Display options
Share it on

BMJ Open Diabetes Res Care. 2016 Jun 23;4(1):e000185. doi: 10.1136/bmjdrc-2015-000185. eCollection 2016.

Physical activity, sedentary behaviors and the incidence of type 2 diabetes mellitus: the Multi-Ethnic Study of Atherosclerosis (MESA).

BMJ open diabetes research & care

Joshua J Joseph, Justin B Echouffo-Tcheugui, Sherita H Golden, Haiying Chen, Nancy Swords Jenny, Mercedes R Carnethon, David Jacobs, Gregory L Burke, Dhananjay Vaidya, Pamela Ouyang, Alain G Bertoni

Affiliations

  1. Johns Hopkins University School of Medicine , Baltimore, Maryland , USA.
  2. Rollins School of Public Health, Emory University, Atlanta, Georgia, USA; Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
  3. Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA; Department of Biostatistical Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA.
  4. Department of Pathology and Laboratory Medicine , University of Vermont College of Medicine , Burlington, Vermont , USA.
  5. Department of Preventive Medicine , Feinberg School of Medicine, Northwestern University , Chicago, Illinois , USA.
  6. Division of Epidemiology and Community Health , School of Public Health, University of Minnesota , Minneapolis, Minnesota , USA.
  7. Division of Public Health Sciences , Wake Forest University Health Sciences , Winston-Salem, North Carolina , USA.

PMID: 27403323 PMCID: PMC4932325 DOI: 10.1136/bmjdrc-2015-000185

Abstract

BACKGROUND: The association between physical activity (PA), sedentary behavior, and incident diabetes has been assessed in whites but is less well investigated in multiethnic populations.

OBJECTIVE: To assess the association between PA, sedentary behavior, and incident diabetes in the Multi-Ethnic Study of Atherosclerosis.

RESEARCH DESIGN AND METHODS: Incident diabetes was assessed among adults without prevalent baseline diabetes (2000-2002) at 5 in-person examinations between 2002 and 2012. Baseline PA (moderate, vigorous, and exercise-specific; metabolic equivalents of task-hours/week) and sedentary behaviors (television watching, reading; hours/day) were assessed by questionnaire. HRs were estimated using Cox proportional hazard models.

RESULTS: Among 5829 adults (mean age 61.8 years, 54% female, 42% white, 12% Chinese-American, 26% African-American, 21% Hispanic-American), there were 655 incident diabetes cases (median follow-up 11.1 years). After adjustment, diabetes risk was lower in those with brisk or striding compared with none or casual walking pace (HR 0.67; 95% CI 0.54 to 0.84), higher levels of exercise PA (HR for highest vs lowest quartile 0.79; 95% CI 0.63 to 0.98), and any compared with no vigorous PA (HR 0.79; 95% CI 0.66 to 0.95). Race/ethnicity influenced the association of walking pace, exercise PA, and any vigorous PA on diabetes risk, which was only significant among whites. Total leisure sedentary behaviors (HR for highest vs lowest quartile 1.65; 95% CI 1.26 to 2.14) and television watching (HR for highest vs lowest quartile 2.68; 95% CI 1.38 to 5.21) were significantly associated with diabetes risk in multiethnic analyses and were influenced by race/ethnicity.

CONCLUSIONS: These results confirm the importance of PA and sedentary behavior on diabetes risk in a multiethnic population and demonstrate potential variations across race/ethnic groups.

Keywords: Physical Activity Epidemiology; Racial Differences; Sedentary Behaviors; Type 2 Diabetes

References

  1. Lancet Diabetes Endocrinol. 2015 Nov;3(11):866-75 - PubMed
  2. Diabetes Care. 2007 Oct;30(10):2517-22 - PubMed
  3. Diabetes Care. 1997 Apr;20(4):537-44 - PubMed
  4. BMJ Open. 2015 Jul 23;5(7):e006181 - PubMed
  5. Diabetologia. 2015 Jun;58(6):1198-202 - PubMed
  6. Metabolism. 2006 Oct;55(10):1358-64 - PubMed
  7. BMC Public Health. 2007 Aug 17;7:212 - PubMed
  8. Am J Epidemiol. 2015 Jan 1;181(1):32-9 - PubMed
  9. Diabetes Care. 2005 Jan;28(1):108-14 - PubMed
  10. JAMA. 1999 Oct 20;282(15):1433-9 - PubMed
  11. Med Sci Sports Exerc. 2008 Jan;40(1):181-8 - PubMed
  12. Diabetes. 1996 Jun;45(6):742-8 - PubMed
  13. Am J Epidemiol. 2009 Feb 15;169(4):444-54 - PubMed
  14. Am J Prev Med. 2000 Jan;18(1):46-53 - PubMed
  15. N Engl J Med. 2006 Jul 20;355(3):241-50 - PubMed
  16. Am J Public Health. 2010 Apr 1;100 Suppl 1:S263-8 - PubMed
  17. Diabetes. 2012 May;61(5):1291-6 - PubMed
  18. Arch Intern Med. 2009 Apr 27;169(8):798-807 - PubMed
  19. Am J Physiol Endocrinol Metab. 2002 Oct;283(4):E799-808 - PubMed
  20. Cytokine. 2005 Apr 7;30(1):14-21 - PubMed
  21. JAMA. 2015 Sep 8;314(10):1021-9 - PubMed
  22. JAMA. 2003 Apr 9;289(14):1785-91 - PubMed
  23. Prev Med. 2014 Jun;63:58-62 - PubMed
  24. Int J Behav Nutr Phys Act. 2009 Jun 03;6:31 - PubMed
  25. Mayo Clin Proc. 2010 Dec;85(12):1138-41 - PubMed
  26. Diabetes Care. 2010 Jan;33 Suppl 1:S62-9 - PubMed
  27. Ethn Dis. 2015 Winter;25(1):31-7 - PubMed
  28. Am J Epidemiol. 2002 Nov 1;156(9):871-81 - PubMed
  29. Circulation. 2010 Feb 2;121(4):586-613 - PubMed
  30. J Appl Physiol (1985). 2005 Apr;98(4):1154-62 - PubMed
  31. Am J Epidemiol. 2009 Feb 15;169(4):428-34 - PubMed
  32. Diabetes Care. 2012 May;35(5):976-83 - PubMed
  33. Ann Epidemiol. 2009 May;19(5):351-7 - PubMed
  34. Diabetes Care. 2013 Aug;36(8):2430-9 - PubMed
  35. Am J Prev Med. 2012 Jan;42(1):8-13 - PubMed
  36. Neuropsychopharmacology. 2000 Feb;22(2):108-24 - PubMed
  37. N Engl J Med. 2004 Feb 12;350(7):664-71 - PubMed
  38. Ann Intern Med. 2015 Apr 21;162(8):542-8 - PubMed
  39. J Clin Endocrinol Metab. 2012 Mar;97(3):1032-40 - PubMed
  40. MMWR Morb Mortal Wkly Rep. 2007 Apr 6;56(13):301-4 - PubMed
  41. Diabetes Care. 2008 Apr;31(4):661-6 - PubMed
  42. Diabetes Care. 2007 Mar;30(3):744-52 - PubMed
  43. Diabetes. 2002 Oct;51(10):2944-50 - PubMed
  44. Diabetes. 2009 Jun;58(6):1411-8 - PubMed
  45. Res Nurs Health. 2005 Aug;28(4):306-15 - PubMed
  46. N Engl J Med. 2001 May 3;344(18):1343-50 - PubMed
  47. Diabetes Care. 2015 Sep;38(9):1694-700 - PubMed
  48. Arch Intern Med. 2001 Jun 25;161(12):1542-8 - PubMed
  49. Clin Chem. 1995 Feb;41(2):264-70 - PubMed
  50. Prev Med. 2015 Jan;70:50-8 - PubMed
  51. JAMA. 2001 Jul 18;286(3):327-34 - PubMed
  52. Diabetes Care. 2006 Sep;29(9):2102-7 - PubMed
  53. N Engl J Med. 2002 Feb 7;346(6):393-403 - PubMed
  54. BMC Geriatr. 2009 Nov 19;9:49 - PubMed
  55. Stroke. 2013 Jul;44(7):1909-14 - PubMed
  56. Curr Opin Endocrinol Diabetes Obes. 2014 Apr;21(2):109-20 - PubMed
  57. Vasc Health Risk Manag. 2011;7:541-50 - PubMed
  58. Diabetes Care. 2015 Apr;38(4):596-603 - PubMed
  59. Diabetes Care. 2003 Mar;26(3):944-5 - PubMed
  60. PLoS One. 2011 Feb 22;6(2):e16987 - PubMed
  61. J Clin Endocrinol Metab. 2009 Feb;94(2):449-55 - PubMed
  62. Lancet. 2009 Nov 14;374(9702):1677-86 - PubMed
  63. J Appl Physiol (1985). 2013 May 15;114(10):1375-82 - PubMed
  64. Diabetologia. 1985 Jul;28(7):412-9 - PubMed
  65. Diabetes Care. 2010 Dec;33(12):e147-67 - PubMed

Publication Types

Grant support