title: A population study on the association between leisure time physical activity and self-rated health among diabetics in Taiwan.
abstract: BACKGROUND
  There is strong evidence for the beneficial effects of physical activity in diabetes. There has been little research demonstrating a dose-response relationship between physical activity and self-rated health in diabetics. The aim of this study was to explore the dose-response association between leisure time physical activity and self-rated health among diabetics in Taiwan.
  
  
  METHODS
  Data came from the 2001 Taiwan National Health Interview Survey (NHIS). Inclusion criteria were a physician confirmed diagnosis of diabetes mellitus and age 18 years and above (n = 797). Self-rated health was assessed by the question "In general, would you say that your health is excellent, very good, good, fair, or poor?" Individuals with a self perceived health status of good, very good, or excellent were considered to have positive health status.
  
  
  RESULTS
  In the full model, the odds ratio (OR) for positive health was 2.51(95% CI = 1.53-4.13), 1.62(95% CI = 0.93-2.84), and 1.35(95% CI = 0.77-2.37), for those with a total weekly energy expenditure of > or = 1000 kcal, between 500 and 999 kcal, and between 1 and 499 kcal, respectively, compared to inactive individuals. Those with duration over 10 years (OR = 0.53, 95%CI = 0.30-0.94), heart disease (OR = 0.50, 95%CI = 0.30-0.85), and dyslipidemia (OR = 0.65, 95% CI = 0.43-0.98) were less likely to have positive health than their counterparts. After stratified participants by duration, those with a duration of diabetes < 6 years, the adjusted OR for positive health was 1.95(95% CI = 1.02-3.72), 1.22(95% CI = 0.59-2.52), and 1.19(95% CI = 0.58-2.41) for those with a total weekly energy expenditure of > or = 1000 kcal, between 500 and 999 kcal, and between 1 and 499 kcal, respectively, compared to inactive individuals. In participants with a duration of diabetes > or = 6 years, total energy expenditure showed a gradient effect on self-perceived positive health. The adjusted OR for positive health was 3.45(95% CI = 1.53-7.79), 2.77(95% CI = 1.11-6.92), and 1.90(95% CI = 0.73-4.94) for those with a total weekly energy expenditure of > or = 1000 kcal, between 500 and 999 kcal, and between 1 and 499 kcal, respectively, compared to inactive individuals.
  
  
  CONCLUSIONS
  Our results highlight that regular leisure activity with an energy expenditure -- 500 kcal per week is associated with better self-rated health for those with longstanding diabetes.
authors.affiliation: Department of Health Care Management, Chang Gung University, Tao-Yuan, Taiwan.
authors.forename: Chia-Lin
authors.initials: CL
authors.lastname: Li
authors.forename: Yi-Chang
authors.initials: YC
authors.lastname: Lai
authors.forename: Chin-Hsiao
authors.initials: CH
authors.lastname: Tseng
authors.forename: Jen-Der
authors.initials: JD
authors.lastname: Lin
authors.forename: Hsing-Yi
authors.initials: HY
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology*; D004734:Energy Metabolism; D015444:Exercise; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013624:Taiwan; D055815:Young Adult