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Risk Estimates for Diabetes and Hypertension with Different Physical Activity Methods

STERNFELD, BARBARA1; GABRIEL, KELLEY PETTEE2,3; JIANG, SHENG-FANG1; WHITAKER, KARA M.4; JACOBS, DAVID R. JR5; QUESENBERRY, CHARLES P. JR1; CARNETHON, MERCEDES6; SIDNEY, STEPHEN1

Medicine & Science in Sports & Exercise: December 2019 - Volume 51 - Issue 12 - p 2498–2505
doi: 10.1249/MSS.0000000000002083
EPIDEMIOLOGY
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Purpose To estimate risks of incident type 2 diabetes (T2D) and stage 2 and greater hypertension associated with self-reported and accelerometer-determined moderate-vigorous physical activity (MVPA) separately and adjusted for each other.

Methods The sample included 2291 black and white men and women, ages 38–50 yr, in the Coronary Artery Risk Development in Young Adults (CARDIA) fitness study, conducted during the year 20 core CARDIA examination. Accelerometer-determined (Actigraph, LLC. model 7164) MVPA (MVPA-Acc), assessed at year 20, was defined as minutes per day of counts ≥2020 min−1. Self-reported MVPA (MVPA-SR) was assessed at year 20 using the CARDIA Physical Activity History. Incident T2D was ascertained at years 25 and 30 from fasting glucose, 2 h glucose tolerance test, HbA1c, or diabetes medication; incident hypertension was ascertained at those same times from measured blood pressure or use of antihypertensive medications. Modified Poisson regression models estimated relative risk (RR) of incident (years 25 and 30) T2D or hypertension, associated with middle and high tertiles of year 20 MVPA-Acc alone, year 20 MVPA-SR alone, and both, adjusted for each other, relative to bottom tertile.

Results In men, MVPA-Acc, but not MVPA-SR, was associated with a 37% to 67% decreased risk of incident T2D in a dose–response relation that persisted with adjustment for BMI, Similar associations were observed in women, although the risk reduction was similar in the second and third tertiles, relative to the bottom tertile. In both men and women, MVPA-Acc was marginally associated with reduced risk of incident stage 2 and greater hypertension, but only after adjustment for BMI, whereas MVPA-SR was not associated in either sex.

Conclusions Accelerometer-determined MVPA may provide more consistent risk estimates for incident diabetes than self-reported MVPA.

1Division of Research, Kaiser Permanente, Oakland, CA

2University of Texas, Health Science Center at Houston, School of Public Health in Austin, Austin, TX

3Department of Women’s Health, The University of Texas at Austin, Dell Medical School, Austin, TX

4Department of Health and Human Physiology and Department of Epidemiology, University of Iowa, Iowa City, IA

5Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN

6Department of Preventive Medicine, Northwestern University, Chicago, IL

Address for correspondence: Barbara Sternfeld, Ph.D., Division of Research, Kaiser Permanente 270 Purdue Ave. Kensington, CA 94708; E-mail: bsternfeld@gmail.com.

Submitted for publication March 2019.

Accepted for publication June 2019.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.acsm-msse.org).

Online date: July 6, 2019

© 2019 American College of Sports Medicine