title: Effect of physical activity measurement type on the association between walking activity and glucose regulation in a high-risk population recruited from primary care.
abstract: BACKGROUND
  We investigate associations of self-reported and objectively assessed walking activity with measures of glucose regulation in a multi-ethnic population at high risk of type 2 diabetes.
  
  
  METHODS
  This study reports data from a 2009-2011 screening programme for impaired glucose regulation (IGR) within a high-risk primary care population in Leicestershire, UK; 2532 participants (38% women, 8% South Asian) with a mean age of 64 ± 8 years and an average BMI of 32.1 ± 5.6 kg/m(2) were included. Walking activity was measured by self-report (International Physical Activity Questionnaire) and objectively (pedometer). Glucose regulation assessments included 2h post-challenge glucose, fasting glucose and HbA1c.
  
  
  RESULTS
  Higher levels of self-reported walking activity and pedometer steps were associated with lower 2h post-challenge glucose after controlling for several known confounding variables, including BMI. Similarly, when categorized in tertiles, both measures were associated with a lower odds of having any form of IGR; odds ratio for lowest vs highest tertile was 0.64 (0.51-0.80) for self-report and 0.69 (0.55-0.87) for pedometer steps. There was no significant difference between self-reported and objective measures in the strength of associations with glucose regulation; associations with self-report were maintained when further adjusted for pedometer steps. Stronger associations between self-reported walking activity and glucose regulation were observed in South Asians compared with White Europeans.
  
  
  CONCLUSIONS
  Self-reported and objectively measured walking activity were equally associated with indices of glucose regulation. Associations with self-reported walking activity were maintained when further adjusted for pedometer steps, suggesting that self-reported walking activity may measure facets of physical activity that are beyond total volume.
authors: National Institute for Health Research Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, University Hospitals of Leicester and University of Leicester, Leicester, UK. Ty20@le.ac.uk
authors: Thomas
authors: T
authors: Yates
authors: Joe
authors: J
authors: Henson
authors: Kamlesh
authors: K
authors: Khunti
authors: Danielle H
authors: DH
authors: Morris
authors: Charlotte
authors: C
authors: Edwardson
authors: Emer
authors: E
authors: Brady
authors: Melanie J
authors: MJ
authors: Davies
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000517:prevention & control*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011159:Population Surveillance; D011320:Primary Health Care; D057566:Self Report; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D016138:Walking / Q000502:physiology*
chemical_list: D001786:Blood Glucose