Abstract P321: Leisure-Time Aerobic Physical Activity Reduces the Risk of Diabetes-Related Mortality: NHANES III

Abstract

Background: Evidence exists to suggest physical activity (PA) reduces risk for diabetes-related mortality (DRM). However, these studies were limited to examining specific modes of PA with only walking, running, and sports participation being consistently related to a reduced risk for DRM. Given the spectrum of leisure-time PA is inclusive of many different modes, it is important to examine this relationship using a more robust measure of PA. Purpose: To examine the relationship between leisure-time moderate-to-vigorous intensity physical activity (MVPA) and the risk of DRM in the Third National Health and Nutrition Examination Survey (1988-1994). Methods: The study sample (n=11,017) included adults, 20-79 years of age, with Mobile Examination Center (MEC) data. An age-standardized physical activity score (PAS) was calculated from the self-reported frequency and intensity of 12 leisure-time aerobic activities. PASs were then used to categorize participants into no activity (PAS = 0) versus any MVPA (PAS > 0). DRM was defined as death from diabetes mellitus, either as the primary cause or as a contributing cause in the National Death Index database. Cox Proportional Hazard models were adjusted for age, sex, race-ethnicity, education, smoking, alcohol consumption, healthy eating index, family history of diabetes, body mass index and diabetes status at the time of the MEC. Race-ethnicity specific models (i.e., non-Hispanic white, non-Hispanic black, and Mexican Americans) were also examined. Results: There was a 68% [HR=0.32 (95% CI 0.23-0.47)] reduction in the risk of DRM, adjusted for age. Following further adjustment for age, race-ethnicity, gender, education, family history of diabetes, body mass index, glycemic status, healthy eating index, smoking status, and alcohol consumption risk estimates were attenuated, but remained statistically significant [HR 0.63 (95% CI 0.43-0.93)]. No interaction between race-ethnicity and MVPA was found. Conclusions: The results of this large, nationally representative prospective study suggest that the accumulation of any volume of MVPA, across a plethora of activities, reduces the risk of DRM.