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Activity Patterns of Obese Adults with Type 2 Diabetes in the Look AHEAD Study

JAKICIC, JOHN M.1; GREGG, EDWARD2; KNOWLER, WILLIAM3; KELLEY, DAVID E.4; LANG, WEI5; MILLER, GARY D.6; PI-SUNYER, F. XAVIER7; REGENSTEINER, JUDITH G.8; REJESKI, W. JACK6; RIBISL, PAUL6; WALKUP, MICHAEL P.5; WOLF, DONNA L.9

Medicine & Science in Sports & Exercise: November 2010 - Volume 42 - Issue 11 - pp 1995-2005
doi: 10.1249/MSS.0b013e3181e054f0
Basic Sciences

Purpose: This study describes baseline physical activity (PA) patterns of individuals with type 2 diabetes mellitus (T2DM) enrolled in the multicenter Look AHEAD Study using an objective measure of PA (accelerometry).

Methods: A total of 2240 participants (age = 59.0 ± 6.8 yr and body mass index (BMI) = 36.5 ± 6.0 kg·m−2) with T2DM provided data for this substudy. Participants were instructed to wear an accelerometer during waking hours for 7 d. Accelerometry data were analyzed to identify periods meeting the criteria of ≥3 MET·min−1 for ≥10 min (moderate- to vigorous-intensity PA (MVPA)) and ≥6 MET·min−1 for ≥10 min (vigorous-intensity PA (VPA)). Self-reported PA was also assessed with a questionnaire. Accelerometry and self-reported PA data were compared across categories of BMI, sex, race, age, fitness, diabetes medication usage, and history of cardiovascular disease.

Results: Self-reported PA was lower at higher levels of BMI, was higher in males, was lowest for African-American/black, and was positively associated with fitness. Multivariate analyses for accelerometer-measured MVPA and VPA showed that more PA bouts per day, minutes per bout, METs per minute, and MET-minutes were associated with higher fitness. For MVPA, bouts per day were higher in men, and METs per minute were higher in women. For VPA, bouts per day was positively associated with increasing age and differed by race/ethnicity. METs per minute were significantly lower at higher levels of BMI and in women. Diabetes medication usage and history of cardiovascular disease were not associated with patterns of PA examined.

Conclusions: Results provide information on factors that contribute to PA patterns in adults with T2DM when PA is assessed using both objective and subjective measures. These data may inform interventions to improve PA in adults with T2DM.

1Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, University of Pittsburgh, Pittsburgh, PA; 2Centers for Disease Control and Prevention, Division of Diabetes Translation, Atlanta, GA; 3National Institute of Diabetes and Digestive and Kidney Diseases, Diabetes Epidemiology & Clinical Research Section, Phoenix, AZ; 4Merck & Co., Inc, Rahway, NJ; 5Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC; 6Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC; 7Department of Medicine, St. Lukes-Roosevelt Hospital Center, New York, NY; and 8University of Colorado Denver School of Medicine, General Internal Medicine, Aurora, CO

Address for correspondence: John M. Jakicic, Ph.D., Department of Health and Physical Activity, Physical Activity and Weight Management Research Center, 140 Trees Hall, University of Pittsburgh, Pittsburgh, PA 15260; E-mail: jjakicic@pitt.edu.

Submitted for publication August 2009.

Accepted for publication March 2010.

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©2010The American College of Sports Medicine