title: Physical activity and incident diabetes in American Indians: the Strong Heart Study.
abstract: The authors examined the association between total physical activity (leisure-time plus occupational) and incident diabetes among 1,651 American Indians who participated in the Strong Heart Study, a longitudinal study of cardiovascular disease and its risk factors among 13 American Indian communities in 4 states (North Dakota, South Dakota, Oklahoma, and Arizona). Discrete Cox models were used to examine the association between physical activity level (in tertiles), compared with no physical activity, and incident diabetes, after adjustment for potential confounders. During 10 years of follow-up (f1989-1999), 454 incident cases of diabetes were identified. Compared with participants who reported no physical activity, those who reported any physical activity had a lower risk of diabetes: Odds ratios were 0.67 (95% confidence interval (CI): 0.46, 0.99), 0.67 (95% CI: 0.45, 0.99), and 0.67 (95% CI: 0.45, 0.99) for increasing tertile of physical activity, after adjustment for age, sex, study site, education, smoking, alcohol use, and family history of diabetes. Further adjustment for body mass index and other potential mediators attenuated the risk estimates. These data suggest that physical activity is associated with a lower risk of incident diabetes in American Indians. This study identifies physical activity as an important determinant of diabetes among American Indians and suggests the need for physical activity outreach programs that target inactive American Indians.
authors.affiliation: Cardiovascular Health Research Unit, University of Washington, 1730 Minor Avenue, Suite 1360, Seattle, WA 98101, USA. amfretts@u.washington.edu
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Fretts
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Kriska
authors.forename: Nicolas L
authors.initials: NL
authors.lastname: Smith
authors.forename: Thomas
authors.initials: T
authors.lastname: Lumley
authors.forename: Elisa T
authors.initials: ET
authors.lastname: Lee
authors.forename: Marie
authors.initials: M
authors.lastname: Russell
authors.forename: David
authors.initials: D
authors.lastname: Siscovick
mesh_terms: D000368:Aged; D001130:Arizona / Q000453:epidemiology; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D004651:Employment; D015444:Exercise; D005260:Female; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data*; D007899:Leisure Activities; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States / Q000453:epidemiology; D009043:Motor Activity; D012307:Risk Factors