The association between physical activity and diabetes among obese US adults: NHANES 2017-2020
Abstract
Introduction and Objective. Diabetes is a pressing public health concern in the United States, with an estimated 38 million cases, primarily Type 2 Diabetes Mellitus (T2DM). Obesity stands out as a leading risk factor for T2DM, necessitating exploration of modifiable factors like physical activity to inform prevention strategies. This study aimed to investigate the association between physical activity and diabetes prevalence among U.S. adults aged >20 with a Body Mass Index (BMI) of 30 or higher. Methods. This cross-sectional analysis utilized NHANES data spanning 2017 to 2020, with approximately 5,000 participants annually, providing a nationally representative sample. Eligible participants were adults >20 years with a BMI >30, excluding pregnant women and those with missing outcome or independent variable data. Physical activity levels were assessed through self-reported questionnaires and categorized based on metabolic equivalents-minutes (MET-minutes). Diabetes prevalence was determined using diagnostic criteria such as self-report, fasting blood glucose levels, or glycohemoglobin levels. Descriptive, bivariate, and multivariable analyses were employed to characterize the sample, explore associations, and adjust for potential confounders. Multiple regression models yielded adjusted odds ratios (aORs), 95% confidence intervals, and p-values. Results. In the unadjusted model, individuals with no physical activity had a significantly higher likelihood of diabetes (OR: 1.81, 95% CI: 1.33-2.46, p = 0.001) compared to those with ≥600 MET-minutes/week. However, upon adjusting for demographic and socioeconomic factors, including gender, age, race, marital status, education, family poverty income ratio, healthcare insurance, and sedentary time, this association lost statistical significance (adjusted OR: 1.20, 95% CI: 0.85-1.70, p = 0.281). Conclusions-Implications. Our findings suggest no significant association between physical activity and diabetes prevalence among obese U.S. adults in the adjusted model. This finding is explained in part by the multifactorial nature of diabetes and in part by the cross-sectional nature of this study, in which obese patients with diabetes might have increased their activity levels as part of the treatment of diabetes, biasing the results towards no association. Longitudinal studies are needed to clarify the role of activity on diabetes incidence among obese adults.
Keywords
Type 2 Diabetes Mellitus, Diabetes, Obesity, Physical Activity, Epidemiology
Presentation Type
Poster Presentation
The association between physical activity and diabetes among obese US adults: NHANES 2017-2020
Introduction and Objective. Diabetes is a pressing public health concern in the United States, with an estimated 38 million cases, primarily Type 2 Diabetes Mellitus (T2DM). Obesity stands out as a leading risk factor for T2DM, necessitating exploration of modifiable factors like physical activity to inform prevention strategies. This study aimed to investigate the association between physical activity and diabetes prevalence among U.S. adults aged >20 with a Body Mass Index (BMI) of 30 or higher. Methods. This cross-sectional analysis utilized NHANES data spanning 2017 to 2020, with approximately 5,000 participants annually, providing a nationally representative sample. Eligible participants were adults >20 years with a BMI >30, excluding pregnant women and those with missing outcome or independent variable data. Physical activity levels were assessed through self-reported questionnaires and categorized based on metabolic equivalents-minutes (MET-minutes). Diabetes prevalence was determined using diagnostic criteria such as self-report, fasting blood glucose levels, or glycohemoglobin levels. Descriptive, bivariate, and multivariable analyses were employed to characterize the sample, explore associations, and adjust for potential confounders. Multiple regression models yielded adjusted odds ratios (aORs), 95% confidence intervals, and p-values. Results. In the unadjusted model, individuals with no physical activity had a significantly higher likelihood of diabetes (OR: 1.81, 95% CI: 1.33-2.46, p = 0.001) compared to those with ≥600 MET-minutes/week. However, upon adjusting for demographic and socioeconomic factors, including gender, age, race, marital status, education, family poverty income ratio, healthcare insurance, and sedentary time, this association lost statistical significance (adjusted OR: 1.20, 95% CI: 0.85-1.70, p = 0.281). Conclusions-Implications. Our findings suggest no significant association between physical activity and diabetes prevalence among obese U.S. adults in the adjusted model. This finding is explained in part by the multifactorial nature of diabetes and in part by the cross-sectional nature of this study, in which obese patients with diabetes might have increased their activity levels as part of the treatment of diabetes, biasing the results towards no association. Longitudinal studies are needed to clarify the role of activity on diabetes incidence among obese adults.