Purpose We sought to describe leisure-time, aerobic, and muscle strengthening physical activity (PA) patterns in U.S. Asian Indians, in comparison to other races/ethnicities. Design, Setting, and Sample We utilized the 2011–2018 National Health Interview Surveys, a set of cross-sectional, nationally representative surveys of the U.S. noninstitutionalized population. Our study population included 257 652 adults who answered PA questions. Measures PA was classified per 2008 U.S. guidelines and continuously per estimated metabolic equivalents (METs). Race was classified into White, Black, Asian Indian, Other Asian, and American Indian/Alaskan Native/Multiracial. Analysis We used survey design-adjusted, multivariable logistic regression to determine odds of sufficient and highly active physical activity levels, adjusting for predisposing, enabling, need, and health care service factors as guided by the Anderson Model. We also used linear regression to determine racial differences in average MET-minutes/week. Analysis was additionally stratified by comorbidity status. Results While Asian Indians (N = 3049) demonstrated similar odds of sufficient aerobic PA as Whites (aOR [95% CI]: .97 [.88,1.07]), Asian Indians had 22% lower odds of meeting highly active aerobic PA levels (.78 [.71,0.87]) and 18% lower odds of meeting sufficient muscle strengthening PA levels (.82 [.73,0.91]). This translated to an average 172 (95% CI: 45 300) fewer MET-minutes. Furthermore, this decrease in MET-minutes/week was especially apparent in those without hypertension (β[95% CI]: −164 [-314,-15]) without diabetes (−185 [-319,-52]), and low/normal BMI (−422 [-623,-222]). Conclusion Asian Indians, especially those without comorbidities, are less likely to engage in high-intensity physical activity than Whites.
Background: Physical activity (PA) is a key lifestyle recommendation for diabetes mellitus (DM) prevention and management. The purpose of this study was to describe the patterns of leisure-time, aerobic & muscle-strengthening PAs across races/ethnicities and DM status. Methods: We included 91,386 adults ≥18 years from the 2011–2018 National Health Interview Surveys who were able to participate in light-moderate PA. Aerobic PA was classified per 2008 guidelines as inactive (0 minutes/week [min/wk] of moderate or vigorous activity), insufficiently active (0–150 moderate-equivalent min/wk, defined as sum of moderate-level and 2*vigorous-level PA), sufficiently active (150–300 moderate-equivalent min/wk), and highly active (>300 min/wk of moderate-level PA, >150 min/wk of vigorous-level PA, or >300 moderate-equivalent min/wk). We also classified aerobic PA continuously in terms of metabolic equivalents (METs; 4 METs for moderate and 8 METs for vigorous PA). Muscle-strengthening PA was dichotomized into ≥3 times/wk (adequate) and <3 times/wk (inadequate). Race/ethnicity was categorized as non-Hispanic White (NHW), non-Hispanic Black (NHB), Asian Indian (AI), Other Asian (OA), and Hispanic/Other (H/O). We used self-reported DM-stratified multivariable logistic and linear regression to assess racial/ethnic differences in PA. All analyses accounted for the survey design and weights to obtain nationally representative estimates. Results: Among the 91,386 participants, 45,676 (53%) were male, 11,835 (10%) were ≥65 years, and 5,106 (5.2%) had DM. Asian groups had lower adequate muscle-strengthening PA than others (%[SE]: NHW, 35[0.3]%; NHB, 35[0.7]%; AI, 27[1.6]%; OA, 30[1.3]%; H/O, 34[0.8]%; p<0.0001). AIs also had a lower proportion of ‘highly active’ individuals (%[SE]: NHW, 67[0.2]%; NHB, 65[0.7]%; AI, 57[1.8]%; OA, 61[1.5]%; H/O, 67[0.8]%; p<0.0001). Non-DM AIs had mean (SE) 622 (133) lower METs than NHWs (covariate adjusted mean METs [SE]: NHW, 3,568 [305]; NHB, 3,873 [309]; AI, 2,946 [333]; OA, 3,107 [321]; H/O, 3,736 [325]; p<0.001). This difference was also present in those with DM (adjusted mean METs [SE]: NHW, 2,231 [314]; NHB, 2,231 [379]; AI, 1,366 [456]; OA, 1,847 [495]; H/O, 2,454 [401]; p=0.013). Non-DM AIs and OAs had ~30% lower odds of being at least ‘sufficiently active’ relative to NHWs (aOR [95% CI]: AI, 0.70 [0.56, 0.87]; OA, 0.72 [0.61, 0.85]). All races/ethnicities had lower odds of adequate muscle-strengthening PA compared to NHWs (aOR [95% CI]: NHB, 0.94 [0.90, 0.99]; AI, 0.68 [0.60, 0.79]; OA, 0.75 [0.68, 0.84]; H/O, 0.73 [0.69, 0.77]). These inverse associations persisted in DM-diagnosed OAs, but not AIs. Conclusion: Among those with and without DM, there exist racial/ethnic differences in strength-related and aerobic activities. Asian groups may benefit from aggressive counseling and PA interventions to both prevent and manage DM.
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