Trends in adherence to recommended physical activity and its effects on cardiometabolic markers in US adults with pre-diabetes

INTRODUCTION: This study aimed to examine the trends in adherence to Physical Activity Guidelines for Americans (PAG) as well as the association between them and cardiometabolic risk factors among US adults with pre-diabetes. RESEARCH DESIGN AND METHODS: This study included 6734 participants who were diagnosed with pre-diabetes from the National Health and Nutrition Examination Survey 2007–2008 to 2017–2018. The logistic regression model and linear regression model were used to test the trends in adherence to PAG. The multivariable linear regression model was used to examine the association between adherence to PAG and cardiometabolic risk factors. RESULTS: The rate of adherence to the PAG for aerobic physical activity was not significantly changed (64.1% in 2007–2008 to 66.4% in 2017–2018, p=0.599). The sedentary time changed significantly (5.6, 6.8, and 6.0 hours in 2007–2008, 2013–2014, and 2017–2018, respectively; p<0.001). Adherence to the PAG was significantly associated with levels of waist circumference, body mass index (BMI), high-density lipoprotein cholesterol (HDL-C), triglycerides, insulin, 2-hour postload plasma glucose, and measurements of insulin resistance (homeostatic model assessment for insulin resistance (HOMA-IR)) and β-cell function (homeostasis model assessment of β-cell function (HOMA-β)). There was a significant relationship between sedentary time and levels of waist circumference, BMI, HDL-C, insulin, 2-hour postload glucose, HOMA-IR, and HOMA-β. The associations of adherence to the PAG and sedentary time with the levels of systolic and diastolic blood pressures and hemoglobin A1c were not significant. CONCLUSIONS: Adherence to PAG for aerobic activity did not change significantly among US adults with pre-diabetes. The time spent on sedentary behavior peaked in 2013–2014 and then decreased afterward. Adhering to the PAG for aerobic activity and reducing sedentary time significantly improved cardiometabolic health among adults with pre-diabetes.