title: Android Adiposity and Lack of Moderate and Vigorous Physical Activity Are Associated With Insulin Resistance and Diabetes in Aging Adults.
abstract: BACKGROUND
  Physical inactivity and excess adiposity are thought to be interdependent "lifestyle" factors and thus, many older adults are at exaggerated risk for preventable diseases. The purposes of this study were to determine the degree of discordance between body mass index (BMI) and adiposity among adults older than 50 years, and to determine the extent to which direct measures of adiposity, and objectively measured sedentary behavior (SB) and physical activity (PA) are associated with insulin resistance (IR) or diabetes.
  
  
  METHODS
  A population representative sample of 2,816 individuals, aged 50-85 years, was included from the combined 2003-2006 National Health and Nutrition Examination Survey (NHANES) datasets. BMI, percent body fat (%BF) and android adiposity as determined by dual energy x-ray absorptiometry, objectively measured SB and PA, established markers of cardiometabolic risk, IR, and type 2 diabetes were analyzed.
  
  
  RESULTS
  Approximately 50% of the men and 64% of the women who were normal weight according to BMI had excessive %BF. Adults with the least SB and greatest moderate and vigorous PA exhibited the healthiest cardiometabolic profiles, whereas adults with the greatest SB and lowest activity had highest risk. Greater android adiposity stores were robustly associated with IR or diabetes in all adults, independent of SB and activity. Among men, less moderate-to-vigorous PA was associated with IR or diabetes; whereas among women, less lifestyle moderate activity was associated with IR or diabetes.
  
  
  CONCLUSIONS
  Android adiposity and low moderate and vigorous PA are the strongest predictors of IR or diabetes among aging adults.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor. mdpeterz@med.umich.edu.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Peterson
authors.affiliation: Division of Rehabilitation Sciences/School of Health Professions, Department of Internal Medicine/Division of Geriatrics, University of Texas Medical Branch, Galveston.
authors.forename: Soham
authors.initials: S
authors.lastname: Al Snih
authors.affiliation: Geriatric Department, Hospital Universitario Gregorio Marañón, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Serra-Rexach
authors.affiliation: Department of Internal Medicine, University of Michigan. Molecular and Integrative Physiology, University of Michigan.
authors.forename: Charles
authors.initials: C
authors.lastname: Burant
mesh_terms: D050154:Adiposity; D000368:Aged; D000375:Aging; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000209:etiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D010641:Phenotype; D057185:Sedentary Behavior
keywords: Android adiposity; Diabetes; Insulin resistance; MVPA; Obesity; Sedentary behavior