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Assessing the Association Between Physical Activity and Prediabetes Using the National Health and Nutrition Examination Survey 2007-2014

Abstract
Prediabetes, a condition in which glucose levels are higher than normal but not high enough to be diagnosed as type 2 diabetes, affects approximately 37% of adults in the United States and is a major public health concern. Extensive research has evaluated the association between physical activity (PA) and type 2 diabetes; however, few studies have examined the association between PA and prediabetes. Therefore, we evaluated the association between PA (including leisure time, occupational and total) and prediabetes status among adults, stratified by gender, using multinomial logistic regression models fit to serial cross-sectional 2007-2014 National Health and Nutrition Examination Survey data. After adjusting for age, race, body mass index, smoking status, family history of hypertension and education, results suggest that the association between leisure time [moderate PA: 0.98 (95% CI: 0.80–1.21); tertile 3: 1.05 (95% CI: 0.75–1.49)] and total PA [tertile 1: 1.15, (95% CI: 0.96–1.38); tertile 2: 1.00, (95% CI: 0.79–1.27); tertile 3: 0.96, (0.77–1.20)] and undiagnosed prediabetes and was not statistically significant among women. However, compared to women who engaged in no occupational PA, engaging in the highest tertile was statistically significantly associated with lower odds of undiagnosed prediabetes [tertile 3: 0.75, (95% CI: 0.58–0.97)]. Compared to men who engaged in no leisure time PA, men engaging in the highest tertile of leisure time PA had a statistically significant lower odds of undiagnosed prediabetes [Tertile 3: 0.79, ( 0.65–0.98)]. Compared to men who did not engage in any PA, men engaging in any PA did not have a statistically significant decrease in odds of undiagnosed prediabetes [tertile 1: 0.90, (0.71–1.16); Tertile 2: 0.93, (0.74–1.18); Tertile 3: 0.99, (0.80–1.21)]. Overall, our results show that for both men and women, there was a general lack of association between leisure-time, occupational, and total physical activity and prediabetes status in adjusted analyses.
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