Obesity, Inactivity, and the Prevalence of Diabetes and Diabetes-Related Cardiovascular Comorbidities in the U.S., 2000–2002

Abstract

OBJECTIVE -Obesity and physical inactivity are established risk factors for type 2 diabetes and cardiovascular comorbidities. Whether adiposity or fitness level is more important to health is controversial. The objective of this research is to determine the relative associations of physical activity and BMI with the prevalence of diabetes and diabetes-related cardiovascular comorbidities in the U.S. RESULTS -The likelihood of having diabetes and diabetes-related cardiovascular comorbidities increased with BMI regardless of physical activity and increased with physical inactivity regardless of BMI. Compared with normal-weight active adults, the multivariate-adjusted odds ratio (OR) for diabetes was 1.52 (95% CI 1.25-1.86) for normal-weight inactive adults and 1.65 (1.40 -1.96) for overweight inactive adults; the OR for diabetes and comorbid hypertension was 1.71 (1.32-2.19) for normal-weight inactive adults and 1.84 (1.47-2.32) for overweight inactive adults. RESEARCH DESIGN AND METHODSCONCLUSIONS -Both physical inactivity and obesity seem to be strongly and independently associated with diabetes and diabetes-related comorbidities. These results support continued research investigating the independent causal nature of these factors. Diabetes Care 28:1599 -1603, 2005T he prevalence of diabetes has been significantly increasing in the U.S.(1). Current estimates suggest that 6 -8% of adults have diabetes, with the true prevalence likely closer to 10% when undiagnosed diabetes is also considered (2-4). Importantly, the prevalence of diabetes has increased nearly 50% over the last decade; Ͼ5 million U.S. adults are newly suffering from the disease (1,3). The burden of diabetes is significant in terms of human and economic costs and is expected to increase in the future (2,5,6).Obesity and physical inactivity are well-established risk factors for the development of type 2 diabetes (7-11). It is estimated that for every 1-kg increase in weight, the prevalence of diabetes increases by 9% (1). Physical inactivity is associated with increased insulin resistance and poorer glycemic control independent of body weight (12).Evidence from randomized controlled trials on three continents has clearly demonstrated that maintenance of modest weight loss through diet and physical activity reduces the incidence of type 2 diabetes in high-risk individuals by ϳ40 -60% over 3-4 years (13-16). Lifestyle improvements, including weight control and increased physical activity, are also the cornerstone of diabetes management (11,12).However, despite the known association of obesity and inactivity with diabetes-related morbidity and mortality, there is limited national data reporting the independent association of each risk factor with the prevalence of diabetes and related cardiovascular comorbidities in the U.S. population. The objective of this study was to determine the relative prevalence of diabetes and related cardiovascular comorbidities among overweight and inactive adults in a nationally representative population. RESEARCH DESIGN AN...

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