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

Abstract

Purpose This study describes baseline physical activity (PA) patterns of individuals with type 2 diabetes mellitus enrolled in the multi-center Look AHEAD Study using an objective measure of PA (accelerometry). Methods 2,240 participants (age = 59.0±6.8 years; BMI = 36.5±6.0 kg/m2) with type 2 diabetes mellitus (T2DM) provided data for this sub-study. Participants were instructed to wear an accelerometer during waking hours over 7 days. Accelerometry data were analyzed to identify periods meeting the criteria of ≥3 METs per minute for ≥10 minutes (MVPA) and ≥6 METs per minute for ≥10 minutes (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 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 physical activity examined. Conclusions Results provide information of 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.

Plasma concentrations of trans fatty acids in persons with type 2 diabetes between September 2002 and April 2004

“…Of the 76 participants with missing information, 40 were missing accelerometry data only, 25 were missing FFQ data only, 7 were missing both FFQ and accelerometry data, 3 were missing serum insulin only, and 1 was missing serum insulin and accelerometry data. Reasons for missing accelerometry data included equipment failure, refusal to participate in the accelerometry substudy, scheduling problems, and other reasons (34). Reasons for missing FFQ information included invalid results such as reporting too few foods or inconsistent reporting of types of foods on the FFQ, failure of the participant to complete the FFQ, or other reasons.…”

Sedentary time, breaks in sedentary time and metabolic variables in people with newly diagnosed type 2 diabetes

“…Despite the potential health benefits, people with diabetes generally record low levels of physical activity and fewer meet physical activity recommendations (aerobic exercise of at least moderate intensity on five or more weekdays,) than in the general population [1,[7][8][9]. In the 2003 Behavioural Risk Factor Surveillance Survey only 23% to 37% of people with diabetes met activity guidelines [7] and participants in the Look AHEAD Study recorded less than one bout of moderate to vigorous physical activity (MVPA) per day [8].…”

“…In the 2003 Behavioural Risk Factor Surveillance Survey only 23% to 37% of people with diabetes met activity guidelines [7] and participants in the Look AHEAD Study recorded less than one bout of moderate to vigorous physical activity (MVPA) per day [8]. These relatively low levels of physical activity and the apparent difficulty of increasing and maintaining higher physical activity in people with diabetes suggest that alternative lifestyle strategies for improving metabolic health may be required.…”

Physical activity and cognitive function in bariatric surgery candidates

“…Though not previously examined, another likely contributor to cognitive impairment in adults with severe obesity is low levels of physical activity [16][17][18]. Bariatric surgery patients are often sedentary [19] and numerous studies show regular physical activity reduces risk for dementia [20][21][22][23] and cognitive decline [24].…”