Objectively Measured Physical Activity and the Subsequent Risk of Incident Dysglycemia

Ponsonby, Anne–Louise; Ukoumunne, Obioha C; Pezic, Angela; Venn, Alison; Shaw, Jonathan E.; Dunstan, David W.; Barr, Elizabeth L.M.; Blair, Steven N.; Cochrane, Jenny; Zimmet, Paul; Dwyer, Terence

doi:10.2337/dc10-2386

Cited by 46 publications

(46 citation statements)

References 24 publications

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“…Some researchers have suggested only a small increase in daily steps is enough to improve outcomes like body weight (Hill, 2005). In support of this notion, recent observational data suggests increasing daily steps by as little as 1,000-2,500 steps/day from a baseline similar to that reported in the current study might be enough to prevent dysglycemia and other cardiometabolic related outcomes (Dwyer et al, 2011;Ponsonby et al, 2011). However, other research has suggested glycemia is not meaningfully influenced by previous levels of physical activity among a large sample of individuals at increased risk for diabetes with an estimated steps/day count of approximately 6,500 (Yates et al, 2015).…”

Section: Discussionsupporting

confidence: 65%

Walking and type 2 diabetes risk using CANRISK scores among older adults

Johnson

Eurich

Lytvyak

et al. 2017

Appl. Physiol. Nutr. Metab.

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The objective of this study was to determine the association between pedometer-assessed steps and type 2 diabetes risk using the Public Health Agency of Canada-developed 16-item Canadian Diabetes Risk Questionnaire (CANRISK) among a large population-based sample of older adults across Alberta, Canada. To achieve our study objective, adults without type 2 diabetes (N = 689) aged 55 years and older provided demographic data and CANRISK scores through computer-assisted telephone interviews between September and November 2012. Respondents also wore a step pedometer over 3 consecutive days to estimate average daily steps. Logistic regression was used to assess the association between achieving 7500 steps/day and risk of diabetes (low vs. moderate and high). Overall, 41% were male, average age was 63.4 (SD 5.5) years, body mass index was 26.7 (SD 5.0) kg/m, and participants averaged 5671 (SD 3529) steps/day. All respondents indicated they were capable of walking for at least 10 min unassisted. CANRISK scores ranged from 13-60, with 18% in the low-risk category (<21). After adjustment, those not achieving 7500 steps/day (n = 507) were more than twice as likely to belong to the higher risk categories for type 2 diabetes compared with those walking ≥7500 steps/day (n = 182) (73.6% vs. 26.4%; odds ratio: 2.37; 95% confidence interval: 1.58 - 3.57). Among older adults without diabetes, daily steps were strongly and inversely associated with diabetes risk using the CANRISK score. Walking remains an important modifiable risk factor target for type 2 diabetes and achieving at least 7500 steps/day may be a reasonable target for older adults.

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Section: Discussionsupporting

confidence: 65%

Walking and type 2 diabetes risk using CANRISK scores among older adults

Johnson

Eurich

Lytvyak

et al. 2017

Appl. Physiol. Nutr. Metab.

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“…The Tasped cohort was developed by pooling three pre-existing cohort studies based on Tasmanian adults–the Australian Diabetes Obesity and Lifestyle (AUSDIAB) study, [ 21 , 22 ] the Tasmanian Older Adult Cohort (TASOAC) study [ 23 ] and the Tasmanian Study of Cognition and Gait (TASCOG) study. [ 24 ] The Tasped cohort participants were linked to the National Death Index, compiled by the Australian Institute of Health and Welfare for all Australian deaths, to determine mortality up to June 2011.…”

Section: Methodsmentioning

confidence: 99%

“…The summary PA measure for each period was the average daily number of steps over two consecutive days where at least one was a weekday. We have previously established this measure of daily steps is inversely and prospectively associated with hypertension (AOR 0.87 (95% CI 0.77–0.97)) [ 22 ] and insulin sensitivity and adiposity in free-living adults. [ 21 ]…”

Section: Methodsmentioning

confidence: 99%

Objectively Measured Daily Steps and Subsequent Long Term All-Cause Mortality: The Tasped Prospective Cohort Study

et al. 2015

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BackgroundSelf–reported physical activity has been inversely associated with mortality but the effect of objectively measured step activity on mortality has never been evaluated. The objective is to determine the prospective association of daily step activity on mortality among free-living adults.Methods and FindingsCohort study of free-living adults residing in Tasmania, Australia between 2000 and 2005 who participated in one of three cohort studies (n = 2 576 total participants). Daily step activity by pedometer at baseline at a mean of 58.8 years of age, and for a subset, repeated monitoring was available 3.7 (SD 1.3) years later (n = 1 679). All-cause mortality (n = 219 deaths) was ascertained by record-linkage to the Australian National Death Index; 90% of participants were followed-up over ten years, until June 2011. Higher daily step count at baseline was linearly associated with lower all-cause mortality (adjusted hazard ratio AHR, 0.94; 95% CI, 0.90 to 0.98 per 1 000 steps; P = 0.004). Risk was altered little by removing deaths occurring in the first two years. Increasing baseline daily steps from sedentary to 10 000 steps a day was associated with a 46% (95% CI, 18% to 65%; P = 0.004) lower risk of mortality in the decade of follow-up. In addition, those who increased their daily steps over the monitoring period had a substantial reduction in mortality risk, after adjusting for baseline daily step count (AHR, 0.39; 95% CI, 0.22 to 0.72; P = 0.002), or other factors (AHR, 0.38; 95% CI, 0.21–0.70; P = 0.002).ConclusionsHigher daily step count was linearly associated with subsequent long term mortality among free living adults. These data are the first to quantify mortality reductions using an objective measure of physical activity in a free living population. They strongly underscore the importance of physical inactivity as a major public health problem.

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“…In order to detect a difference in daily steps, both groups were calculated to need 25 participants when using a one‐sided test with a power of 80% and an alpha level of 0·05. We decided to also conservatively include 25 participants in the DM group as reported daily steps in patients with diabetes were 10 500 ± 4000 . Thus, 75 participants were required.…”

Section: Methodsmentioning

confidence: 99%

Differences in the daily activity of patients with diabetic foot ulcers compared to controls in their free‐living environments

Sheahan

Canning

Refausse

et al. 2017

International Wound Journal

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The aims of our study were to investigate multiple daily activity outcomes in patients with diabetic foot ulcers (DFU) compared to diabetic peripheral neuropathy (DPN) and diabetes (DM) controls in their free-living environments. We examined daily activity outcomes of 30 patients with DFU, 23 DPN and 20 DM. All patients wore a validated multi-sensor device for > 5 days (>22 hours per day) to measure their daily activity outcomes: steps, energy expenditure (kJ), average metabolic equivalent tasks (METs), physical activity (>3·0 METs) duration and energy expenditure, lying duration, sleep duration and sleep quality. We found that DFU patients recorded fewer median (interquartile ranges, IQR) daily steps [2154 (1621-4324)] than DPN [3660 (2742-7705)] and DM [5102 (4011-7408)] controls (P < 0·05). In contrast, DFU patients recorded more mean ± SD daily energy expenditure (kJ) (13 006 ± 3559) than DPN (11 085 ± 1876) and DM (11 491 ± 1559) controls (P < 0·05). We found no other differences in daily activity outcomes (P > 0·1). We conclude that DFU patients typically take fewer steps but expend more energy during their normal daily activity than DPN and DM controls. We hypothesise that the increased energy expenditure for DFU patients may be due to wound healing or an inefficient gait strategy. Further investigations into this energy imbalance in DFU patients may improve healing in future.

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Objectively Measured Physical Activity and the Subsequent Risk of Incident Dysglycemia

Cited by 46 publications

References 24 publications

Walking and type 2 diabetes risk using CANRISK scores among older adults

Walking and type 2 diabetes risk using CANRISK scores among older adults

Objectively Measured Daily Steps and Subsequent Long Term All-Cause Mortality: The Tasped Prospective Cohort Study

Differences in the daily activity of patients with diabetic foot ulcers compared to controls in their free‐living environments

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