Abstract
BackgroundThere is strong evidence for the beneficial effects of physical activity in diabetes. There has been little research demonstrating a dose-response relationship between physical activity and self-rated health in diabetics. The aim of this study was to explore the dose-response association between leisure time physical activity and self-rated health among diabetics in Taiwan.MethodsData came from the 2001 Taiwan National Health Interview Survey (NHIS). Inclusion criteria were a physician confirmed diagnosis of diabetes mellitus and age 18 years and above (n = 797). Self-rated health was assessed by the question "In general, would you say that your health is excellent, very good, good, fair, or poor?" Individuals with a self perceived health status of good, very good, or excellent were considered to have positive health status.ResultsIn the full model, the odds ratio (OR) for positive health was 2.51(95% CI = 1.53-4.13), 1.62(95% CI = 0.93-2.84), and 1.35(95% CI = 0.77-2.37), for those with a total weekly energy expenditure of ≥ 1000 kcal, between 500 and 999 kcal, and between 1 and 499 kcal, respectively, compared to inactive individuals. Those with duration over 10 years (OR = 0.53, 95%CI = 0.30-0.94), heart disease (OR = 0.50, 95%CI = 0.30-0.85), and dyslipidemia (OR = 0.65, 95% CI = 0.43-0.98) were less likely to have positive health than their counterparts. After stratified participants by duration, those with a duration of diabetes < 6 years, the adjusted OR for positive health was 1.95(95% CI = 1.02-3.72), 1.22(95% CI = 0.59-2.52), and 1.19(95% CI = 0.58-2.41) for those with a total weekly energy expenditure of ≥ 1000 kcal, between 500 and 999 kcal, and between 1 and 499 kcal, respectively, compared to inactive individuals. In participants with a duration of diabetes ≥ 6 years, total energy expenditure showed a gradient effect on self-perceived positive health. The adjusted OR for positive health was 3.45(95% CI = 1.53-7.79), 2.77(95% CI = 1.11-6.92), and 1.90(95% CI = 0.73-4.94) for those with a total weekly energy expenditure of ≥ 1000 kcal, between 500 and 999 kcal, and between 1 and 499 kcal, respectively, compared to inactive individuals.ConclusionsOur results highlight that regular leisure activity with an energy expenditure ≧ 500 kcal per week is associated with better self-rated health for those with longstanding diabetes.
Highlights
There is strong evidence for the beneficial effects of physical activity in diabetes
Positive health status was significantly associated with years of education ^ 7 years (OR = 3.22; 95% confidence intervals (CI) = 1.96 5.29), reported leisure activity with a total energy expenditure of ^ 1000 kcal per week (OR = 2.89; 95% CI = 1.87 4.47), and a total energy expenditure of between 500 and 999 kcal per week (OR = 1.81; 95% CI = 1.09 - 2.98)
After adjustment for age, sex, and education, we found that positive health status was significantly less likely to be reported by those with a duration of diabetes of ^ 10 years, and/or comorbidities such as heart disease and dyslipidemia (Model 1)
Summary
There is strong evidence for the beneficial effects of physical activity in diabetes. Maddigan et al recently used population-based data from the Canadian Community Health Survey Cycle (2000-2001) to show that the comorbidities of stroke and depression had the largest impact on health, and health behaviours such as physical activity were an important determinant of health for people with type 2 diabetes [12] Another recent study of a nationally representative sample of U.S adults with diabetes aged ^18 years demonstrated that undertaking moderate physical activity for ^ 30 min on ^ 5 days or vigorous physical activity for ^ 20 min on ^ 3 days per week was significantly associated with better self-rated general health [13]. For people with diabetes it remains unclear whether taking up physical activity has an independent effect on the way they assess their health, or if it acts indirectly due to the beneficial effect of physical activity on glycemic control
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