Physical Activity and Incident Diabetes in American Indians: The Strong Heart Study

摘要

The authors examined the association between total physical activity (leisure-time plus occupational) and in-ncident diabetes among 1,651 American Indians who participated in the Strong Heart Study, a longitudinal study ofncardiovascular disease and its risk factors among 13 American Indian communities in 4 states (North Dakota,nSouth Dakota, Oklahoma, and Arizona). Discrete Cox models were used to examine the association betweennphysical activity level (in tertiles), compared with no physical activity, and incident diabetes, after adjustment fornpotential confounders. During 10 years of follow-up (f1989–1999), 454 incident cases of diabetes were identified.nCompared with participants who reported no physical activity, those who reported any physical activity had a lowernrisk of diabetes: Odds ratios were 0.67 (95% confidence interval (CI): 0.46, 0.99), 0.67 (95% CI: 0.45, 0.99), andn0.67 (95% CI: 0.45, 0.99) for increasing tertile of physical activity, after adjustment for age, sex, study site,neducation, smoking, alcohol use, and family history of diabetes. Further adjustment for body mass index and othernpotential mediators attenuated the risk estimates. These data suggest that physical activity is associated withna lower risk of incident diabetes in American Indians. This study identifies physical activity as an important de-nterminant of diabetes among American Indians and suggests the need for physical activity outreach programs thatntarget inactive American Indians.