische Schwerpunktpraxis Dr. Silke Otto-Hagemann (diabetes center) Vechta, Vechta, Germany
| | - B Wenz
- Institute of Gerontology, Vechta University, Vechta, Germany
| | - I Pahmeier
- Sport Science, Vechta University, Vechta, Germany
| | - A Teti
- Institute of Gerontology, Vechta University, Vechta, Germany
| |
Collapse
|
4
|
Replacing Sedentary Time with Physically Active Behaviour Predicts Improved Body Composition and Metabolic Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148760. [PMID: 35886612 PMCID: PMC9325190 DOI: 10.3390/ijerph19148760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/13/2022] [Accepted: 07/15/2022] [Indexed: 02/05/2023]
Abstract
Background: Discretionary leisure time for health-promoting physical activity (PA) is limited. This study aimed to predict body composition and metabolic health marker changes from PA reallocation using isotemporal substitution analysis. Methods: Healthy New Zealand women (n = 175; 16–45 y) with high BMI (≥25 kg/m2) and high body fat percentage (≥30%) were divided into three groups by ethnicity (Māori n = 37, Pacific n = 54, and New Zealand European n = 84). PA, fat mass, lean mass, and metabolic health were assessed. Isotemporal substitution paradigms reallocated 30 min/day of sedentary behaviour to varying PA intensities. Results: Reallocating sedentary behaviour with moderate intensity, PA predicted Māori women would have improved body fat% (14.83%), android fat% (10.74%), and insulin levels (55.27%) while the model predicted Pacific women would have improved waist-to-hip (6.40%) and android-to-gynoid (19.48%) ratios. Replacing sedentary time with moderate-vigorous PA predicted Māori women to have improved BMI (15.33%), waist circumference (9.98%), body fat% (16.16%), android fat% (12.54%), gynoid fat% (10.04%), insulin (55.58%), and leptin (43.86%) levels; for Pacific women, improvement of waist-to-hip-ratio (5.30%) was predicted. Conclusions: Sedentary behaviour must be substituted with PA of at least moderate intensity to reap benefits. Māori women received the greatest benefits when reallocating PA. PA recommendations to improve health should reflect the needs and current activity levels of specific populations.
Collapse
|
5
|
Asgari S, Masrouri S, Hosseinpour‐Niazi S, Moslehi N, Azizi F, Hadaegh F. The Association of Ideal Cardiovascular Health Metrics and Incident Type 2 Diabetes Mellitus Among an urban population of Iran: a decade follow-up in Tehran Lipid and Glucose Study. J Diabetes Investig 2022; 13:1711-1722. [PMID: 35588067 PMCID: PMC9533049 DOI: 10.1111/jdi.13839] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/15/2022] [Accepted: 05/18/2022] [Indexed: 12/01/2022] Open
Abstract
AIMS To evaluate the association between ideal cardiovascular health metrics (ICVHM) and incident type diabetes (T2DM) among Iranian men and women. METHODS The study population included 7,488 Iranian adults aged ≥20 years (4236 women) free from diabetes at baseline. The ICVHM was defined according to the 2020-American Heart Association. The multivariable Cox proportional hazards regression analysis was used to calculate the hazard ratios (HRs) for ICVHM both as continuous and categorical variables. RESULTS Over the median of 9.1 years of follow-up, we identified 922 new cases of T2DM (526 women). Body mass index <30 kg/m2 , untreated systolic/diastolic blood pressure <120/80 mmHg in both genders, and physical activity ≥1500 MET mins/wk (only among men) were significantly associated with a lower risk of T2DM. Each additional unit in the ICVHM was associated with a 21% and 15% lower risk of T2DM in men and women, respectively (p-values<0.05). Compared with participants having poor cardiovascular health (CVH), the HR (95% confidence interval) for T2DM risk was 0.69 (0.56-0.85) and 0.35 (0.21-0.59) for men with intermediate and ideal CVHM, respectively. The corresponding values for women were 0.79 (0.65-0.97) and 0.30 (0.15-0.60), respectively. in a subpopulation with nutritional data (n=2236), ideal and intermediate nutritional status was associated with 83% and 77% lower risk of T2DM only among women (p-values<0.05). CONCLUSION We found a strong inverse association between having higher global ICVHM with incident T2DM; the issue is mainly attributable to normal blood pressure, normal body weight, and intensive physical activity (only for men).
Collapse
Affiliation(s)
- Samaneh Asgari
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Soroush Masrouri
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Somaye Hosseinpour‐Niazi
- Nutrition and Endocrine Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Nazanin Moslehi
- Nutrition and Endocrine Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Fereidoun Azizi
- Endocrine Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| |
Collapse
|
6
|
Kalo MB, Rezaei M. In vitro toxic interaction of arsenic and hyperglycemia in mitochondria: an important implication of increased vulnerability in pre-diabetics. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:28375-28385. [PMID: 34993818 DOI: 10.1007/s11356-022-18513-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/01/2022] [Indexed: 06/14/2023]
Abstract
Environmental pollutants and lifestyle both contribute to the rapidly increasing prevalence of type 2 diabetes mellitus (T2DM) worldwide. Evidence suggests that exposure to environmental contaminants such as arsenic is associated with impaired glucose metabolism and insulin signaling. In the present study, isolated rat liver mitochondria (1 mg/ml) were co-exposed to low concentration of arsenic trioxide (ATO) ( IC25 = 40 µM) and hyperglycemic condition (20, 40, 80, 160 mM glucose or 20, 40, 80, 160 mM pyruvate (PYR)). Mitochondrial dehydrogenase activity (complex II), glutathione content (GSH), reactive oxygen species (ROS), lipid peroxidation, mitochondrial membrane potential (ΔΨ), and mitochondrial swelling were then evaluated in the presence of ATO 40 µM and PYR 40 mM. Unexpectedly, glucose alone (20, 40, 80, 160 mM) had no toxic effect on mitochondria, even at very high concentrations and even when combined with ATO. Interestingly, PYR at low concentrations (≤ 10 mM) has a protective effect on mitochondria, but at higher concentrations (≥ 40 mM) with ATO, it decreased the complex II activity and increased mitochondrial ROS production, lipid peroxidation, GSH depletion, mitochondrial membrane damage, and swelling (p < 0.05). In conclusion, PYR but not glucose increased ATO mitochondrial toxicity even at low concentrations. These results suggest that pre-diabetics with non-clinical hyperglycemia, who are inevitably exposed to low concentrations of arsenic through food and water, may develop mitochondrial dysfunction that accelerates their progression to diabetes over time.
Collapse
Affiliation(s)
- Mersad Bagherpour Kalo
- Department of Toxicology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohsen Rezaei
- Department of Toxicology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| |
Collapse
|
7
|
Yu HJ, Ho M, Liu X, Yang J, Chau PH, Fong DYT. Association of weight status and the risks of diabetes in adults: a systematic review and meta-analysis of prospective cohort studies. Int J Obes (Lond) 2022; 46:1101-1113. [PMID: 35197569 DOI: 10.1038/s41366-022-01096-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 12/30/2022]
Abstract
Obesity is a known risk factor for type 2 diabetes mellitus (T2DM); however, the associations between underweight and T2DM and between weight status and prediabetes have not been systematically reviewed. We aimed to estimate the relative risks (RRs) of prediabetes/T2DM in underweight/overweight/obesity relative to normal weight. PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to December 8, 2021. Prospective cohort studies with a minimum 12-month follow-up period reporting the association between baseline body mass index (BMI) categories and risk of prediabetes/T2DM in adults were included. Study quality was assessed using the Newcastle-Ottawa Scale. The main analyses of T2DM risk were performed using the ethnic-specific (Asian/non-Asian) BMI classification and additional analyses of prediabetes/T2DM risk by including all eligible studies. Random-effects models with inverse variance weighting were used. Subgroup analyses and meta-regression were conducted to explore the potential effects of pre-specified modifiers. The study protocol was registered with PROSPERO (CRD42020215957). Eighty-four articles involving over 2.69 million participants from 20 countries were included. The pooled RR of prediabetes risk was 1.24 (95% CI: 1.19-1.28, I2 = 9.7%, n = 5 studies) for overweight/obesity vs. normal weight. The pooled RRs of T2DM based on the ethnic-specific BMI categories were 0.93 (95% CI: 0.75-1.15, I2 = 55.5%, n = 12) for underweight, 2.24 (95% CI: 1.95-2.56, I2 = 92.0%, n = 47) for overweight, 4.56 (95% CI: 3.69-5.64, I2 = 96%, n = 43) for obesity, and 22.97 (95% CI: 13.58-38.86, I2 = 92.1%, n = 6) for severe obesity vs. normal weight. Subgroup analyses indicated that underweight is a protective factor against T2DM in non-Asians (RR = 0.68, 95% CI: 0.40-0.99, I2 = 56.1%, n = 6). The magnitude of the RR of T2DM in overweight/obesity decreased with age and varied by region and the assessment methods for weight and T2DM. Overweight/obesity was associated with an increased prediabetes/T2DM risk. Further studies are required to confirm the association between underweight and prediabetes/T2DM, particularly in Asian populations.
Collapse
Affiliation(s)
- Hong-Jie Yu
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Mandy Ho
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China.
| | | | - Jundi Yang
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | - Pui Hing Chau
- School of Nursing, the University of Hong Kong, Hong Kong, SAR, China
| | | |
Collapse
|
8
|
Wang J, He L, Yang N, Li Z, Xu L, Li W, Ping F, Zhang H, Li Y. Occupational and domestic physical activity and diabetes risk in adults: Results from a long-term follow-up cohort. Front Endocrinol (Lausanne) 2022; 13:1054046. [PMID: 36568093 PMCID: PMC9780271 DOI: 10.3389/fendo.2022.1054046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Physical activity (PA) has been associated with decreased incidence of diabetes. However, few studies have evaluated the influence of occupational and domestic PA on the risk of diabetes with a long-term follow-up. We aimed to examine the association between occupational and domestic PA and the risk of diabetes in a long-term prospective cohort of Chinese adults. METHODS A total of 10,343 adults who were followed up in the China Health and Nutrition Survey from 1997 to 2015 were included in our analysis. Occupational and domestical PA were collected with detailed seven-day data and were converted into metabolic equivalents values. Total PA included occupational, domestic, transportation, and leisure time PA. Diabetes cases were identified by self-reported doctor/health professional diagnosis of diabetes, fasting blood glucose ≥7.0 mmol/L, and glycosylated hemoglobin (HbA1c) ≥6.5%. Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS During up to 18 years of follow-up (median 10 years), there were 575 diabetes cases documented. Occupational PA accounted for the majority of total PA (68%) in Chinese population, followed by domestic PA (25%). With adjustments for possible covariates, the highest quartiles of total PA (HR, 0.728 [95% CI, 0.570-0.929]) and occupational PA (HR, 0.765 [95% CI, 0.596-0.982]) were significantly associated with a lower risk of diabetes compared with lowest quartiles. The association between domestic PA and the risk of diabetes was insignificant (P >0.05). CONCLUSION Higher levels of occupational PA were associated with a decreased risk of diabetes risk in the Chinese population. Domestic PA was not associated with the incidence of diabetes.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Yuxiu Li
- *Correspondence: Huabing Zhang, ; Yuxiu Li,
| |
Collapse
|
9
|
Critical examination of relationships between early growth and childhood overweight in extremely preterm infants. J Perinatol 2021; 41:2774-2781. [PMID: 34404924 DOI: 10.1038/s41372-021-01182-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 07/19/2021] [Accepted: 07/29/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To identify the prevalence and risk factors for childhood overweight and obesity (OWO) at 3-year corrected age in children born <1500 g <29 weeks gestation. STUDY DESIGN A multicentre retrospective cohort study for preterm infants admitted to neonatal intensive care units between 2001 and 2014. RESULTS Data were available for 911 (89.4%) of the 1019 infants who met the inclusion criteria. Of them, 22 (2.4%) had OWO. There were no associations between OWO and being small for gestational age (RR = 1.3, 95% confidence interval (CI): 0.3-5.4) or weight <10th percentile at 36 weeks (RR = 1.1, 95% CI: 0.4-2.8). OWO was associated with low maternal education (RR = 7.4, 95% CI: 2.1-26), maternal diabetes (RR = 5.2, 95% CI: 1.9-15) and neonatal brain injury (RR = 4.9, 95% CI: 1.8-14). Adjusting for concurrent child weight at 3 years of age resulted in an overadjustment bias. CONCLUSION Small size at birth or at 36 weeks gestation in extremely preterm infants is not associated with increased risk of early childhood overgrowth or obesity. CLINICAL TRIAL REGISTRATION NCT03064022.
Collapse
|
10
|
Li W, Li S, Feldman MW. Socioeconomic Status, Institutional Power, and Body Mass Index among Chinese Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010620. [PMID: 34682366 PMCID: PMC8535575 DOI: 10.3390/ijerph182010620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 11/18/2022]
Abstract
Despite the vast literature on the socioeconomic status (SES) gradient of obesity among adult people, no study has investigated the relationship between institutional power and body mass index. Using national survey data from the “China Labor-force Dynamics Survey 2016” (CLDS 2016), multistage cluster-stratified probability proportional to size (PPS) sampling was employed to select cases from 29 provinces, cities, and autonomous regions in China. This study adopts an institutional approach to explore the influences of SES and institutional power on the state of being overweight or severely overweight (obese) among Chinese adults. It is shown that SES has a non-linear influence on being overweight or obese, higher education has a negative effect on being overweight or obese, income has an inverted U-shaped effect on being overweight or obese, and having a managerial or administrative job has a positive effect on being overweight but less so on obesity. These findings reveal that disparities in health outcome and risks are due to inequality in SES. The work unit is a stronger predictor of adults being overweight or obese than occupation. Working in the public sector has a positive effect on being overweight relative to working in the private sector, and only state institutions and government departments have a positive association with obesity. Our results indicate that institutional structure still has effects on individuals’ life chances in the era of China’s market transition.
Collapse
Affiliation(s)
- Weidong Li
- Department of Sociology, School of Philosophy and Government, Shaanxi Normal University, Xi’an 710119, China
- Correspondence:
| | - Shuzhuo Li
- Institute for Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China;
| | - Marcus W. Feldman
- Morrison Institute for Population and Resource Studies, Stanford University, Stanford, CA 94305, USA;
| |
Collapse
|
11
|
Incorporating Post-Cessation Weight-Control Coaching into Smoking Cessation Therapy to Reduce Type 2 Diabetes Risk. Nutrients 2021; 13:nu13103360. [PMID: 34684360 PMCID: PMC8539112 DOI: 10.3390/nu13103360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/19/2021] [Accepted: 09/22/2021] [Indexed: 11/26/2022] Open
Abstract
Post-cessation weight gain (PCWG) facilitates short-term type 2 diabetes (T2D) risk in prediabetic smokers in the absence of complementary measures. In this shared decision-making-based non-randomized controlled trial, prediabetic smokers joined the Fight Tobacco and Stay Fit (FIT2) program or received usual care. The 16-week FIT2 program combined smoking cessation therapy with individualized coaching in diet and physical activity strategies for PCWG restriction (NCT01926041 at ClinicalTrials.gov). During a mean follow-up period of 1316 days, 217 participants (36.8%) developed T2D, and 68 (11.5%) regressed to normoglycemia. In the intention-to-treat analysis (n = 589), the FIT2 program was associated with a reduced T2D risk (HR, 0.58; 95% CI, 0.40–0.84) and a higher probability of regression to normoglycemia (HR, 1.91; 95% CI, 1.04–3.53) compared with usual care. The post-program quitters were at lower T2D risk (HR, 0.63; 95% CI, 0.44–0.92) and were more likely to regress to normoglycemia (HR, 1.83; 95% CI, 1.01–3.30) compared with the controls in the time-varying analysis (n = 532). We demonstrated that the FIT2 program was negatively associated with long-term T2D risk and positively associated with the probability of regression to normoglycemia compared with usual care. To prevent T2D development, we recommend simultaneously promoting smoking abstinence and lifestyle coaching for PCWG restriction.
Collapse
|
12
|
Länsitie M, Kangas M, Jokelainen J, Venojärvi M, Vaaramo E, Härkönen P, Keinänen-Kiukaanniemi S, Korpelainen R. Association between accelerometer-measured physical activity, glucose metabolism, and waist circumference in older adults. Diabetes Res Clin Pract 2021; 178:108937. [PMID: 34217770 DOI: 10.1016/j.diabres.2021.108937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 12/11/2022]
Abstract
AIMS To examine the association of physical activity (PA) and sedentary time (ST) with glucose metabolism according to waist circumference (WC) in older people. METHODS A population-based sample of 702 individuals (aged 67-70 years) wore wrist-worn accelerometers for two weeks and underwent an oral glucose tolerance test. The associations between moderate-to-vigorous (MVPA) and light (LPA) PA, ST, and glucose metabolism across the tertiles of WC were analysed using general linear regression. RESULTS Among highest WC tertile, LPA negatively associated with fasting insulin (β = - 0.047, 95% CI - 0.082 to - 0.012), HOMA-IR (β = - 0.098, 95% CI - 0.184 to - 0.012), and HOMA-β (β = - 3.367, CI - 6.570 to - 0.783). ST associated with 120 min glucose (β = 0.140, CI 0.021 to 0.260). Among lowest WC tertile, MVPA negatively associated with 30 min insulin (β = - 0.086, 95% CI - 0.168 to - 0.004) and 120 min insulin (β = - 0.160, 95% CI - 0.257 to - 0.063) and positively associated with Matsuda index (β = 0.076, 95% CI 0.014 to 0.139). Light PA negatively associated with 120 min insulin (β = - 0.054, 95% CI - 0.104 to - 0.005). CONCLUSION With the limitation of the cross-sectional study, reducing ST and increasing LPA may be beneficial for glucose metabolism among abdominally obese older adults. Lean older adults could benefit more from increasing MVPA.
Collapse
Affiliation(s)
- Miia Länsitie
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - Maarit Kangas
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
| | - Jari Jokelainen
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Finland; Unit of General Practice, Oulu University Hospital, Oulu, Finland.
| | - Mika Venojärvi
- Institute of Biomedicine, Sports and Exercise Medicine, University of Eastern Finland, Kuopio, Finland.
| | - Eeva Vaaramo
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Finland.
| | - Pirjo Härkönen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.
| | - Sirkka Keinänen-Kiukaanniemi
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland; Healthcare and Social Services of Selänne, Pyhäjärvi, Finland.
| | - Raija Korpelainen
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland.
| |
Collapse
|
13
|
Guía ESC 2020 sobre cardiología del deporte y el ejercicio en pacientes con enfermedad cardiovascular. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
14
|
Pelliccia A, Sharma S, Gati S, Bäck M, Börjesson M, Caselli S, Collet JP, Corrado D, Drezner JA, Halle M, Hansen D, Heidbuchel H, Myers J, Niebauer J, Papadakis M, Piepoli MF, Prescott E, Roos-Hesselink JW, Graham Stuart A, Taylor RS, Thompson PD, Tiberi M, Vanhees L, Wilhelm M. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J 2021; 42:17-96. [PMID: 32860412 DOI: 10.1093/eurheartj/ehaa605] [Citation(s) in RCA: 687] [Impact Index Per Article: 229.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
|
15
|
Jang HJ, Oh H. Trends and Inequalities in Overall and Abdominal Obesity by Sociodemographic Factors in Korean Adults, 1998-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084162. [PMID: 33920007 PMCID: PMC8070993 DOI: 10.3390/ijerph18084162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/01/2021] [Accepted: 04/09/2021] [Indexed: 12/16/2022]
Abstract
Few studies have comprehensively examined the nationwide trends in overall and abdominal obesity prevalence and related sociodemographic inequalities in Korea. In the Korea National Health and Nutrition Examination Survey 1998–2018, we estimated the age-standardized prevalence of overall (body mass index ≥ 25 kg/m2) and abdominal obesity (waist circumference ≥ 90 cm men, ≥85 cm women) in each sociodemographic subgroup of Korean adults (aged 19–79 years). For each survey year, weighted logistic regression was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between obesity prevalence and sociodemographic factors. During the study period, the prevalence of overall and abdominal obesity increased in men (24.8% to 42.4%; 20.1% to 32.1%; respectively) but only a small change was observed in women (26.5% to 26.0%; 22.7% to 20.9%; respectively). Obesity prevalence increased in all sociodemographic groups of men but varied across groups in women. In women, income (4th vs. 1st quartiles in 2016–2018: OR (95% CI) = 0.66 (0.56–0.78) overall obesity; 0.60 (0.51–0.71) abdominal obesity) and education (college or higher vs. high school or less: 0.62 (0.54–0.72) overall obesity; 0.58 (0.50–0.68) abdominal obesity) were inversely associated with obesity prevalence, and the gaps became more pronounced since 2007. Our data suggest that the inequalities in obesity prevalence by sex and by socioeconomic status have become more apparent over time in Korea.
Collapse
Affiliation(s)
- Ha-Jin Jang
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Korea;
| | - Hannah Oh
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul 02841, Korea;
- Division of Health Policy and Management, College of Health Sciences, Korea University, Seoul 02841, Korea
- Correspondence: ; Tel.: +82-2-3290-5678
| |
Collapse
|
16
|
Jadhav RA, Maiya GA, Hombali A, Umakanth S, Shivashankar KN. Effect of physical activity promotion on adiponectin, leptin and other inflammatory markers in prediabetes: a systematic review and meta-analysis of randomized controlled trials. Acta Diabetol 2021; 58:419-429. [PMID: 33211181 PMCID: PMC8053655 DOI: 10.1007/s00592-020-01626-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 10/21/2020] [Indexed: 12/16/2022]
Abstract
AIMS Inflammatory stage in prediabetes is associated with increase in level of adipokines and pro-inflammatory cytokines. Physical activity promotion considered as a first-line therapeutic strategy to treat prediabetes. We have conducted the systematic review and meta-analysis to strengthen the evidence on the impact of physical activity promotion on inflammatory markers in prediabetes. METHODS Studies were identified using electronic search and manual search techniques by choosing keywords for prediabetes, physical activity and inflammatory marker. Randomized controlled trials on individuals diagnosed with prediabetes and provided intervention in the form of physical activity were included in this review. Adiponectin, leptin, C-reactive protein, interleukin-6 and tumour necrosis factor-α were the considered outcome measures. RESULTS Our search retrieved 1,688 citations, 31 full-text articles assessed for eligibility of inclusion. Nine studies satisfied the pre-specified criteria for inclusion. Meta-analysis found that physical activity with or without dietary or lifestyle modification reduces level of leptin (MD-2.11 ng/mL, 95% CI -3.81 - -0.42) and interleukin-6 (MD -0.15 pg/mL, 95% CI -0.25--0.04). It has no effect on level of adiponectin (MD 0.26 µg/mL, 95% CI -0.42- 0.93), C-reactive protein (MD -0.05 mg/L, 95% CI -0.33-0.23) and tumour necrosis factor-α (MD 0.67 pg/mL, 95% CI -2.56-3.89). CONCLUSIONS This review suggests that physical activity promotion with dietary and lifestyle modification may reduce the level of leptin and interleukin-6 but are uncertain if there is any effect on levels of adiponectin, C-reactive protein and tumour necrosis factor-α in the individuals with prediabetes.
Collapse
Affiliation(s)
- Radhika Aditya Jadhav
- Department of Physiotherapy, Centre for Diabetic Foot Care and Research, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - G Arun Maiya
- Department of Physiotherapy, Centre for Diabetic Foot Care and Research, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
| | - Aditi Hombali
- Independent Systematic Reviewer, Luton, Bedfordshire, UK
| | - Shashikiran Umakanth
- Department of Medicine, Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - K N Shivashankar
- Department of Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| |
Collapse
|
17
|
Association between obesity and education level among the elderly in Taipei, Taiwan between 2013 and 2015: a cross-sectional study. Sci Rep 2020; 10:20285. [PMID: 33219305 PMCID: PMC7680111 DOI: 10.1038/s41598-020-77306-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/20/2020] [Indexed: 11/29/2022] Open
Abstract
The inverse association between obesity and education level has been demonstrated in many developed countries; however, few studies have investigated obesity in geriatric populations. This cross-sectional analysis explored the association between geriatric obesity and education level, along with other demographic characteristics in Taipei, Taiwan between 2013 and 2015. Taipei citizens ≥ 65 years (aborigines ≥ 55 years) were recruited to participate in the elderly health examination programme. Logistic regression was applied to analyse the relationship between obesity (defined as body mass index ≥ 27 kg/m2 in Taiwan) and education level among men and women after controlling for age, race, income status, and smoking status. A total of 28,092 men and 31,835 women were included in the final analysis. Compared to those with education years ≥ 16, older men and women with education years ≤ 12 had higher odds of being obese. The odds ratios increase as years of education decrease, and the trend is more pronounced among women. Aborigines had much higher chances of being obese among men and women, while there were no differences by income status. The results clarified the factors related to obesity in the elderly, and will be useful for authorities working to improve health outcomes among this population.
Collapse
|
18
|
Zhang F, Huang L, Peng L. The Degree of Influence of Daily Physical Activity on Quality of Life in Type 2 Diabetics. Front Psychol 2020; 11:1292. [PMID: 32695043 PMCID: PMC7338712 DOI: 10.3389/fpsyg.2020.01292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 05/18/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives: This study mainly explored the degree of influence of daily physical activity (PA) on the quality of life (QoL) and then provided a basis for improving PA and QoL in patients with Type 2 diabetes mellitus (T2DM). Methods: Long International PA Questionnaire (IPAQ-L) and Diabetic Mellitus QoL Scale (DMQLS) were used to investigate the daily PA and QoL, respectively, of patients with T2DM. The obtained data were analyzed by SPSS19.0 data analysis software. The correlation between PA and QoL was analyzed by Pearson correlation analysis and the degree of influence of PA on the QoL of patients with T2DM was analyzed by optimal scale regression analysis. Results: The total daily PA of the participants was 1172.79 ± 1266.23 MET-min/week and the overall score of QoL was 149.17 ± 17.16 points. Positive correlation has been found between PA and QoL and all its dimensions (all P < 0.05). It was found in the optimal scale regression that among many influencing factors, PA was significant and ranks first in importance among factors of the patient’s total QoL (importance = 0.432, P < 0.05) and its disease, physiological, psychological, and social dimension. The degrees of influence of PA on sub-dimensions of QoL were in the following order: physiology (0.476), society (0.441), disease (0.388), psychology (0.377), and satisfaction (0.089). Conclusion: The level of daily PA of patients with T2DM in southwestern China was moderate. Among the influencing factors such as gender, age, course of disease, education background, monthly income, BMI, work status, and complications, daily PA is the most important factor for QoL and its physiological, social, psychological, and disease dimension. The degrees of influence of daily PA on sub-dimensions of QoL were (in descending order) as follows: physiology, social, disease, psychology, and satisfaction. Therefore, in view of the importance of daily PA for QoL, more attention should be paid to the daily PA of T2DM patients in the future, including the study on more targeted testing methods, promotion strategies of daily PA, and its more extensive positive effects.
Collapse
Affiliation(s)
- Feng Zhang
- College of Physical Education, Southwest University, Chongqing, China.,Key Lab of Physical Fitness Evaluation and Motor Function Monitoring, Southwest University, Chongqing, China
| | - Li Huang
- College of Physical Education, Southwest University, Chongqing, China.,Key Lab of Physical Fitness Evaluation and Motor Function Monitoring, Southwest University, Chongqing, China
| | - Li Peng
- College of Physical Education, Southwest University, Chongqing, China.,Key Lab of Physical Fitness Evaluation and Motor Function Monitoring, Southwest University, Chongqing, China
| |
Collapse
|
19
|
Mao P, Jiang S, Guo J, Long Q, Zhang H, Chen JL. Do obesity and low levels of physical activity increase the risk for developing type 2 diabetes mellitus among women with prior gestational diabetes in rural China? Res Nurs Health 2020; 43:387-395. [PMID: 32515856 DOI: 10.1002/nur.22043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 03/22/2020] [Accepted: 05/19/2020] [Indexed: 12/15/2022]
Abstract
Moderate-to-vigorous intensity physical activity (MVPA) and obesity play important roles in the development of type 2 diabetes mellitus (T2DM) among women with prior gestational diabetes mellitus (GDM). Yet, how MVPA affects the risk of developing T2DM among women with prior GDM across the different categories of obesity indicators is unclear. This study aimed to describe the levels of postpartum abnormal glucose tolerance (AGT), obesity indicators (body mass index [BMI] and waist circumference [WC]), and MVPA and to explore the independent effect and joint effect of MVPA and obesity indicators (BMI and WC) on the risk for developing AGT among women with prior GDM in rural China. A total of 425 women with prior GDM were recruited from two county-level hospitals in Western and Eastern Hunan, China. Data were collected with self-reported measurements on sociodemographics and clinical factors as well as postpartum weight-related behaviors (physical activity and dietary intake). The 75-g oral glucose tolerance test, weight, height, and WC were measured on site. Binary logistic regression models and multiplitive interaction models were used to explore the independent and joint associations of BMI and MVPA as well as WC and MVPA on AGT, respectively. One-fifth (20.9%) of the sample women had AGT. The obesity indicators were significantly associated with an increased risk of postpartum AGT, but MVPA was not. In joint effect analyses, larger WC and insufficient MVPA were not significantly associated with increased risk of AGT compared with normal WC and sufficient MVPA (mutually adjusted odds ratio [OR], 1.43; 95% confidence interval [CI], 0.46-4.43; p > .05). In joint effect analyses of MVPA and BMI, the mutually adjusted OR for developing AGT in women who were obese and had insufficient MVPA was 4.49 (95% CI, 1.35-14.92; p < .05) compared with normal weight and sufficient MVPA. Adequate weight management and increased MVPA are warranted for Chinese women with prior GDM to prevent T2DM.
Collapse
Affiliation(s)
- Ping Mao
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shan Jiang
- Department of Clinical Nursing, Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jia Guo
- Department of Clinical Nursing, Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Qing Long
- Department of Clinical Nursing, Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Honghui Zhang
- Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, Chingsha, Hunan, China
| | - Jyu-Lin Chen
- Department of Family Nursing, School of Nursing, University of California, San Francisco, California
| |
Collapse
|
20
|
Lee JY, Lee YR, Kim HR, Myong JP, Kang MY. Trends in Obesity Prevalence by Occupation Based on Korean National Health and Nutrition Examination Survey From 1998 to 2015. Saf Health Work 2020; 11:97-102. [PMID: 32206379 PMCID: PMC7078515 DOI: 10.1016/j.shaw.2019.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 07/12/2019] [Accepted: 08/26/2019] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND It is well known that the prevalence of obesity in Korea is increasing over time, however it is not known how the trends among occupational groups and sex differ in such increasing trends. This study was designed to provide recent trends of obesity among workers in Korea and to identify whether there were differences among occupational groups. METHODS We used data from the Korean National Health and Nutrition Examination Survey, Phases I to VI (1998-2015), to analyze trends in the prevalence of obesity in adult Korean workers. Obesity was defined as a body mass index of 25 kg/m2 or higher. Occupations were classified into 3 groups: (a) nonmanual workers, (b) service/sales workers, and (c) manual workers. RESULTS During the period of the Korean National Health and Nutrition Examination Survey Phases I to VI, the prevalence of obesity in male workers increased in all occupations (31.1% to 39.5% in manual workers, 32.3% to 38.2% in service/sales workers, and 25.3% to 39.7% in manual workers). However, female workers did not show any particular tendency toward obesity, except for a significant decrease in the prevalence rate in service/sales workers (30.8% to 23.9%, p for trend = 0.0048). CONCLUSION The trends of obesity prevalence by sex and occupation were different. For male manual workers, the prevalence rate increased steadily during the data period, while it decreased steadily in female sales/service workers.
Collapse
Affiliation(s)
| | | | | | | | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
21
|
Mutie PM, Drake I, Ericson U, Teleka S, Schulz CA, Stocks T, Sonestedt E. Different domains of self-reported physical activity and risk of type 2 diabetes in a population-based Swedish cohort: the Malmö diet and Cancer study. BMC Public Health 2020; 20:261. [PMID: 32085709 PMCID: PMC7035654 DOI: 10.1186/s12889-020-8344-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 02/11/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND While a dose-response relationship between physical activity and risk of diabetes has been demonstrated, few studies have assessed the relative importance of different measures of physical activity on diabetes risk. The aim was to examine the association between different self-reported measures of physical activity and risk of type 2 diabetes in a prospective cohort study. METHODS Out of 26,615 adults (45-74 years, 60% women) in the population-based Swedish Malmö Diet and Cancer Study cohort, 3791 type 2 diabetes cases were identified from registers during 17 years of follow-up. Leisure-time (17 activities), occupational and domestic physical activity were assessed through a questionnaire, and these and total physical activity were investigated in relation to type 2 diabetes risk. RESULTS All physical activity measures showed weak to modest associations with type 2 diabetes risk. The strongest association was found in the lower end of leisure-time physical activity in dose-response analysis at levels approximately below 22 MET-hrs/week (300 min/week) representing around 40% of the population. Compared with the lowest quintile, the moderate leisure-time physical activity category had a 28% (95% CI: 0.71, 0.87) decreased risk of type 2 diabetes. Total physical activity showed a similar, but weaker, association with diabetes risk as to that of leisure-time physical activity. Domestic physical activity was positively and linearly related to diabetes risk, HR = 1.11 (95% CI: 0.99, 1.25) comparing highest to lowest quintile. There was no association between occupational physical activity and diabetes risk. CONCLUSION A curvilinear association was observed between leisure-time physical activity and risk of diabetes. Beyond a threshold level of approximately 22 MET-hrs/week or 300 min/week, no additional risk reduction was observed with increase in physical activity.
Collapse
Affiliation(s)
- Pascal M Mutie
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Isabel Drake
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Ulrika Ericson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Stanley Teleka
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Christina-Alexandra Schulz
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.,Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Bonn, Germany
| | - Tanja Stocks
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Emily Sonestedt
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
| |
Collapse
|
22
|
Dolan C, Glynn R, Lawlor B. A Systematic Review and Delphi Study to Ascertain Common Risk Factors for Type 2 Diabetes Mellitus and Dementia and Brain-Related Complications of Diabetes in Adults. Can J Diabetes 2020; 44:628-635. [PMID: 32127297 DOI: 10.1016/j.jcjd.2020.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 11/11/2019] [Accepted: 01/06/2020] [Indexed: 12/09/2022]
Abstract
OBJECTIVES Both type 2 diabetes (T2DM) and dementia have multifactorial etiologies. Both are associated with aging and have well-recognized lifestyle, cardiovascular and psychosocial risk factors. However, uncertainty exists in the literature with regard to: 1) the potentially modifiable risk factors common to both dementia and T2DM, and 2) the risk of brain-related complications in those with established diabetes. In this study, we address this uncertainty and inform design of a survey questionnaire to assess knowledge about diabetes and brain health among at-risk groups. METHODS This investigation consisted of a mixed-methods approach, including a Delphi consensus study preceded by a systematic literature review. The review was conducted using MEDLINE, EMBASE and Cochrane Library databases. A 2-round online Delphi study, informed by the review, invited international experts to rate their agreement with proposed risk factors and complications. RESULTS Of 7,337 abstracts retrieved, 13 were included in the final review. Among 46 international experts invited to take part in the Delphi study, 14 (32%) responded. In the Delphi study, hypertension, obesity, physical inactivity and heavy alcohol consumption reached consensus as risk factors common to both T2DM and dementia. Proposed brain-related diabetes complications, depression and dementia were also identified. CONCLUSIONS Results revealed expert consensus and literature review agreement on a number of common modifiable risk factors for T2DM and dementia, as well as agreement on brain-related complications of diabetes. A number of other proposed shared risk factors did not reach consensus agreement, suggesting a need for more high-quality studies to add to the evidence base.
Collapse
Affiliation(s)
- Catherine Dolan
- Psychiatry of Old Age Department, Sligo Leitrim Mental Health Services, Sligo, Ireland.
| | | | - Brian Lawlor
- Department of Psychiatry, University of Dublin Trinity College, Dublin, Ireland
| |
Collapse
|
23
|
Zhang Y, Pan XF, Chen J, Xia L, Cao A, Zhang Y, Wang J, Li H, Yang K, Guo K, He M, Pan A. Combined lifestyle factors and risk of incident type 2 diabetes and prognosis among individuals with type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies. Diabetologia 2020; 63:21-33. [PMID: 31482198 DOI: 10.1007/s00125-019-04985-9] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/19/2019] [Indexed: 12/14/2022]
Abstract
AIMS/HYPOTHESIS A healthy lifestyle has been widely recommended for the prevention and management of type 2 diabetes. However, no systematic review has summarised the relationship between combined lifestyle factors (including, but not limited to, smoking, alcohol drinking, physical activity, diet and being overweight or obese) and incident type 2 diabetes and risk of health outcomes among diabetic individuals. METHODS EMBASE and PubMed were searched up to April 2019 without language restrictions. References included in articles in relevant publications were also screened. Cohort studies investigating the combined associations of at least three lifestyle factors with incident type 2 diabetes and health outcomes among diabetic individuals were included. Reviewers were paired and independently screened studies, extracted data and evaluated study quality. Random-effects models were used to calculate summary HRs. Heterogeneity and publication bias tests were also conducted. RESULTS Compared with participants considered to have the least-healthy lifestyle, those with the healthiest lifestyle had a 75% lower risk of incident diabetes (HR 0.25 [95% CI 0.18, 0.35]; 14 studies with approximately 1 million participants). The associations were largely consistent and significant among individuals from different socioeconomic backgrounds and baseline characteristics. Among individuals with type 2 diabetes (10 studies with 34,385 participants), the HRs (95% CIs) were 0.44 (0.33, 0.60) for all-cause death, 0.51 (0.30, 0.86) for cardiovascular death, 0.69 (0.47, 1.00) for cancer death and 0.48 (0.37, 0.63) for incident cardiovascular disease when comparing the healthiest lifestyle with the least-healthy lifestyle. CONCLUSIONS/INTERPRETATION Adoption of a healthy lifestyle is associated with substantial risk reduction in type 2 diabetes and long-term adverse outcomes among diabetic individuals. Tackling multiple risk factors, instead of concentrating on one certain lifestyle factor, should be the cornerstone for reducing the global burden of type 2 diabetes.
Collapse
Affiliation(s)
- Yanbo Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junxiang Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lu Xia
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Anlan Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuge Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiqi Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Yang
- Department of Endocrinology, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, China
| | - Kunquan Guo
- Department of Endocrinology, Affiliated Dongfeng Hospital, Hubei University of Medicine, Shiyan, China
| | - Meian He
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| |
Collapse
|
24
|
Paul LA, Burnett RT, Kwong JC, Hystad P, van Donkelaar A, Bai L, Goldberg MS, Lavigne E, Copes R, Martin RV, Kopp A, Chen H. The impact of air pollution on the incidence of diabetes and survival among prevalent diabetes cases. ENVIRONMENT INTERNATIONAL 2020; 134:105333. [PMID: 31775094 DOI: 10.1016/j.envint.2019.105333] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 11/13/2019] [Accepted: 11/13/2019] [Indexed: 05/18/2023]
Abstract
PURPOSE Growing evidence implicates ambient air pollutants in the development of major chronic diseases and premature mortality. However, epidemiologic evidence linking air pollution to diabetes remains inconclusive. This study sought to determine the relationships between selected air pollutants (nitrogen dioxide [NO2], fine particulate matter [PM2.5], ozone [O3], and oxidant capacity [Ox; the redox-weighted average of O3 and NO2]) and the incidence of diabetes, as well as the risk of cardiovascular or diabetes mortality among individuals with prevalent diabetes. RESEARCH DESIGN AND METHODS We followed two cohorts, which included 4.8 million Ontario adults free of diabetes and 452,590 Ontario adults with prevalent diabetes, from 2001 to 2015. Area-level air pollution exposures were assigned to subjects' residential areas, and outcomes were ascertained using health administrative data with validated algorithms. We estimated hazard ratios for the association between each air pollutant and outcome using Cox proportional hazards models, and modelled the shape of the concentration-response relationships. RESULTS Over the study period, 790,461 individuals were diagnosed with diabetes. Among those with prevalent diabetes, 26,653 died from diabetes and 64,773 died from cardiovascular diseases. For incident diabetes, each IQR increase in NO2 had a hazard ratio of 1.04 (95% CI: 1.03-1.05). This relationship was relatively robust to all sensitivity analyses considered, and exhibited a near-linear shape. There were also positive associations between incident diabetes and PM2.5, O3, and Ox, but these estimates were somewhat sensitive to different models considered. Among those with prevalent diabetes, almost all pollutants were associated with increased diabetes and cardiovascular mortality risk. The strongest association was observed between diabetes mortality and exposure to NO2 (HR = 1.08, 95% CI: 1.02-1.13). CONCLUSIONS Selected air pollutants, especially NO2, were linked to an increased risk of incident diabetes, as well as risk of cardiovascular or diabetes mortality among persons with prevalent diabetes. As NO2 is frequently used as a proxy for road traffic exposures, this result may indicate that traffic-related air pollution has the strongest effect on diabetes etiology and survival after diabetes development.
Collapse
Affiliation(s)
- Lauren A Paul
- Department of Environmental and Occupational Health, Public Health Ontario, 480 University Ave. Suite 300, Toronto, ON M5G 1V2, Canada.
| | - Richard T Burnett
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Finance Bldg, 101 Tunney's Pasture Drwy, Ottawa, ON K1A 0K9, Canada.
| | - Jeffrey C Kwong
- Public Health Ontario Laboratories, Public Health Ontario, 480 University Ave. Suite 300, Toronto, ON M5G 1V2, Canada; ICES, 2075 Bayview Ave. G1 06, Toronto, ON M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St. Room 500, Toronto, ON M5T 3M7, Canada; Department of Family and Community Medicine, University of Toronto, 500 University Ave. 5(th) Floor, Toronto, ON M5G 1V7, Canada.
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Women's Bldg, 160 SW 26th St., Corvallis, OR 97331, USA.
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Sir James Dunn Bldg, 6310 Coburg Rd., Halifax, NS B3H 4J5, Canada.
| | - Li Bai
- ICES, 2075 Bayview Ave. G1 06, Toronto, ON M4N 3M5, Canada.
| | - Mark S Goldberg
- Department of Medicine, McGill University, 1001 Decarie Blvd Suite D05-2212, Montreal, QC H4A 3J1, Canada; Division of Clinical Epidemiology, McGill University Health Centre, 687 Pine Ave. W R4.29, Montreal, QC H3A 1A1, Canada.
| | - Eric Lavigne
- Air Health Science Division, Health Canada, 269 Laurier Ave. W A.L. 4903B, Ottawa, ON K1A 0K9, Canada; School of Epidemiology and Public Health, University of Ottawa, Alta Vista Campus, 600 Peter Morand Cres. Room 101, Ottawa, ON K1G 5Z3, Canada.
| | - Ray Copes
- Department of Environmental and Occupational Health, Public Health Ontario, 480 University Ave. Suite 300, Toronto, ON M5G 1V2, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St. Room 500, Toronto, ON M5T 3M7, Canada.
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Sir James Dunn Bldg, 6310 Coburg Rd., Halifax, NS B3H 4J5, Canada.
| | - Alexander Kopp
- ICES, 2075 Bayview Ave. G1 06, Toronto, ON M4N 3M5, Canada.
| | - Hong Chen
- Department of Environmental and Occupational Health, Public Health Ontario, 480 University Ave. Suite 300, Toronto, ON M5G 1V2, Canada; Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Finance Bldg, 101 Tunney's Pasture Drwy, Ottawa, ON K1A 0K9, Canada; ICES, 2075 Bayview Ave. G1 06, Toronto, ON M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College St. Room 500, Toronto, ON M5T 3M7, Canada.
| |
Collapse
|
25
|
Bennett DA, Du H, Bragg F, Guo Y, Wright N, Yang L, Bian Z, Chen Y, YU C, Wang S, Meng F, Lv J, Chen J, Li L, Clarke R, Chen Z. Physical activity, sedentary leisure-time and risk of incident type 2 diabetes: a prospective study of 512 000 Chinese adults. BMJ Open Diabetes Res Care 2019; 7:e000835. [PMID: 31908799 PMCID: PMC6936425 DOI: 10.1136/bmjdrc-2019-000835] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/31/2019] [Accepted: 11/03/2019] [Indexed: 01/19/2023] Open
Abstract
Objective Aim to examine the independent and joint associations of physical activity (PA) and sedentary leisure-time (SLT) with risk of diabetes and assess the extent to which these associations were mediated by adiposity. Research design and methods The prospective China Kadoorie Biobank recruited ~512 000 adults from 10 diverse areas across China. Self-reported PA was estimated based on type, frequency and duration of specific types of PA, covering four domains (occupation, leisure, household and commuting). SLT was defined as hours per day spent watching television, reading or playing card games. Stratified Cox proportional hazards models were used to estimate adjusted HRs (aHRs) for PA and SLT associated with incident diabetes. Analyses were stratified by age-at-risk (5-year intervals), sex and region and adjusted for household income, education, alcohol consumption, smoking, fresh fruit intake, self-reported general health status, family history of diabetes and body mass index (BMI) status. Analyses of total PA, occupational and non-occupational PA and SLT were mutually adjusted for each other, as appropriate. Results After ~9 years of follow-up, there were 14 940 incident diabetes cases among 460 736 participants without prior diabetes or cardiovascular diseases at baseline. The mean (SD) age at baseline was 51 (10.6) years, 59% were women and 43% resided in urban areas. Overall, the mean BMI was 23.5 (3.3) kg/m2, which differed by ~0.5 kg/m2 among individuals in the highest compared with the lowest PA and SLT groups. PA was inversely associated the risk of diabetes 16% (aHR: 0.84, 95% CI 0.81 to 0.88) lower in top than bottom fifth. After further adjustment for BMI this was attenuated to 0.99 (95% CI 0.98 to 1.00). SLT was positively associated with diabetes and each 1 hour per day higher usual level was associated with aHR of 1.13 (95% CI 1.09 to 1.17) for diabetes, attenuated to 1.05 (95% CI 1.01 to 1.09) after further adjustment for BMI. Conclusions Among Chinese adults, higher levels of PA and lower levels of SLT were associated with lower risks of diabetes with no evidence of effect modification by each other. These associations appeared to arise mainly through adiposity.
Collapse
Affiliation(s)
- Derrick A Bennett
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Huaidong Du
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Fiona Bragg
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Neil Wright
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Canqing YU
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Sisi Wang
- Non-Communicable Disease Prevention and Control Department, Liuzhou CDC, Liuzhou, Guangxi, China
| | - Fanwen Meng
- Non-Communicable Disease Prevention and Control Department, Liuzhou CDC, Liuzhou, Guangxi, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment (CFSA), Beijing, China
| | - Liming Li
- Chinese Academy of Medical Sciences, Beijing, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| |
Collapse
|
26
|
Cuadrado C, Dunstan J, Silva-Illanes N, Mirelman AJ, Nakamura R, Suhrcke M. Effects of a sugar-sweetened beverage tax on prices and affordability of soft drinks in Chile: A time series analysis. Soc Sci Med 2019; 245:112708. [PMID: 31862547 PMCID: PMC7267770 DOI: 10.1016/j.socscimed.2019.112708] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 11/19/2019] [Accepted: 11/27/2019] [Indexed: 01/15/2023]
Abstract
Chile is one of several countries that recently implemented a fiscal policy to reduce soft drink (SD) intake and obesity. In 2014 the government increased the existing ad-valorem tax on high-sugar SD by 5% and decreased by 3% the tax on low-sugar SD, based on a 6.25gr/100 ml sugar threshold. This study aims to evaluate the tax modification passed-on to consumers through prices, and to calculate changes in affordability of SDs. We analysed nationally representative consumer price index data of 41 soft drinks within 6 beverage categories between 2009 and 2016. Price change post-tax implementation was estimated for different categories (carbonates, juices, concentrates, waters and energy-sport drinks), using time-series analyses. In addition, changes in affordability were evaluated by estimating the changes in prices relative to wages. The price of carbonates increased by 5.60% (CI 95% 3.18–8.03%) immediately after the tax was implemented. A sustained increase in the prices of concentrates was observed after the implementation. Unexpectedly, a smaller increase was also seen for the price of bottled water – a category that saw no tax change. There were no effects for juices and energy-sports drinks. There was a reduction in affordability for carbonates, concentrates and waters. Overall, the fiscal policy was effective in increasing prices and there are some signs of reduced affordability. Results varied substantially among categories directly affected by the tax policy. While for carbonates the price increase exceeded the tax change (‘over-shifting’), in other categories subject to a tax cut, a price reduction was expected but the opposite occurred. As the effect of the tax on prices differed between categories, the effects of the tax policy on consumption patterns are likely to be mixed. Our findings underline the need to better understand and anticipate price setting behaviour of firms in response to a tax. Chile implemented a tax policy on soft drinks (SD) to promote healthier diets in 2014. It consists in a 5% tax increase on high-sugar SD and 3% reduction on low-sugar SD. Using consumer price index data we estimate policy impact on SD price/affordability. Overall, the policy was effective to increase prices and reduce affordability. Results varied substantially among SD categories, with some counterintuitive effects.
Collapse
Affiliation(s)
| | | | | | | | - Ryota Nakamura
- Centre for Health Economics, University of York, UK; Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Japan
| | - Marc Suhrcke
- Centre for Health Economics, University of York, UK; Luxembourg Institute of Socio-economic Research, Luxembourg
| |
Collapse
|
27
|
Burns RJ. Dyadic Associations Between Body Mass Index and the Development of Type 2 Diabetes in Romantic Couples: Results From the Health and Retirement Study. Ann Behav Med 2019; 54:291-296. [DOI: 10.1093/abm/kaz042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Body mass index (BMI) is linked to Type 2 diabetes (T2D). Although romantic partners influence each other's health outcomes, it is unclear if partner's BMI is related to the development of T2D.
Purpose
To test prospective, dyadic associations between BMI and the development of T2D in middle-aged and older adult couples over 8 years.
Methods
Data came from 950 couples in the Health and Retirement Study. Neither partner had diabetes at baseline (2006). The actor–partner interdependence model was used to examine dyadic associations between BMI at baseline and the development of T2D during the next 8 years.
Results
After adjusting for covariates, a significant actor effect was observed such that one's BMI at baseline was positively associated with one's own odds of developing T2D during follow-up (odds ratio [OR] = 1.08, p < .001). A significant partner effect was also observed such that the BMI of one's partner at baseline was positively associated with one's own odds of developing T2D during follow-up above and beyond one's own baseline BMI (OR = 1.04, p = .003). These associations were not moderated by sex. This pattern of results held when BMI was coded categorically (not overweight/obese; overweight; obese).
Conclusions
Partner's BMI was prospectively associated with the likelihood of developing T2D. Future research should consider interpersonal risk factors for chronic health conditions, such as T2D. There is an opportunity to develop theoretical models that specify how and when partner characteristics are linked to physical morbidity.
Collapse
Affiliation(s)
- Rachel J Burns
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| |
Collapse
|
28
|
Mollentze WF, Joubert G, Prins A, van der Linde S, Marx GM, Tsie KG. The safety and efficacy of a low-energy diet to induce weight loss, improve metabolic health, and induce diabetes remission in insulin-treated obese men with type 2 diabetes: a pilot RCT. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-019-00734-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
29
|
Zhao Q, Zhang K, Li Y, Zhen Q, Shi J, Yu Y, Tao Y, Cheng Y, Liu Y. Capacity of a body shape index and body roundness index to identify diabetes mellitus in Han Chinese people in Northeast China: a cross-sectional study. Diabet Med 2018; 35:1580-1587. [PMID: 30059165 DOI: 10.1111/dme.13787] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2018] [Indexed: 12/21/2022]
Abstract
AIM To assess the capacity of a body shape index and body roundness index to identify people with diabetes mellitus and those with prediabetes, and to determine whether a body shape index and/or body roundness index is superior to the traditional overall adiposity index, BMI, in Han Chinese people in Northeast China. METHODS A total of 15 078 participants were enrolled from Jilin province in 2012 using a multi-stage stratified random cluster sampling method. Demographic data were collected, and anthropometric indices and biochemical indices were measured. Receiver-operating characteristic curves were used to compare the validity of each anthropometric index, and the area under the receiver-operating characteristic curve was calculated for each anthropometric index. RESULTS Body roundness index had the highest areas under the receiver-operating curve for prediabetes, diagnosed diabetes and undiagnosed diabetes in both men and women (all P<0.01). The optimum threshold values for body roundness index for prediabetes, undiagnosed diabetes and diagnosed diabetes, respectively, were 2.8, 3.7 and 3.3 in men, and 3.4, 3.8 and 3.6 in women. The cumulative proportions of prediabetes, undiagnosed diabetes and diagnosed diabetes identified by the optimum threshold values of body roundness index were 79.2%, 67.5% and 77.0% (82.3%, 62.5% and 75.3% in men; 74.6%, 74.9% and 78.3% in women), respectively. CONCLUSIONS BMI, a body shape index and body roundness index may identify the presence of diabetes. Among the three anthropometric indices, BMI had the weakest association with diabetes. Body roundness index is an alternative index for assessing diabetes in Han Chinese people in Northeast China.
Collapse
Affiliation(s)
- Q Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - K Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Y Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Q Zhen
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - J Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Y Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Y Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Y Cheng
- Cardiovascular Centre, First Hospital of Jilin University, Changchun, China
- Laboratory for Cardiovascular Diseases, First Hospital of Jilin University, Changchun, China
| | - Y Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| |
Collapse
|
30
|
Neermark S, Holst C, Bisgaard T, Bay-Nielsen M, Becker U, Tolstrup JS. Validation and calibration of self-reported height and weight in the Danish Health Examination Survey. Eur J Public Health 2018; 29:291-296. [DOI: 10.1093/eurpub/cky187] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Soren Neermark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Gastrounit, Surgical Division, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Charlotte Holst
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Thue Bisgaard
- Gastrounit, Surgical Division, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Morten Bay-Nielsen
- Gastrounit, Medical Division, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Gastrounit, Medical Division, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| |
Collapse
|
31
|
Low fasting plasma glucose level as a predictor of new-onset diabetes mellitus on a large cohort from a Japanese general population. Sci Rep 2018; 8:13927. [PMID: 30224631 PMCID: PMC6141503 DOI: 10.1038/s41598-018-31744-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 08/23/2018] [Indexed: 01/08/2023] Open
Abstract
Although fasting plasma glucose levels <70 mg/dL are associated with a high incidence of cardiovascular disease (CVD), whether there is any risk of new-onset diabetes mellitus owing to fasting plasma glucose at this range has not been clarified. We measured the odds ratio (OR) of new-onset diabetes mellitus relative to fasting plasma glucose levels at various ranges in a nation-wide Japanese population with and without CVD history. Of 186,749 participants without diabetes in 2008, 171,408 had no history of CVD, while 15,341 did. Participants were classified into 8 categories according to their fasting plasma glucose levels. Unadjusted and multivariable-adjusted logistic regression models were used to measure the OR of new-onset diabetes mellitus in the 3-year follow up. In all participants, multivariable-adjusted OR increased when fasting plasma glucose levels were <70 mg/dL or 90–125 mg/dL. Participants without CVD showed increased OR when glucose levels were <70 mg/dL or 90–125 mg/dL. Participants with a history of CVD showed increased OR with glucose levels of 95–125 mg/dL. The risk of new-onset diabetes mellitus is higher when fasting glucose levels are <70 mg/dL, indicating that the paradox of fasting glucose seeks a new risk stratification for new-onset diabetes mellitus.
Collapse
|
32
|
Bell JA, Hamer M, Richmond RC, Timpson NJ, Carslake D, Davey Smith G. Associations of device-measured physical activity across adolescence with metabolic traits: Prospective cohort study. PLoS Med 2018; 15:e1002649. [PMID: 30204755 PMCID: PMC6133272 DOI: 10.1371/journal.pmed.1002649] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 08/03/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Multiple occasions of device-measured physical activity have not been previously examined in relation to metabolic traits. We described associations of total activity, moderate-to-vigorous physical activity (MVPA), and sedentary time from three accelerometry measures taken across adolescence with detailed traits related to systemic metabolism. METHODS AND FINDINGS There were 1,826 male and female participants recruited at birth in 1991-1992 via mothers into the Avon Longitudinal Study of Parents and Children offspring cohort who attended clinics in 2003-2005, 2005-2006, and 2006-2008 who were included in ≥1 analysis. Waist-worn uniaxial accelerometers measured total activity (counts/min), MVPA (min/d), and sedentary time (min/d) over ≥3 d at mean age 12y, 14y, and 15y. Current activity (at age 15y), mean activity across occasions, interaction by previous activity, and change in activity were examined in relation to systolic and diastolic blood pressure, insulin, C-reactive protein, and 230 traits from targeted metabolomics (nuclear magnetic resonance spectroscopy), including lipoprotein cholesterol and triglycerides, amino and fatty acids, glycoprotein acetyls, and others, at age 15y. Mean current total activity was 477.5 counts/min (SD = 164.0) while mean MVPA and sedentary time durations were 23.6 min/d (SD = 17.9) and 522.1 min/d (SD = 66.0), respectively. Mean body mass index at age 15y was 21.4 kg/m2 (SD = 3.5). Correlations between first and last activity measurement occasions were low (e.g., r = 0.40 for counts/min). Current activity was most strongly associated with cholesterol and triglycerides in high-density lipoprotein (HDL) and very low-density lipoprotein (VLDL) particles (e.g., -0.002 mmol/l or -0.18 SD units; 95% CI -0.24--0.11 for triglycerides in chylomicrons and extremely large very low-density lipoprotein [XL VLDL]) and with glycoprotein acetyls (-0.02 mmol/l or -0.16 SD units; 95% CI -0.22--0.10), among others. Associations were similar for mean activity across 3 occasions. Attenuations were modest with adjustment for fat mass index based on dual-energy X-ray absorptiometry (DXA). In mutually adjusted models, higher MVPA and sedentary time were oppositely associated with cholesterol and triglycerides in VLDL and HDL particles (MVPA more strongly with glycoprotein acetyls and sedentary time more strongly with amino acids). Associations appeared less consistent for sedentary time than for MVPA based on longer-term measures and were weak for change in all activity types from age 12y-15y. Evidence was also weak for interaction between activity types at age 15y and previous activity measures in relation to most traits (minimum P = 0.003; median P = 0.26 for counts/min) with interaction coefficients mostly positive. Study limitations include modest sample sizes and relatively short durations of accelerometry measurement on each occasion (3-7 d) and of time lengths between first and last accelerometry occasions (<4 years), which can obscure patterns from chance variation and limit description of activity trajectories. Activity was also recorded using uniaxial accelerometers which predated more sensitive triaxial devices. CONCLUSIONS Our results support associations of physical activity with metabolic traits that are small in magnitude and more robust for higher MVPA than lower sedentary time. Activity fluctuates over time, but associations of current activity with most metabolic traits do not differ by previous activity. This suggests that the metabolic effects of physical activity, if causal, depend on most recent engagement.
Collapse
Affiliation(s)
- Joshua A. Bell
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Mark Hamer
- School of Sport, Exercise & Health Sciences, Loughborough University, Leicestershire, United Kingdom
| | - Rebecca C. Richmond
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Nicholas J. Timpson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - David Carslake
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - George Davey Smith
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| |
Collapse
|
33
|
Galaviz KI, Weber MB, Straus A, Haw JS, Narayan KMV, Ali MK. Global Diabetes Prevention Interventions: A Systematic Review and Network Meta-analysis of the Real-World Impact on Incidence, Weight, and Glucose. Diabetes Care 2018; 41:1526-1534. [PMID: 29934481 PMCID: PMC6463613 DOI: 10.2337/dc17-2222] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 03/30/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Understanding the real-world impacts of lifestyle modification (LSM) for diabetes prevention is imperative to inform resource allocation. The purpose of this study was to synthetize global evidence on the impact of LSM strategies on diabetes incidence and risk factors in one parsimonious model. RESEARCH DESIGN AND METHODS PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were searched for studies published between January 1990 and April 2015. Effectiveness/translation studies of any design testing LSM strategies, targeting high-risk populations (with prediabetes or diabetes risk factors), and reporting diabetes incidence, weight, or glucose outcomes were included. We extracted number of diabetes cases/incidence rates and mean changes in weight (kg), fasting blood glucose (FBG, mmol/L), 2-h postload glucose (mmol/L), and hemoglobin A1c (%). Pairwise random-effects and frequentist random-effects network meta-analyses were used to obtain pooled effects. RESULTS Sixty-three studies were pooled in the meta-analysis (n = 17,272, mean age 49.7 years, 28.8% male, 60.8% white/European). In analyses restricted to controlled studies (n = 7), diabetes cumulative incidence was 9% among intervention participants and 12% among control participants (absolute risk reduction 3%; relative risk 0.71 [95% CI 0.58, 0.88]). In analyses combining controlled and uncontrolled studies (n = 14), participants receiving group education by health care professionals had 33% lower diabetes odds than control participants (odds ratio 0.67 [0.49, 0.92]). Intervention participants lost 1.5 kg more weight [-2.2, -0.8] and achieved a 0.09 mmol/L greater FBG decrease [-0.15, -0.03] than control participants. Every additional kilogram lost by participants was associated with 43% lower diabetes odds (β = 0.57 [0.41, 0.78]). CONCLUSIONS Real-world LSM strategies can reduce diabetes risk, even with small weight reductions.
Collapse
Affiliation(s)
- Karla Ivette Galaviz
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Mary Beth Weber
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | | | - Jeehea Sonya Haw
- Division of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - K M Venkat Narayan
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Mohammed K Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| |
Collapse
|
34
|
Weggemans RM, Backx FJG, Borghouts L, Chinapaw M, Hopman MTE, Koster A, Kremers S, van Loon LJC, May A, Mosterd A, van der Ploeg HP, Takken T, Visser M, Wendel-Vos GCW, de Geus EJC. The 2017 Dutch Physical Activity Guidelines. Int J Behav Nutr Phys Act 2018; 15:58. [PMID: 29940977 PMCID: PMC6016137 DOI: 10.1186/s12966-018-0661-9] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/12/2018] [Indexed: 01/19/2023] Open
Abstract
Background The objective of this study was to derive evidence-based physical activity guidelines for the general Dutch population. Methods Two systematic reviews were conducted of English language meta-analyses in PubMed summarizing separately randomized controlled trials and prospective cohort studies on the relation between physical activity and sedentary behaviour on the one hand and the risk of all-cause mortality and incidence of 15 major chronic diseases and conditions on the other hand. Other outcome measures were risk factors for cardiovascular disease and type 2 diabetes, physical functioning, and fitness. On the basis of these reviews, an expert committee derived physical activity guidelines. In deriving the guidelines, the committee first selected only experimental and observational prospective findings with a strong level of evidence and then integrated both lines of evidence. Results The evidence found for beneficial effects on a large number of the outcome measures was sufficiently strong to draw up guidelines to increase physical activity and reduce sedentary behaviour, respectively. At the same time, the current evidence did not provide a sufficient basis for quantifying how much physical activity is minimally needed to achieve beneficial health effects, or at what amount sedentary behaviour becomes detrimental. A general tenet was that at every level of current activity, further increases in physical activity provide additional health benefits, with relatively larger effects among those who are currently not active or active only at light intensity. Three specific guidelines on (1) moderate- and vigorous-intensity physical activity, (2) bone- and muscle-strengthening activities, and (3) sedentary behaviour were formulated separately for adults and children. Conclusions There is an unabated need for evidence-based physical activity guidelines that can guide public health policies. Research in which physical activity is measured both objectively (quantity) and subjectively (type and quality) is needed to provide better estimates of the type and actual amount of physical activity required for health. Electronic supplementary material The online version of this article (10.1186/s12966-018-0661-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Rianne M Weggemans
- Health Council of the Netherlands, P.O. Box 16052, 2500, BB, The Hague, The Netherlands.
| | | | - Lars Borghouts
- Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Mai Chinapaw
- VU University Medical Center, Amsterdam, The Netherlands
| | | | | | - Stef Kremers
- Maastricht University Medical Center+, Maastricht, The Netherlands
| | | | - Anne May
- University Medical Center, Utrecht, the Netherlands
| | - Arend Mosterd
- Meander Medical Center Amersfoort, Amersfoort, The Netherlands
| | | | - Tim Takken
- University Medical Center, Utrecht, the Netherlands
| | - Marjolein Visser
- Vrije Universiteit Amsterdam and VU University Medical Center, Amsterdam, The Netherlands
| | - G C Wanda Wendel-Vos
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Eco J C de Geus
- Vrije Universiteit Amsterdam and VU University Medical Center, Amsterdam, The Netherlands
| | | |
Collapse
|
35
|
Elinder LS, Hakimi S, Lager A, Patterson E. Global region of birth is an independent risk factor for type 2 diabetes in Stockholm, Sweden. Eur J Public Health 2018; 27:447-453. [PMID: 27864357 DOI: 10.1093/eurpub/ckw207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background In Stockholm, type 2 diabetes (T2D) is a public health concern and much more prevalent in areas with a high proportion of foreign-born individuals. One in five individuals in Stockholm County are born outside of Sweden, and we therefore investigated if global region of birth was associated with diabetes risk, adjusting for established risk factors. Cross-sectional data from the population-based Stockholm Public Health Survey 2010 ( N = 69 115) was combined with registry-based information on country of birth grouped into eight global geographical regions. Cases of T2D were identified through self-reported physician-diagnosed diabetes and age at diagnosis. Region of birth was the independent risk factor and multivariable logistic regression analysis was performed adjusting for the risk factors age, sex, weight status, educational level, multiple dietary factors, tobacco, alcohol and physical activity. T2D prevalence was 5.1% in the sample. Relative to Swedish-born participants, higher odds ratio (OR) were found in those born in Asia [OR 3.2, 95% confidence interval (CI) 2.2-4.7], Sub-Saharan Africa (OR 2.5, 95% CI 1.5-4.1) and North Africa/the Middle East (OR 2.1, 95% CI 1.6-2.8), after adjustment for established risk factors. Participants from Eastern Europe and Latin America had an elevated risk but this did not remain after adjustment for other risk factors. Region of birth was found to be an independent risk factor for T2D for participants born in Asia, Africa and the Middle East. This increased risk should be taken into consideration when allocating resources for prevention, detection and care.
Collapse
Affiliation(s)
- Liselotte Schäfer Elinder
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Shawn Hakimi
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Anton Lager
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Emma Patterson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| |
Collapse
|
36
|
Yanai H, Adachi H, Masui Y, Katsuyama H, Kawaguchi A, Hakoshima M, Waragai Y, Harigae T, Hamasaki H, Sako A. Exercise Therapy for Patients With Type 2 Diabetes: A Narrative Review. J Clin Med Res 2018; 10:365-369. [PMID: 29581797 PMCID: PMC5862082 DOI: 10.14740/jocmr3382w] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/26/2018] [Indexed: 01/01/2023] Open
Abstract
To achieve excellent glycemic control in patients with type 2 diabetes, an adequate prescription of exercise therapy is required. The meta-analyses proposed that high-intensity training improves metabolic parameters in patients with pre-diabetes or type 2 diabetes and low physical activity is associated with an increased risk of incident type 2 diabetes. Here, we would introduce literatures about effects of physical activity on mortality, cardiovascular events, and metabolic parameters, to encourage understanding of exercise therapy, and then describe how to prescribe exercise therapy for patients with type 2 diabetes. We also show the usefulness of non-exercise activity thermogenesis for diabetic patients who cannot perform volitional sporting-like exercise because of diabetic complication and/or comorbidity, by presenting results of our previous studies.
Collapse
Affiliation(s)
- Hidekatsu Yanai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Hiroki Adachi
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Yoshinori Masui
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Hisayuki Katsuyama
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Akiko Kawaguchi
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Mariko Hakoshima
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Yoko Waragai
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Tadanao Harigae
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Hidetaka Hamasaki
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| | - Akahito Sako
- Department of Internal Medicine, National Center for Global Health and Medicine Kohnodai Hospital, Chiba, Japan
| |
Collapse
|
37
|
Emerson JA, Dunsiger S, Williams DM. Reciprocal within-day associations between incidental affect and exercise: An EMA study. Psychol Health 2018; 33:130-143. [PMID: 28665227 PMCID: PMC5738286 DOI: 10.1080/08870446.2017.1341515] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Previous research suggests that how people feel throughout the course of a day (i.e. incidental affect) is predictive of exercise behaviour. A mostly separate literature suggests that exercise can lead to more positive incidental affect. OBJECTIVE This study examines the potential reciprocal effects of incidental affect and exercise behaviour within the same day. DESIGN Fifty-nine low-active (exercise <60 min/week), overweight (BMI: 25.0-39.9) adults (ages 18-65) participated in a six-month print-based exercise promotion programme. MAIN OUTCOME MEASURES Ecological momentary assessment was used to record self-reported exercise sessions in real time and incidental affective valence (feeling good/bad) as assessed by the 11-point Feeling Scale at random times throughout the day. RESULTS Use of a within-subjects cross-lagged, autoregressive model showed that participants were more likely to exercise on days when they experienced more positive incidental affect earlier in the day (b = .58, SE = .10, p < .01), and participants were more likely to experience more positive incidental affect on days when they had exercised (b = .26, SE = .03, p < .01), with the former association significantly stronger than the latter (t = 23.54, p < .01). CONCLUSION The findings suggest a positive feedback loop whereby feeling good and exercising are reciprocally influential within the course of a day.
Collapse
Affiliation(s)
- Jessica A. Emerson
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Shira Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - David M. Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
38
|
Picavet HSJ, Blokstra A, Spijkerman AMW, Verschuren WMM. Cohort Profile Update: The Doetinchem Cohort Study 1987-2017: lifestyle, health and chronic diseases in a life course and ageing perspective. Int J Epidemiol 2017; 46:1751-1751g. [PMID: 29040549 PMCID: PMC5837330 DOI: 10.1093/ije/dyx103] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/16/2017] [Accepted: 05/22/2017] [Indexed: 12/26/2022] Open
Affiliation(s)
- H S J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands and
| | - Anneke Blokstra
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands and
| | - Annemieke MW Spijkerman
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands and
| | - WM Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands and
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
39
|
Koloverou E, Tambalis K, Panagiotakos DB, Georgousopoulou E, Chrysohoou C, Skoumas I, Tousoulis D, Stefanadis C, Pitsavos C. Moderate physical activity reduces 10-year diabetes incidence: the mediating role of oxidative stress biomarkers. Int J Public Health 2017; 63:297-305. [PMID: 29128918 DOI: 10.1007/s00038-017-1052-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 07/06/2017] [Accepted: 11/06/2017] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To evaluate the effect of physical activity levels on 10-year diabetes incidence and investigate the potential mechanism. METHODS In 2001-2002, a random sample of apparently healthy 3042 men and women (18-89 years) was selected to participate in the ATTICA study. Several socio-demographic, clinical and lifestyle characteristics were recorded. Physical activity level was recorded through a translated, validated, version of International Physical Activity Questionnaire (IPAQ); MET min/week was calculated and quartiles constructed. Diabetes diagnosis was defined according to the ADA criteria. During 2011-2012, a 10-year follow-up was performed. RESULTS n = 191 cases were recorded, yielding an incidence of 12.9%. In multivariable analysis, moderate physical activity level (331-1484 MET min/week) was found to decrease 10-year diabetes incidence by 53% compared to very low physical activity (< 150 MET min/week) (OR = 0.47; 95% CI 0.24, 0.93). For high physical activity level (> 1484 MET min/week), the results were not significant. The antidiabetic effect was found to be mediated by oxidized LDL and total antioxidant capacity. CONCLUSIONS The current work revealed the significant beneficial role of moderate physical activity against diabetes development, potentially through attenuating oxidative stress.
Collapse
Affiliation(s)
- Efi Koloverou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, St. El. Venizelou 70, Kallithea, Athens, Greece
| | - Konstantinos Tambalis
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, St. El. Venizelou 70, Kallithea, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, St. El. Venizelou 70, Kallithea, Athens, Greece.
| | - Ekavi Georgousopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, St. El. Venizelou 70, Kallithea, Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Ioannis Skoumas
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Dimitrios Tousoulis
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | | | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | | |
Collapse
|
40
|
Morais Junior GS, Souza VC, Machado-Silva W, Henriques AD, Melo Alves A, Barbosa Morais D, Nóbrega OT, Brito CJ, dos Santos Silva RJ. Acute strength training promotes responses in whole blood circulating levels of miR-146a among older adults with type 2 diabetes mellitus. Clin Interv Aging 2017; 12:1443-1450. [PMID: 28979106 PMCID: PMC5608226 DOI: 10.2147/cia.s141716] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) consists of a set of metabolic and endocrine disorders which evolve into deficiency in insulin action and hyperglycemia. Physical exercise is considered the main intervention to prevent and control T2DM. Literature has suggested that circulating microRNAs (miRs) help to understand responses to physical activity among diabetic patients. Thus, the aim of this study was to analyze the acute effect of two interventions (strength and cardiovascular) on the total, whole blood circulating concentrations of miR-126, miR-146a and miR-155 in older adults with and without T2DM. A total of 23 male and female older adults (68.2±5.3 years) participated in the trial, 13 of whom presented with controlled T2DM and 10 were nondiabetics. They underwent both interventions separately, performed with intensity from 60% to 70% of reserve heart rate. Glucose and miRs levels were quantified and compared across groups with baseline titers as covariables. Diabetic patients showed more reduction in serum blood glucose than nondiabetics, with a great magnitude of reduction after the strength training intervention, which was paralleled by a positive change of the whole blood circulating levels of miR-146a, but not of the other miRs. Our report supports evidence that miR-146a levels in peripheral blood leukocytes are negatively associated with a state of insulin resistance, which is suggested as a novel marker to trace response to antidiabetic interventions.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Ciro José Brito
- Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | | |
Collapse
|
41
|
Li X, Zhao Y, Jin Y, Zhang T, Chang X, Liao S, Xu H, Liu X, Yang J, Zhang J, Zhang Y. Associations between serum adipocytokines and glycemic tolerance biomarkers in a rural Chinese population. PLoS One 2017; 12:e0182273. [PMID: 28786989 PMCID: PMC5546634 DOI: 10.1371/journal.pone.0182273] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 07/14/2017] [Indexed: 01/10/2023] Open
Abstract
Although experimental studies have shown that adiponectin and leptin modulate glucose tolerance and insulin resistance, it remains unclear whether these adipocytokines exert similar effects in general human populations. We evaluated the associations of serum adiponectin and leptin with β-cell function and insulin resistance in a population with low obesity prevalence. A cross-sectional study of 783 rural residents, aged 25-74 years, recruited in Ningxia, China was conducted during 2008-2012. β-cell function and insulin resistance were estimated using the Homeostasis Model Assessment. Serum adiponectin and leptin were measured with ELISA. Serum adiponectin concentrations (mean ± SD) were highest in subjects with normal glucose tolerance (36.65 ± 61.13 μg/ml), intermediate in those with impaired fasting glucose (25.92 ± 34.48 μg/ml), and lowest in those with diabetes (15.08 ± 12.14 μg/ml) (p = 0.001). A similar pattern of differences was found for β-cell function, whereas opposite results were observed for insulin resistance and blood glucose. After adjustment for confounders including metabolic syndrome components, serum adiponectin (μg/ml) was inversely associated with β-cell function (%β) [β (95% CI): -7.57 (-12.33, -2.81)] and insulin resistance (100/%S) [β (95% CI): -0.21 (-0.33, -0.09)]. A significant inverse association also existed between serum leptin and β-cell function, but serum leptin was not significantly associated with insulin resistance. The present study suggests that adiponectin and leptin play a role in the development of insulin resistance and diabetes independent of metabolic syndrome.
Collapse
Affiliation(s)
- Xiaoxia Li
- Department of Epidemiology, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, People’s Republic of China
| | - Yi Zhao
- Department of Epidemiology, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, People’s Republic of China
| | - Yanan Jin
- Ningxia Center for Disease Control and Prevention, Yinchuan, Ningxia Hui Autonomous Region, People’s Republic of China
| | - Tianjing Zhang
- Department of Epidemiology, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, People’s Republic of China
| | - Xiaoyu Chang
- Department of Epidemiology, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, People’s Republic of China
| | - Sha Liao
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan Province, People’s Republic of China
| | - Hongxia Xu
- Department of Epidemiology, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, People’s Republic of China
| | - Xiuying Liu
- Department of Epidemiology, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, People’s Republic of China
| | - Jianjun Yang
- Department of Epidemiology, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, People’s Republic of China
| | - Jianjun Zhang
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, United States of America
- * E-mail: (YHZ); (JJZ)
| | - Yuhong Zhang
- Department of Epidemiology, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, People’s Republic of China
- * E-mail: (YHZ); (JJZ)
| |
Collapse
|
42
|
Callisaya M, Nosaka K. Effects of Exercise on Type 2 Diabetes Mellitus-Related Cognitive Impairment and Dementia. J Alzheimers Dis 2017; 59:503-513. [DOI: 10.3233/jad-161154] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Michele Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
- Stroke and Ageing Research Group, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Kazunori Nosaka
- Centre for Exercise and Sports Science Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| |
Collapse
|
43
|
den Braver NR, de Vet E, Duijzer G, Ter Beek J, Jansen SC, Hiddink GJ, Feskens EJM, Haveman-Nies A. Determinants of lifestyle behavior change to prevent type 2 diabetes in high-risk individuals. Int J Behav Nutr Phys Act 2017; 14:78. [PMID: 28606146 PMCID: PMC5468963 DOI: 10.1186/s12966-017-0532-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/26/2017] [Indexed: 01/01/2023] Open
Abstract
Background Although there are many effective lifestyle interventions for type 2 diabetes (T2DM) prevention, insight into effective intervention pathways, especially of long-term interventions, is often lacking. This study aims to provide insight into the effective intervention pathways of the SLIMMER diabetes prevention intervention using mediation analyses. Methods In total, 240 participants at increased risk of T2DM were included in the analyses over 18 months. The intervention was a combined lifestyle intervention with a dietary and a physical activity (PA) component. The primary and secondary outcomes were change in fasting insulin (pmol/L) and change in body weight (kg) after 18 months, respectively. Firstly, in a multiple mediator model, we investigated whether significant changes in these outcomes were mediated by changes in dietary and PA behavior. Secondly, in multiple single mediator models, we investigated whether changes in dietary and PA behavior were mediated by changes in behavioral determinants and the participants’ psychological profile. The mediation analyses used linear regression models, where significance of indirect effects was calculated with bootstrapping. Results The effect of the intervention on decreased fasting insulin was 40% mediated by change in dietary and PA behavior, where dietary behavior was an independent mediator of the association (34%). The effect of the intervention on decreased body weight was 20% mediated by change in dietary and PA behavior, where PA behavior was an independent mediator (17%). The intervention significantly changed intake of fruit, fat from bread spread, and fiber from bread. Change in fruit intake was mediated by change in action control (combination of consciousness, self-control, and effort), motivation, self-efficacy, intention, and skills. Change in fat intake was mediated by change in action control and psychological profile. No mediators could be identified for change in fiber intake. The change in PA behavior was mediated by change in action control, motivation, and psychological profile. Conclusion The effect of the SLIMMER intervention on fasting insulin and body weight was mediated by changes in dietary and PA behavior, in distinct ways. These results indicate that changing dietary as well as PA behavior is important in T2DM prevention. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0532-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- N R den Braver
- Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands. .,Department of Epidemiology and Biostatistics, VU Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - E de Vet
- Strategic Communication Chair group, Wageningen University & Research, Wageningen, The Netherlands
| | - G Duijzer
- Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands.,GGD Noord- en Oost-Gelderland, Warnsveld, The Netherlands
| | - J Ter Beek
- GGD Noord- en Oost-Gelderland, Warnsveld, The Netherlands
| | - S C Jansen
- GGD Noord- en Oost-Gelderland, Warnsveld, The Netherlands
| | - G J Hiddink
- Strategic Communication Chair group, Wageningen University & Research, Wageningen, The Netherlands
| | - E J M Feskens
- Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands
| | - A Haveman-Nies
- Division of Human Nutrition, Wageningen University & Research, Wageningen, The Netherlands.,GGD Noord- en Oost-Gelderland, Warnsveld, The Netherlands
| |
Collapse
|
44
|
Hart PD, Benavidez G, Erickson J. Meeting Recommended Levels of Physical Activity in Relation to Preventive Health Behavior and Health Status Among Adults. J Prev Med Public Health 2017; 50:10-17. [PMID: 28173688 PMCID: PMC5327681 DOI: 10.3961/jpmph.16.080] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 12/02/2016] [Indexed: 11/09/2022] Open
Abstract
Objectives The purpose of this study was to examine the relationship of meeting the recommended levels of physical activity (PA) with health status and preventive health behavior in adults. Methods A total of 5630 adults 18 years of age or older were included in this study. PA was assessed using a series of questions that categorized activities based on their metabolic equivalent values and then categorized individuals based on the reported frequency and duration of such activities. Participants reporting 150 minutes or more of moderate-intensity PA per week were considered to have met the PA guidelines. Multiple logistic regression was used to model the relationships between meeting PA guidelines and health status and preventive health behavior, while controlling for confounding variables. Results Overall, 53.9% (95% confidence interval [CI], 51.9 to 55.9%) of adults reported meeting the recommended levels of PA. Among adults with good general health, 56.9% (95% CI, 54.7 to 59.1%) reported meeting the recommended levels of PA versus 43.1% (95% CI, 40.9 to 45.3%) who did not. Adults who met the PA guidelines were significantly more likely not to report high cholesterol, diabetes, chronic obstructive pulmonary disease, arthritis, asthma, depression, or overweight. Furthermore, adults meeting the PA guidelines were significantly more likely to report having health insurance, consuming fruits daily, consuming vegetables daily, and not being a current cigarette smoker. Conclusions In this study, we found meeting the current guidelines for PA to have a protective relationship with both health status and health behavior in adults. Health promotion programs should focus on strategies that help individuals meet the current guidelines of at least 150 minutes per week of moderate-intensity PA.
Collapse
Affiliation(s)
- Peter D Hart
- Health Promotion Program, Montana State University-Northern, Havre, MT, USA
| | - Gabriel Benavidez
- Health Promotion Program, Montana State University-Northern, Havre, MT, USA
| | - James Erickson
- Health Promotion Program, Montana State University-Northern, Havre, MT, USA
| |
Collapse
|
45
|
Prevalence and factors associated with erectile dysfunction in patients with chronic kidney disease on conservative treatment. Int J Impot Res 2017; 29:219-224. [DOI: 10.1038/ijir.2017.20] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 02/05/2017] [Accepted: 03/02/2017] [Indexed: 12/19/2022]
|