You reap what you sow: the long-term benefits of your investment

Abstract

In a very important and elegant study described in this issue, Fernandes and Zanesco highlight the epidemiologic data regarding the prevalence of type 2 diabetes mellitus and concomitant arterial hypertension.1 The authors examine an adult cohort in a retrospective study of four cities in an industrialized state in Brazil wherein the estimated prevalence of hypertension was 36% and that of type 2 diabetes mellitus 29%. The authors confirm the high prevalence of arterial hypertension in patients with type 2 diabetes mellitus. In this study, 1436 adults were analyzed; 61% were women and the age range was broad, ranging from 18 to 94 years, with one in five participants (20.2%) being older than 65. Self-reported physical activity was documented through interviews. Body mass index (BMI) was calculated from self-reported body anthropometrics. The Baecke Questionnaire2 was used to identify the level of physical activity. Of note, both leisure time physical activities as well as regular aerobic-type exercise were recorded. Physical activity was recorded in youth, childhood, adolescence and adulthood. Specific questions were asked regarding physical activity after school. The results of the study showed that, in general, men were more physically active than women in this Brazilian population. Subjects with a higher formal education who were younger also had greater levels of physical activity. Obese and overweight patients had lower levels of physical activity. Approximately 9% of patients self-reported diabetes mellitus, and 26% self-reported hypertension, with a male preponderance for the diagnosis of high blood pressure. Further, the study shows that the prevalence of arterial hypertension and type 2 diabetes mellitus increases with advancing age and is positively associated with BMI. Higher levels of formal education were associated with lower incidences of diabetes or hypertension. In addition, overweight and obese adults were less likely to participate in regular exercise activity as adults and were also less likely to have exercised in youth compared with subjects with a normal BMI (less than 25 kg m−2). The odds ratio for current engagement in physical activity was 2.38 (95% confidence interval (CI) 1.73–3.28; P=0.001). The authors point out that any physical activity was associated with a lower occurrence of arterial hypertension and type 2 diabetes mellitus. However, current physical activity was not associated with either disease. The odds ratio was 0.44 (95% CI 0.3–0.64) for arterial hypertension and 0.32 (95% CI 0.17–0.61) for type 2 diabetes in adults who had regularly engaged in sport activities in childhood and adolescence.