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Daily step count and incident diabetes in community-dwelling 70-year-olds: a prospective cohort study
BACKGROUND: Older adults with diabetes take fewer steps per day than those without diabetes. The purpose of the present study was to investigate the association of daily step count with incident diabetes in community-dwelling 70-year-olds. METHODS: This prospective cohort study included N = 3055 com...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706282/ https://www.ncbi.nlm.nih.gov/pubmed/33256704 http://dx.doi.org/10.1186/s12889-020-09929-2 |
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author | Ballin, Marcel Nordström, Peter Niklasson, Johan Alamäki, Antti Condell, Joan Tedesco, Salvatore Nordström, Anna |
author_facet | Ballin, Marcel Nordström, Peter Niklasson, Johan Alamäki, Antti Condell, Joan Tedesco, Salvatore Nordström, Anna |
author_sort | Ballin, Marcel |
collection | PubMed |
description | BACKGROUND: Older adults with diabetes take fewer steps per day than those without diabetes. The purpose of the present study was to investigate the association of daily step count with incident diabetes in community-dwelling 70-year-olds. METHODS: This prospective cohort study included N = 3055 community-dwelling 70-year-olds (52% women) who participated in a health examination in Umeå, Sweden during 2012–2017, and who were free from diabetes at baseline. Daily step count was measured for 1 week using Actigraph GT3X+ accelerometers. Cases of diabetes were collected from the Swedish National Patient Register. The dose-response association was evaluated graphically using a flexible parametric model, and hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regressions. RESULTS: During a mean follow-up of 2.6 years, diabetes was diagnosed in 81 participants. There was an inverse nonlinear dose-response association between daily step count and incident diabetes, with a steep decline in risk of diabetes from a higher daily step count until around 6000 steps/day. From there, the risk decreased at a slower rate until it leveled off at around 8000 steps/day. A threshold of 4500 steps/day was found to best distinguish participants with the lowest risk of diabetes, where those taking ≥ 4500 steps/day, had 59% lower risk of diabetes, compared to those taking fewer steps (HR, 0.41, 95% CI, 0.25–0.66). Adjusting for visceral adipose tissue (VAT) attenuated the association (HR, 0.64, 95% CI, 0.38–1.06), which was marginally altered after further adjusting for sedentary time, education and other cardiometabolic risk factors and diseases (HR, 0.58, 95% CI, 0.32–1.05). CONCLUSIONS: A higher daily step count is associated with lower risk of incident diabetes in community-dwelling 70-year-olds. The greatest benefits occur at the lower end of the activity range, and much earlier than 10,000 steps/day. With the limitation of being an observational study, these findings suggest that promoting even a modest increase in daily step count may help to reduce the risk of diabetes in older adults. Because VAT appears to partly mediate the association, lifestyle interventions targeting diabetes should apart from promoting physical activity also aim to prevent and reduce central obesity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-020-09929-2. |
format | Online Article Text |
id | pubmed-7706282 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-77062822020-12-02 Daily step count and incident diabetes in community-dwelling 70-year-olds: a prospective cohort study Ballin, Marcel Nordström, Peter Niklasson, Johan Alamäki, Antti Condell, Joan Tedesco, Salvatore Nordström, Anna BMC Public Health Research Article BACKGROUND: Older adults with diabetes take fewer steps per day than those without diabetes. The purpose of the present study was to investigate the association of daily step count with incident diabetes in community-dwelling 70-year-olds. METHODS: This prospective cohort study included N = 3055 community-dwelling 70-year-olds (52% women) who participated in a health examination in Umeå, Sweden during 2012–2017, and who were free from diabetes at baseline. Daily step count was measured for 1 week using Actigraph GT3X+ accelerometers. Cases of diabetes were collected from the Swedish National Patient Register. The dose-response association was evaluated graphically using a flexible parametric model, and hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regressions. RESULTS: During a mean follow-up of 2.6 years, diabetes was diagnosed in 81 participants. There was an inverse nonlinear dose-response association between daily step count and incident diabetes, with a steep decline in risk of diabetes from a higher daily step count until around 6000 steps/day. From there, the risk decreased at a slower rate until it leveled off at around 8000 steps/day. A threshold of 4500 steps/day was found to best distinguish participants with the lowest risk of diabetes, where those taking ≥ 4500 steps/day, had 59% lower risk of diabetes, compared to those taking fewer steps (HR, 0.41, 95% CI, 0.25–0.66). Adjusting for visceral adipose tissue (VAT) attenuated the association (HR, 0.64, 95% CI, 0.38–1.06), which was marginally altered after further adjusting for sedentary time, education and other cardiometabolic risk factors and diseases (HR, 0.58, 95% CI, 0.32–1.05). CONCLUSIONS: A higher daily step count is associated with lower risk of incident diabetes in community-dwelling 70-year-olds. The greatest benefits occur at the lower end of the activity range, and much earlier than 10,000 steps/day. With the limitation of being an observational study, these findings suggest that promoting even a modest increase in daily step count may help to reduce the risk of diabetes in older adults. Because VAT appears to partly mediate the association, lifestyle interventions targeting diabetes should apart from promoting physical activity also aim to prevent and reduce central obesity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-020-09929-2. BioMed Central 2020-11-30 /pmc/articles/PMC7706282/ /pubmed/33256704 http://dx.doi.org/10.1186/s12889-020-09929-2 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Ballin, Marcel Nordström, Peter Niklasson, Johan Alamäki, Antti Condell, Joan Tedesco, Salvatore Nordström, Anna Daily step count and incident diabetes in community-dwelling 70-year-olds: a prospective cohort study |
title | Daily step count and incident diabetes in community-dwelling 70-year-olds: a prospective cohort study |
title_full | Daily step count and incident diabetes in community-dwelling 70-year-olds: a prospective cohort study |
title_fullStr | Daily step count and incident diabetes in community-dwelling 70-year-olds: a prospective cohort study |
title_full_unstemmed | Daily step count and incident diabetes in community-dwelling 70-year-olds: a prospective cohort study |
title_short | Daily step count and incident diabetes in community-dwelling 70-year-olds: a prospective cohort study |
title_sort | daily step count and incident diabetes in community-dwelling 70-year-olds: a prospective cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706282/ https://www.ncbi.nlm.nih.gov/pubmed/33256704 http://dx.doi.org/10.1186/s12889-020-09929-2 |
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