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Lifestyle risk behaviors among stroke survivors with and without diabetes

Bailey, Ryan R. PhD, OTR/La; Phad, Allison MPHa; McGrath, Ryan PhDb; Ford, Andria L. MDc; Tabak, Rachel PhD, RDa; Haire-Joshu, Debra PhDa

American Journal of Physical Medicine & Rehabilitation: June 11, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/PHM.0000000000001194
Research Article: PDF Only

Objective History of stroke and diabetes increase risk for cardiometabolic disease, which can be mitigated through lifestyle management. To evaluate lifestyle risk behaviors among stroke survivors, we compared the prevalence of three lifestyle risk behaviors—physical inactivity, consuming ≤1 fruit and ≤1 vegetable daily, and overweight/obesity—between stroke survivors with and without diabetes.

Design Data from the 2013 and 2015 Behavioral Risk Factor Surveillance System (BRFSS) were examined. Weighted and age-adjusted prevalence estimates, and crude and adjusted odds ratios (adjusted for sociodemographic characteristics), were calculated to compare lifestyle risk behaviors between U.S. stroke survivors with and without diabetes.

Results Prevalence and adjusted odds ratios (AOR) for lifestyle risk behaviors were higher in participants with diabetes compared to those without diabetes for consuming ≤1 fruit and ≤1 vegetable daily (58.8% vs. 53.7%, AOR:1.14), physical inactivity (65.7% vs. 54.6%, AOR: 1.41), and overweight/obesity (87.2% vs. 63.1%, AOR: 2.42).

Conclusion Prevalence of select lifestyle risk behaviors exceeds 50% in adults with stroke, but are higher in adults with diabetes compared to adults without diabetes. Effective interventions, community programs, and healthcare policy are needed to promote lifestyle management in adults with stroke, particularly among those with diabetes.

aWashington University in St. Louis, Brown School of Social Work;

bNorth Dakota State University, Department of Health, Nutrition, and Exercise Sciences;

cWashington University School of Medicine in St. Louis, Department of Neurology.

CORRESPONDENCE: Ryan Bailey, PhD, OTR/L; Campus Box 1196, One Brookings Drive, St. Louis MO, 63110; Phone: 314-935-3073; Fax: (314) 935-4859; Email:

AUTHOR DISCLOSURES: The authors report no conflicts of interest. This work was supported by the National Institutes of Health under Grant P30DK092950 and Grant 5T32HL130357-02. The contents of this work are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. The authors report no financial benefit to the authors from this study. At the time of submission, this work has not been previously presented in any form.

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