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Financial Strain and Impaired Fasting Glucose: The Moderating Role of Physical Activity in the Coronary Artery Risk Development in Young Adults Study

Puterman, Eli PhD; Adler, Nancy PhD; Matthews, Karen A. PhD; Epel, Elissa PhD

doi: 10.1097/PSY.0b013e3182448d74
Original Articles

Objectives Physical activity and financial strain are independent, and opposite, predictors of disease. This study examines whether physical activity modifies the concurrent and prospective relation between financial strain and impaired fasting glucose.

Methods Participants were part of the Coronary Artery Risk Development in Young Adults study, a prospective study examining the development of disease. Participants were recruited in 1985 to 1986 and followed up for 20 years. The outcome measures were fasting glucose (FG) levels at Years 7 and 20. FG was available at Years 7 and 20 from 3991 and 3500 participants, respectively.

Results The effects of financial strain on elevated glucose levels differed by physical activity levels as indicated by the significant interaction terms for the analyses of covariance at Year 7 (p = .02) and Year 20 (p = .04). Planned contrast comparisons demonstrated that FG levels in financially strained participants who were physically inactive were significantly different from financially strained participants who were active, and all participants with low financial strain. Specifically, in less active participants, the adjusted mean FG levels were higher in financially strained participants (2.27 mg/dL at Year 7 and 5.86 mg/dL at Year 20). In active participants, these differences were −1.78 mg/dL at Year 7 and negligible at Year 20.

Conclusions In adults burdened by financial strain, physical activity is associated with a reduced risk of developing impaired FG up to 13 years later. This adds to a growing literature showing the potential of physical activity to moderate stress-related disease processes.

From the Department of Psychiatry, University of California - San Francisco (E.P., N.A., E.E.), San Francisco, California; and University of Pittsburgh School of Medicine (K.M.), Pittsburgh, Pennsylvania.

Address correspondence and reprint requests to Eli Puterman, PhD, 3333 California St, Suite 465, San Francisco, CA 94118. E-mail:

This study was financially supported by the MacArthur Research Network on Socioeconomic Status and Health.

Received for publication March 16, 2011; revision received October 6, 2011.

Copyright © 2012 by American Psychosomatic Society
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