Sedentary Behavior and Diabetes Risk Among Women Over the Age of 65 Years: The OPACH Study - PubMed (original) (raw)

. 2021 Feb;44(2):563-570.

doi: 10.2337/dc20-0709. Epub 2020 Dec 3.

Michael J LaMonte 3, Genevieve N Healy 4 5 6, Sandy Liles 7 2, Kelly R Evenson 8, Chongzhi Di 9, Jacqueline Kerr 7, I-Min Lee 10, Eileen Rillamas-Sun 9, David Buchner 11, Melbourne F Hovell 2 12, Andrea Z LaCroix 7

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Sedentary Behavior and Diabetes Risk Among Women Over the Age of 65 Years: The OPACH Study

John Bellettiere et al. Diabetes Care. 2021 Feb.

Abstract

Objective: To evaluate whether sedentary time (ST) and/or sedentary behavior patterns are related to incident diabetes in the U.S.'s oldest age-groups.

Research design and methods: Women without physician-diagnosed diabetes (n = 4,839, mean ± SD age = 79 ± 7 years) wore accelerometers for ≥4 days and were followed up to 6 years for self-reported newly diagnosed diabetes requiring treatment with medications. Hazard ratios (HRs) for incident diabetes were estimated across quartiles of accelerometer-measured ST and mean bout duration with use of Cox proportional hazards models. We conducted isotemporal substitution analyses using Cox regression and tested associations with risk for diabetes after statistically replacing ST with light physical activity (PA) or moderate-to-vigorous PA (MVPA) and after replacing light PA with MVPA.

Results: During 20,949 person-years, 342 diabetes cases were identified. Women in ST quartile (Q)2, Q3, and Q4 (vs. Q1) had incident diabetes HR 1.20 (95% CI 0.87-1.65), 1.33 (0.97-1.82), and 1.21 (0.86-1.70); P trend = 0.04. Respective HRs following additional adjustment for BMI and MVPA were 1.04 (95% CI 0.74-1.47), 1.04 (0.72-1.50), and 0.85 (0.56-1.29); P trend = 0.90. Fully adjusted isotemporal substitution results indicated that each 30 min of ST replaced with MVPA (but not light PA) was associated with 15% lower risk for diabetes (HR 0.85 [95% CI 0.75-0.96]; P = 0.01); the HR for replacing 30 min of light PA with MVPA was 0.85 (95% CI 0.73-0.98); P = 0.03. Mean bout duration was not associated with incident diabetes.

Conclusions: Statistically replacing ST or light PA with MVPA was associated with lower diabetes risk in older women. While reducing ST is important for several health outcomes, results indicate that to reduce diabetes risk among older adults, the primary public health focus should be on increasing MVPA.

© 2020 by the American Diabetes Association.

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Figures

Figure 1

Figure 1

Statistically replacing (reducing) ST with (increasing) light PA or MVPA and statistically replacing (reducing) light PA with (increasing) MVPA. Results from isotemporal substitution Cox proportional hazards models adjusted for age, race/ethnicity, education, smoking status, alcohol use, family history of diabetes, multimorbidity, physical functioning, self-rated health, and BMI. HRs are shown with 95% CIs. *Statistically replacing 30 min with light PA or MVPA.

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