Abstract
Aims/hypothesisThe aim of this study was to examine the prospective associations between objectively measured physical activity energy expenditure (PAEE), sedentary time, moderate-to-vigorous-intensity physical activity (MVPA), cardiorespiratory fitness (CRF) and cardiometabolic risk factors over 4 years in individuals with recently diagnosed diabetes.MethodsAmong 308 adults (mean age 61.0 [SD 7.2] years; 34% female) with type 2 diabetes from the Anglo–Danish–Dutch Study of Intensive Treatment in People with Screen Detected Diabetes in Primary Care (ADDITION)-Plus study, we measured physical activity using individually calibrated combined heart rate and movement sensing. Multivariable linear regression models were constructed to examine the associations between baseline PAEE, sedentary time, MVPA, CRF and cardiometabolic risk factors and clustered cardiometabolic risk (CCMR) at follow-up, and change in these exposures and change in CCMR and its components over 4 years of follow-up.ResultsIndividuals who increased their PAEE between baseline and follow-up had a greater reduction in waist circumference (−2.84 cm, 95% CI −4.84, −0.85) and CCMR (−0.17, 95% CI −0.29, −0.04) compared with those who decreased their PAEE. Compared with individuals who decreased their sedentary time, those who increased their sedentary time had a greater increase in waist circumference (3.20 cm, 95% CI 0.84, 5.56). Increases in MVPA were associated with reductions in systolic blood pressure (−6.30 mmHg, 95% CI −11.58, −1.03), while increases in CRF were associated with reductions in CCMR (−0.23, 95% CI −0.40,−0.05) and waist circumference (−3.79 cm, 95% CI −6.62, −0.96). Baseline measures were generally not predictive of cardiometabolic risk at follow-up.Conclusions/interpretationEncouraging people with recently diagnosed diabetes to increase their physical activity and decrease their sedentary time may have beneficial effects on their waist circumference, blood pressure and CCMR.
Highlights
Individuals with type 2 diabetes are at increased risk of developing cardiovascular disease (CVD) and have poorer survival rates after diagnosis of CVD in comparison with those without diabetes [1,2,3]
While it is known that increases in physical activity are associated with increases in cardiorespiratory fitness (CRF), we have previously shown that the beneficial association between physical activity energy expenditure (PAEE; the energy expended above that required when resting) and metabolic risk factors is independent of CRF [15]
Baseline PAEE, sedentary time, moderate-to-vigorous-intensity physical activity (MVPA) and CRF measures were moderately correlated with the same measures at follow-up (ρ=0.61, 0.55, 0.58 and 0.57, respectively)
Summary
Individuals with type 2 diabetes are at increased risk of developing cardiovascular disease (CVD) and have poorer survival rates after diagnosis of CVD in comparison with those without diabetes [1,2,3]. While it is known that increases in physical activity are associated with increases in cardiorespiratory fitness (CRF), we have previously shown that the beneficial association between physical activity energy expenditure (PAEE; the energy expended above that required when resting) and metabolic risk factors is independent of CRF [15]. This is important because it means that increases in PAEE, even when below the level required to improve CRF, can still lead to important improvements in cardiometabolic health
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