Physical activity, sedentary behaviors and the incidence of type 2 diabetes mellitus: The multi-ethnic study of atherosclerosis (MESA)

Joshua J. Joseph, Justin B. Echouffo-Tcheugui, Sherita H. Golden, Haiying Chen, Nancy Swords Jenny, Mercedes R. Carnethon, David Jacobs, Gregory L. Burke, Dhananjay Vaidya, Pamela Ouyang, Alain G. Bertoni

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83 Scopus citations


Background: The association between physical activity (PA), sedentary behavior, and incident diabetes has been assessed in whites but is less well investigated in multiethnic populations. Objective: To assess the association between PA, sedentary behavior, and incident diabetes in the Multi- Ethnic Study of Atherosclerosis. Research design and methods: Incident diabetes was assessed among adults without prevalent baseline diabetes (2000–2002) at 5 in-person examinations between 2002 and 2012. Baseline PA (moderate, vigorous, and exercise-specific; metabolic equivalents of task-hours/week) and sedentary behaviors (television watching, reading; hours/day) were assessed by questionnaire. HRs were estimated using Cox proportional hazard models. Results: Among 5829 adults (mean age 61.8 years, 54% female, 42% white, 12% Chinese-American, 26% African-American, 21% Hispanic-American), there were 655 incident diabetes cases (median follow-up 11.1 years). After adjustment, diabetes risk was lower in those with brisk or striding compared with none or casual walking pace (HR 0.67; 95% CI 0.54 to 0.84), higher levels of exercise PA (HR for highest vs lowest quartile 0.79; 95% CI 0.63 to 0.98), and any compared with no vigorous PA (HR 0.79; 95% CI 0.66 to 0.95). Race/ethnicity influenced the association of walking pace, exercise PA, and any vigorous PA on diabetes risk, which was only significant among whites. Total leisure sedentary behaviors (HR for highest vs lowest quartile 1.65; 95% CI 1.26 to 2.14) and television watching (HR for highest vs lowest quartile 2.68; 95% CI 1.38 to 5.21) were significantly associated with diabetes risk in multiethnic analyses and were influenced by race/ethnicity. Conclusions: These results confirm the importance of PA and sedentary behavior on diabetes risk in a multiethnic population and demonstrate potential variations across race/ethnic groups.

Original languageEnglish (US)
Article numbere000185
JournalBMJ Open Diabetes Research and Care
Issue number1
StatePublished - Jun 1 2016

Bibliographical note

Funding Information:
This work was supported by National Institutes of Health, National Heart Lung and Blood Institute grant numbers N01-HC-95159 through N01-HC-95165 and N01-HC-95169. JJJ was supported by the National Institute of Diabetes, Digestive, and Kidney Diseases institutional training grant T32 DK062707.

Publisher Copyright:
© 2016, BMJ Publishing Group. All rights reserved.


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