Protective role of physical activity on type 2 diabetes: <scp>A</scp>nalysis of effect modification by race–ethnicity

Boyer, William R.; Churilla, James R.; Ehrlich, Samantha F.; Crouter, Scott E.; Hornbuckle, Lyndsey M.; Fitzhugh, Eugene C.

doi:10.1111/1753-0407.12574

Cited by 17 publications

(15 citation statements)

References 67 publications

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“…(10,11) In terms of ethnological background, several studies reported disparate race/ethnicity-based influences of PA on the prevalence of type 2 diabetes. (14,15) Recent emerging data have suggested that NAFLD is a sexually dimorphic disease with sex-based differences impacting various physiological functions and acting as effect modifiers. (16,17) In addition, there may be significant behavior-related differences in PA between men and women based on rewards and/or motivation associated with PA and sex hormones.…”

Section: Inadequate Physical Activity and Sedentary Behavior Are Independent Predictors Of Nonalcoholic Fatty Liver Disease Donghee Kimmentioning

confidence: 99%

Inadequate Physical Activity and Sedentary Behavior Are Independent Predictors of Nonalcoholic Fatty Liver Disease

Kim

Vazquez‐Montesino

et al. 2020

Hepatology

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Background and Aims In general, physical activity (PA) and nonalcoholic fatty liver disease (NAFLD) have an inverse association. However, studies assessing the impact of the widely accepted Physical Activity Guidelines for Americans (PA Guidelines) on NAFLD are lacking. Approach and Results We performed a serial, cross‐sectional analysis among adults by using the 2007‐2016 US National Health and Nutrition Examination Survey. NAFLD and advanced fibrosis were defined by using various noninvasive panels. A PA questionnaire assessed the leisure‐time PA, occupation‐related PA, transportation‐related PA, and total sitting time as sedentary behavior. PA was categorized according to the PA Guidelines. Of the 24,588 individuals (mean age, 47.4 years; 47.9% males), leisure‐time PA (≥150 minutes per week) demonstrated 40% lower odds of NAFLD, whereas transportation‐related PA was associated with a 33% risk reduction in NAFLD. Analysis of total PA and sitting times simultaneously showed a dose‐response association between sitting time and NAFLD (P for trend < 0.001). Compliance with the PA Guidelines was lower in individuals with NAFLD versus those without NAFLD. The trends in compliance with the PA Guidelines for any type of PA remained stable in individuals with NAFLD except for a downtrend in transportation‐related PA. In contrast, an improvement in compliance with the PA Guidelines for leisure time was noted in the cohort without NAFLD. Although PA demonstrated a 10% stronger association with risk reduction of NAFLD in women, women showed a lower tendency of meeting the PA Guidelines. Trends in total sitting time increased significantly regardless of NAFLD status. Conclusions Sedentary behavior emerged as an independent predictor of NAFLD. Overall compliance with the PA Guidelines was lower in the cohort with NAFLD, with sex‐ and ethnicity‐based differences. Implementation of these observations in clinical practice may improve our understanding as well as clinical outcomes.

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Section: Inadequate Physical Activity and Sedentary Behavior Are Independent Predictors Of Nonalcoholic Fatty Liver Disease Donghee Kimmentioning

confidence: 99%

Inadequate Physical Activity and Sedentary Behavior Are Independent Predictors of Nonalcoholic Fatty Liver Disease

Kim

Vazquez‐Montesino

et al. 2020

Hepatology

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“…The authors found only three studies investigating the effect of occupational PA (OPA) on diabetes risk, all of which reported varying results (3). Further, meta-analyses and narrative reviews suggest differential effects of PA on diabetes prevalence by race/ethnicity, indicating that most racial/ethnic groups benefit from PA, except among non-Latino blacks, where no significant protective effect has been observed (8,9).…”

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confidence: 99%

Diabetes Prevalence by Leisure-, Transportation-, and Occupation-Based Physical Activity Among Racially/Ethnically Diverse U.S. Adults

et al. 2019

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Leisure-time physical activity (LTPA) has been shown to prevent or delay the development of diabetes. However, little research exists examining how other domains of PA (e.g., occupation based [OPA] and transportation based [TPA]) are associated with diabetes prevalence across diverse racial/ethnic groups. We examined associations between OPA, TPA, and LTPA and diabetes prevalence and whether associations differed by race/ethnicity. RESEARCH DESIGN AND METHODS Participants in the 2011-2016 National Health and Nutrition Examination Survey (NHANES) self-reported domain-specific PA. Diabetes status was determined by self-reported doctor/health professional-diagnosis of diabetes or a glycosylated hemoglobin (HbA 1c) measurement of ‡6.5% (48 mmol/mol). Multivariable log binomial models examined differences in diabetes prevalence by PA level in each domain and total PA among Latinos (n = 3,931), non-Latino whites (n = 6,079), and non-Latino blacks (n = 3,659). RESULTS Whites reported the highest prevalence of achieving PA guidelines (64.9%), followed by Latinos (61.6%) and non-Latino blacks (60.9%; P < 0.0009). Participants achieving PA guidelines were 19-32% less likely to have diabetes depending on PA domain in adjusted models. Diabetes prevalence was consistently higher among non-Latino blacks (17.1%) and Latinos (14.1%) compared with non-Latino whites (10.7%; P < 0.0001), but interaction results showed the protective effect of PA was similar across PA domain and race/ethnicitydexcept within TPA, where the protective effect was 4% greater among non-Latino whites compared with Latinos (adjusted difference in risk differences 0.04, P = 0.01). CONCLUSIONS PA policies and programs, beyond LTPA, can be leveraged to reduce diabetes prevalence among all population groups. Future studies are needed to confirm potentially differential effects of transportation-based active living on diabetes prevalence across race/ethnicity.

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“…It is known that a dose-response relationship exists between PA and morbidity and mortality, with greater volumes of PA being strongly associated with a reduced risk of morbidity and mortality. However, evidence suggests that similar doses of PA may elicit different magnitudes of morbidity and mortality risk reduction dependent upon race-ethnic identity [8][9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that consistent participation in physical activity (PA) plays an important role in reducing risk for mortality, and cardiovascular and metabolic diseases, as well as improving CMRF profiles [7]. However, multiple studies [8][9][10][11][12][13][14] have suggested that the dose of PA needed to significantly reduce morbidity and mortality risk may vary depending upon racial/ethnic identity. For example, two recent studies by Boyer et al [11,14] found that participating in similar volumes of aerobic PA significantly decreased allcause and diabetes-related mortality risk among non-Hispanic whites (NHW) and non-Hispanic blacks (NHB) but not Mexican Americans (MA).…”

Section: Introductionmentioning

confidence: 99%

Accelerometer-Measured Physical Activity and Cardiometabolic Risk Factors by Race-Ethnicity: 2003–2006 NHANES

Boyer

Bassett

Fitzhugh

et al. 2021

J. Racial and Ethnic Health Disparities

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Previous studies suggest that the magnitude of morbidity/mortality reduction may differ between race-ethnic groups despite equated dose of physical activity (PA). The purpose of this study was to compare the potential racial-ethnic differences in cardiometabolic risk factors (CMRF) across quartiles of accelerometer-derived total activity counts/day (TAC/d) among US adults. The final sample (n=4144) included adults who participated in the 2003-2006 National Health and Nutrition Examination Survey (NHANES). CMRF included fasting glucose (FG), fasting insulin (FI), HOMA-IR, resting systolic (SBP) and diastolic blood pressure (DBP), waist circumference (WC), BMI, CRP, HDL-C, LDL-C, and triglycerides. Race-ethnic groups examined included non-Hispanic white (NHW), non-Hispanic black (NHB), and Mexican American (MA). In the highest quartile, NHW had significantly lower values of HOMA-IR, FI, SBP, BMI, WC, and HDL-C when compared to NHB. Compared to MA in the highest quartile, NHW had significantly lower values of HOMA-IR, FI, BMI, and triglycerides. Significant race-ethnic differences were found for several CMRF, especially among those who were in the top quartile of PA (e.g., the most active adults). It is probable that the protective effect of higher volumes of PA on CMRF is moderated by other non-PA factors distinct to NHB and MA.

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Protective role of physical activity on type 2 diabetes: Analysis of effect modification by race–ethnicity

Cited by 17 publications

References 67 publications

Inadequate Physical Activity and Sedentary Behavior Are Independent Predictors of Nonalcoholic Fatty Liver Disease

Inadequate Physical Activity and Sedentary Behavior Are Independent Predictors of Nonalcoholic Fatty Liver Disease

Diabetes Prevalence by Leisure-, Transportation-, and Occupation-Based Physical Activity Among Racially/Ethnically Diverse U.S. Adults

Accelerometer-Measured Physical Activity and Cardiometabolic Risk Factors by Race-Ethnicity: 2003–2006 NHANES

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