scholarly journals Adherence to physical activity recommendations and barriers to physical activity participation among adults with type 1 diabetes

2021 ◽  
Author(s):  
Mary Finn ◽  
Mark Sherlock ◽  
Sinead Feehan ◽  
Emer M. Guinan ◽  
Kevin B. Moore
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Type 1 Diabetes ◽  
Accurate Information ◽  
Linear Regression Models ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Barriers To Physical Activity

Abstract Background Physical activity (PA) is important for those with type 1 diabetes (T1DM); however, accurate information on PA in people with T1DM is limited. Aims This study assessed adherence to PA guidelines using both objective and subjective PA measures and evaluated the relationship between accelerometer-measured PA and cardiovascular disease (CVD) risk factors. Barriers to PA were also assessed. Methods Using an observational cross-sectional design, PA was measured objectively over 7 days in 72 participants (34 males) using an accelerometer (ActiGraph) and subjectively using the International Physical Activity Questionnaire (IPAQ). Perceived barriers to PA were assessed using the Barriers to Physical Activity in Diabetes (type 1) scale. Multiple linear regression models assessed the influence of PA on HbA1c and CVD risk factors. Results Mean age ± SD was 40.9 ± 12.9 years, diabetes duration was 18 ± 11.6 years, and HbA1c was 65 ± 14 mmol/mol /8.0 ± 1.3%. Twenty-three (32%) participants exercised according to PA recommendations as measured by an accelerometer. Sixty-nine (97%) participants reported meeting the recommendations as per the IPAQ. Those meeting recommendations (accelerometry) had a lower HbA1c (p = 0.001), BMI (p = 0.032), waist circumference (p = 0.006), and fat mass (p = 0.032) and a greater number of hypoglycaemic events (p = 0.004). Fear of hypoglycaemia was the strongest barrier to PA (mean 3.4 ± 2.0). Conclusion The majority of participants failed to meet PA recommendations. Meeting the recommendations was associated with healthier CVD risk factor profiles. Individuals with T1DM possibly overestimate their PA using self-reported measures and require support and education to safely improve activity levels.

scholarly journals Association between physical activity level and cardiovascular risk factors in adolescents living with type 1 diabetes mellitus: a cross-sectional study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nana Wu ◽  
Shannon S. D. Bredin ◽  
Veronica K. Jamnik ◽  
Michael S. Koehle ◽  
Yanfei Guan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Chinese Youth

Abstract Background Type 1 diabetes mellitus (T1DM) is associated with an increased risk for cardiovascular disease (CVD) related morbidity and premature mortality. Regular physical activity plays an important role in the primary and secondary prevention of CVD, improving overall health and wellbeing. Previous observational studies have examined the associations between self-reported physical activity and CVD risk factors in largely adult Caucasian populations. However, limited work has evaluated the relationship between objectively measured physical activity and CVD risk factors in other ethnicities, particularly Chinese youth living with T1DM. Methods This cross-sectional study assessed CVD risk factors, physical activity, and aerobic fitness (and their associations) in Chinese youth living with T1DM (n = 48) and peers (n = 19) without T1DM. Primary outcomes included blood pressure, lipid profiles, and physical activity (accelerometry). Statistical differences between groups were determined with chi-square, independent-samples t-tests, or analysis of covariance. The associations between aerobic fitness, daily physical activity variables, and CVD risk factors were assessed with univariate and multivariate linear regression analyses. Results Results were summarized using means and standard deviation (SD) for normally distributed variables and medians and 25–75th quartile for non-normally distributed variables. In comparison to peers without diabetes, youth living with T1DM showed higher levels of total cholesterol (3.14 ± 0.67 vs. 4.03 ± 0.81 mmol·L-1, p = 0.001), low-density lipoprotein cholesterol (1.74 ± 0.38 vs. 2.31 ± 0.72 mmol·L-1, p = 0.005), and triglycerides (0.60 ± 0.40 vs. 0.89 ± 0.31 mmol·L-1p = 0.012), and lower maximal oxygen power (44.43 ± 8.29 vs. 35.48 ± 8.72 mL·kg-1·min-1, p = 0.003), total physical activity counts (451.01 ± 133.52 vs. 346.87 ± 101.97 counts·min-1, p = 0.004), metabolic equivalents (METs) (2.41 ± 0.60 vs. 2.09 ± 0.41 METs, p = 0.033), moderate-to-vigorous intensity physical activity [MVPA: 89.57 (61.00–124.14) vs (53.19 (35.68–63.16) min, p = 0.001], and the percentage of time spent in MVPA [11.91 (7.74–16.22) vs 8.56 (6.18–10.12) %, p = 0.038]. The level of high-density lipoprotein cholesterol was positively associated with METs (β = 0.29, p = 0.030, model R2 = 0.168), and the level of triglycerides was negatively associated with physical activity counts (β = − 0.001, p = 0.018, model R2 = 0.205) and METs (β = − 0.359, p = 0.015, model R2 = 0.208), and positively associated with time spent in sedentary behaviour (β = 0.002, p = 0.041, model R2 = 0.156) in persons living with T1DM. Conclusions Chinese youth with T1DM, despite their young age and short duration of diabetes, present early signs of CVD risk, as well as low physical activity levels and cardiorespiratory fitness compared to apparently healthy peers without diabetes. Regular physical activity is associated with a beneficial cardiovascular profile in T1DM, including improvements in lipid profile. Thus, physical activity participation should be widely promoted in youth living with T1DM.

scholarly journals Risk Factors for Cardiovascular Disease (CVD) in Adults with Type 1 Diabetes: Findings from Prospective Real-life T1D Exchange Registry

2020 ◽  
Vol 105 (5) ◽  
pp. e2032-e2038 ◽  
Author(s):  
Viral N Shah ◽  
Ryan Bailey ◽  
Mengdi Wu ◽  
Nicole C Foster ◽  
Rodica Pop-Busui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
The United States ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Impact

Abstract Context Cardiovascular disease (CVD) is a major cause of mortality in adults with type 1 diabetes. Objective We prospectively evaluated CVD risk factors in a large, contemporary cohort of adults with type 1 diabetes living in the United States. Design Observational study of CVD and CVD risk factors over a median of 5.3 years. Setting The T1D Exchange clinic network. Patients Adults (age ≥ 18 years) with type 1 diabetes and without known CVD diagnosed before or at enrollment. Main Outcome Measure Associations between CVD risk factors and incident CVD were assessed by multivariable logistic regression. Results The study included 8,727 participants (53% female, 88% non-Hispanic white, median age 33 years [interquartile ratio {IQR} = 21, 48], type 1 diabetes duration 16 years [IQR = 9, 26]). At enrollment, median HbA1c was 7.6% (66 mmol/mol) (IQR = 6.9 [52], 8.6 [70]), 33% used a statin, and 37% used blood pressure medication. Over a mean follow-up of 4.6 years, 325 (3.7%) participants developed incident CVD. Ischemic heart disease was the most common CVD event. Increasing age, body mass index, HbA1c, presence of hypertension and dyslipidemia, increasing duration of diabetes, and diabetic nephropathy were associated with increased risk for CVD. There were no significant gender differences in CVD risk. Conclusion HbA1c, hypertension, dyslipidemia and diabetic nephropathy are important risk factors for CVD in adults with type 1 diabetes. A longer follow-up is likely required to assess the impact of other traditional CVD risk factors on incident CVD in the current era.

scholarly journals Sex-Related Differences in Cardiovascular Disease Risk Profile in Children and Adolescents with Type 1 Diabetes

2021 ◽  
Vol 22 (19) ◽  
pp. 10192
Author(s):  
Darja Smigoc Schweiger ◽  
Tadej Battelino ◽  
Urh Groselj
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Risk Profile ◽  
Cvd Risk Factors ◽  
Cvd Risk

Cardiovascular disease (CVD) is the primary cause of higher and earlier morbidity and mortality in people with type 1 diabetes (T1D) compared to people without diabetes. In addition, women with T1D are at an even higher relative risk for CVD than men. However, the underlying pathophysiology is not well understood. Atherosclerotic changes are known to progress early in life among people with T1D, yet it is less clear when excess CVD risk begins in females with T1D. This review explores the prevalence of classical CVD risk factors (such as glycemic control, hypertension, dyslipidemia, obesity, albuminuria, smoking, diet, physical inactivity), as well as of novel biomarkers (such as chronic inflammation), in children and adolescents with T1D with particular regard to sex-related differences in risk profile. We also summarize gaps where further research and clearer clinical guidance are needed to better address this issue. Considering that girls with T1D might have a more adverse CVD risk profile than boys, the early identification of and sex-specific intervention in T1D would have the potential to reduce later CVD morbidity and excess mortality in females with T1D. To conclude, based on an extensive review of the existing literature, we found a clear difference between boys and girls with T1D in the presence of individual CVD risk factors as well as in overall CVD risk profiles; the girls were on the whole more impacted.

scholarly journals Association Between Physical Activity Level and Cardiovascular Risk Factors in Adolescents Living with Type 1 Diabetes: A Cross-sectional Study

2020 ◽  
Author(s):  
Nana Wu ◽  
Shannon Bredin ◽  
Veronica Jamnik ◽  
Michael Koehle ◽  
Yanfei Guan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Type 1 Diabetes ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Sectional Study ◽  
Cross Sectional

Abstract Background: Type 1 diabetes (T1D) is associated with a high risk of cardiovascular disease (CVD) and an increased rate of premature mortality from CVD. Regular physical activity can improve overall health and wellbeing and plays an important role in primary and secondary prevention of CVD. Methods: This cross-sectional study assessed cardiovascular risk factors, physical activity, and fitness (and their associations) in young individuals living with T1D and healthy controls. Primary outcomes included blood pressure, lipid profiles, and physical activity (accelerometry). We included a total of 48 individuals living with T1D and 19 healthy controls, aged 12 to 17 years. Statistical differences between groups were determined with chi-square, independent-samples t-tests or analysis of covariance. The associations between aerobic fitness, daily physical activity variables and cardiovascular risk factors were assessed with univariate and multivariate linear regression analysis.Results: In comparison to healthy controls, youth living with T1D showed higher levels of total cholesterol (4.03 ± 0.81 vs. 3.14 ± 0.67 mmol·L-1, p = 0.001), low-density lipoprotein cholesterol (LDL-C) (2.31 ± 0.72 vs. 1.74 ± 0.38 mmol·L-1, p = 0.035), and triglycerides (0.89 ± 0.31 vs. 0.60 ± 0.40 mmol·L-1 p = 0.012), and lower maximal oxygen power (VO2max) (35.48 ± 8.72 vs. 44.43 ± 8.29 mL·kg-1·min-1, p = 0.003), total physical activity counts (346.87 ± 101.97 vs. 451.01 ± 133.52 counts·min-1, p = 0.004), metabolic equivalents (METs) (2.09 ± 0.41 vs. 2.41 ± 0.60 METs, p = 0.033), moderate to vigorous intensity physical activity (MVPA), and the percentage of time spent in MVPA. The level of HDL-C was positively associated with METs (β = 0.29, p = 0.030, model R2 = 0.17), and the level of triglycerides was negatively associated with physical activity counts (β = -0.001, p = 0.018, model R2 = 0.205) and METs (β = -0.359, p = 0.015, model R2 = 0.208) in persons living with T1D. Conclusions:Youth with T1D, despite their young age and short duration of diabetes, present early signs of CVD risk, as well as low physical activity levels and cardiorespiratory fitness compared to healthy controls. Regular physical activity is associated with a beneficial cardiovascular profile in T1D, including improvements in lipid profile. Thus, physical activity participation should be widely promoted in youth living with T1D.

scholarly journals Cardiovascular risk factors from diagnosis in children with type 1 diabetes mellitus: a longitudinal cohort study

2019 ◽  
Vol 7 (1) ◽  
pp. e000625 ◽  
Author(s):  
Stephanie Jones ◽  
Amal R Khanolkar ◽  
Evelien Gevers ◽  
Terence Stephenson ◽  
Rakesh Amin
Keyword(s):  
Risk Factors ◽  
Type 1 Diabetes ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Density Lipoprotein ◽  
Diabetes Duration ◽  
Lipoprotein Cholesterol ◽  
Cvd Risk Factors ◽  
Cvd Risk

BackgroundFor childhood onset type 1 diabetes (T1D), the pathogenesis of atherosclerosis is greatly accelerated and results in early cardiovascular disease (CVD) and increased mortality. However, cardioprotective interventions in this age group are not routinely undertaken.AimsTo document prevalence of cardiovascular risk factors from diagnosis of childhood T1D and their relationship with disease duration and ethnicity.MethodsRoutinely collected clinical records for 565 children with T1D were retrospectively analyzed. Data were collected from diagnosis and at routine check-ups at pediatric diabetes clinics across Barts Health National Health Service Trust. Age at diagnosis was 8.5 years (0.9–19.4). Mean follow-up 4.3 years (0–10.8). 48% were boys and 60% were non-white. Linear longitudinal mixed effects models were used to evaluate relationships between risk factors and diabetes duration.ResultsCVD risk factors were present at first screening; 33.8% of children were overweight or obese, 20.5% were hypertensive (elevated diastolic blood pressure (BP)) and total cholesterol, low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol were abnormal in 63.5%, 34.2% and 22.0%, respectively. Significant associations between diabetes duration and annual increases of body mass index (0.6 kg/m2), BP (0.1 SD score) and lipids (0.02–0.06 mmol/L) were noted. Annual increases were significantly higher in black children for BP and Bangladeshi children for lipids. Bangladeshi children also had greatest baseline levels.ConclusionsCVD risk factors are present in up to 60% of children at diagnosis of T1D and increase in prevalence during the early years of the disease. Commencing screening in younger children and prioritizing appropriate advice and attention to ethnic variation when calculating risk should be considered.

Abstract P282: Cross-sectional Relationship Between Physical Activity and Cardiovascular Risk Factors in Kidney Transplant Patients: A Baseline Examination of the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) Trial

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Augustine W Kang ◽  
Carol E Garber ◽  
Charles B Eaton ◽  
Patricia M Risica ◽  
Andrew G Bostom
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Multiple Regression ◽  
Kidney Transplant ◽  
Chronically Ill ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Hierarchical Multiple Regression ◽  
History Of

Introduction: Data characterizing the potential relationship between physical activity and cardiovascular disease (CVD) risk factors in kidney transplant recipients (KTRs) are limited in the published literature. Accordingly, we sought to: (1) describe the levels of physical activity (PA) in KTRs; and (2) analyze the associations between PA levels and CVD risk factors in KTRs. We report the largest cross-sectional study of PA levels and CVD risk factors in KTRs to date. Methods: Baseline data from the large multiethnic, multicenter trial (FAVORIT) were examined with n = 4034 participants (37% female; mean age 51.9 ± 9.4 years; 75% White; 97% with stage 2T-4T Chronic Kidney Disease; 20% with prevalent CVD). PA was categorized in tertiles (low, moderate, high) derived from a modified PA summary score from the Yale Physical Activity Survey (YPAS). CVD risk factors were examined across levels of PA by ANOVA, Kruskal-Wallis rank test and hierarchical multiple regression modeling. Results: Collectively, participants were less active (mean YPAS 39.9 ± 20.6) compared to similar-aged rheumatoid arthritis (48 ± 21) and osteoarthritis (51 ± 20) samples from other studies. Participants in the “high” PA tertile reported more vigorous PA and walking, compared to participants in moderate and low tertiles (both p < .001). No differences were observed for daily household, occupational or sedentary activities (i.e., standing, sitting, moving about) across PA tertiles. More participants in the “low” PA tertile were overweight/obese and had a history of prevalent diabetes and/or CVD, compared with more active participants (all p < .001). Hierarchical multiple regression revealed that lower age ( p = .002), having a cadaveric donor source ( p = .006), shorter transplant vintage ( p = .025), lower pulse pressure ( p < .001) and no history of diabetes ( p < .001) were significantly associated with higher PA scores. Conclusion: KTR participants appear to be less active than samples of other chronically ill participants. In our data, lower levels of PA were positively associated with the presence of most CVD risk factors in the KTR population. Furthermore, higher PA levels were associated with younger age and variables associated with more positive KTR outcomes. Future longitudinal analyses of this unique KTR cohort will examine whether higher PA levels are associated with reduced risk for the development of hard, centrally-adjudicated CVD outcomes.

scholarly journals Dietary fat Intake Had a Different Influence on Body Mass Index in Active and Inactive Subjects: a Cross-Sectional Study

2020 ◽  
Vol 22 (2) ◽  
pp. 164-170
Author(s):  
Ana Gabriella Pereira Alves ◽  
Mário Flávio Cardoso Lima ◽  
Maria Sebastiana Silva
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Nutrient Intake ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Energy And Nutrient Intake

The understanding of cardiovascular disease (CVD) risk factors and their association with food and physical activity is not yet completely clear. This study aimed to evaluate the association between CVD risk factors with dietary intake, according to the physical activity level. A cross-sectional study was conducted with Brazilian individuals attended by the Public Health System. Demographic, blood pressure, physical activity practice, anthropometry and food intake data were collected and evaluated. Of the 83 participants, 61.4% were active. No difference were observed in the frequency of CVD risk factors, anthropometric data, blood pressure, estimated energy requirement, energy and nutrient intake between the active and inactive subjects (p ≥ .05). There was also no difference in the frequency of energy and nutrient intake adequacy between groups (p ≥ .05). Among the inactive subjects, it was found that the consumption of total (OR: 1.021, p = .035) and saturated (OR: 1.060, p = .033) fat was predictor of being overweight, with no relationship between food intake and the risk factors for CVD when the total participants or active individuals were considered (p ≥ .05). No difference was observed in the frequency of CVD risk factors between active and inactive individuals, however, total and saturated fat consumption increased the chance of being overweight among the inactive individuals. Keywords: Cardiovascular Diseases. Food Consumption. Exercise. Body Weight. Health Systems. Resumo O conhecimento da associação entre os fatores de risco para doenças cardiovasculares com a alimentação e atividade física ainda não está totalmente elucidada. Este estudo teve como objetivo avaliar a associação entre os fatores de risco cardiovascular e o consumo alimentar, segundo o nível de atividade física. Foi realizado um estudo transversal com individuos brasileiros atendidos pelo Sistema Único de Saúde. Foram coletados e avaliados dados demográficos, pressão arterial, prática de atividade física, antropometría e consumo alimentar. Dos 83 participantes, 61,4% eram ativos. Não foi observado diferença na frequência dos fatores de risco cardiovascular, dados antropométricos, pressão arterial, estimativa da necessidade energética, consumo de energía e nutrientes entre os individuos ativos e inativos (p ≥ 0,05). Também não houve diferença na frequência de adequação no consumo de energia e nutrientes entre os grupos (p ≥ 0,05). Entre os participantes inativos, observou-se que o consumo de gordura total (OR: 1,021; p = 0,035) e saturada (OR: 1,060; p = 0,033) foram preditores do sobrepeso, sem relação entre o consumo alimentar e os fatores de risco cardiovascular quando se considerou todos os participantes ou apenas os indivíduos ativos (p ≥ 0,05). Não foi observado diferença na frequência dos fatores de risco cardiovascular entre os sujeitos ativos e inativos, entretanto o consumo de gordura total e saturada aumentou a chance de sobrepeso entre os indivíduos inativos. Palavras-chave: Doenças Cardiovasculares. Consumo de Alimentos. Exercício Físico. Peso Corporal. Sistemas de Saúde.

scholarly journals Geographical profiles of cardiovascular risk and the risk factors in China: data from a nationwide population-based screening project

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.Q Wu ◽  
X Li ◽  
J.P Lu ◽  
B.W Chen ◽  
Y.C Li ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Population Based ◽  
Staple Food ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Food Factor ◽  
Rural And Urban ◽  
Activity Factor

Abstract Background In China, an abundance of cardiovascular risk factors has contributed to the increasing prevalence of cardiovascular diseases (CVD), which caused almost 4 million deaths per year. However, comprehensive evidence on the geographical profiles of cardiovascular disease risk in China is lacking, as findings in prior studies have been limited to relatively small sample sizes, had incomplete regional coverage, or focused on a narrow risk factor spectrum. Purpose To compare the population CVD risk among different regions across China, and to describe the geographical distributions of CVD risk factors and their clusters throughout the nation. Methods In a nationwide population-based screening project covering 252 counties of China, standardized measurements were conducted to collect information on 12 major CVD risk factors. Individuals of high CVD risk were identified as those with previous CVD, or with a predicted 10-year risk of CVD greater than 10% according to the WHO risk prediction charts. We applied factor analysis to generate “clusters” that characterized the clustering of these risk factors, then explored their relationship with the local ambient temperature and per capital GDP. Results Among 983476 participants included, 9.2% were of high CVD risk, with a range of 1.6% to 23.6% across counties. Among the seven regions in China, the rate was relatively high in the Northeast (11.8%) and North China (10.4%), while low in the South China (7.2%) and Northwest (7.8%). We identified 6 clusters underlying CVD risk factors, including Obesity factor, Blood pressure factor, Staple food factor, Non-staple food factor, Smoking and alcohol factor, and Metabolic and physical activity factor (Figure). We found high risk regions were facing different leading challenges, like obesity and blood pressure for the North China, while unhealthy non-staple food for the Northeast. The South China, as the region with the lowest CVD risk, still had the highest prevalence of unhealthy staple food. Lower annual average ambient temperature was associated with higher risk in Blood pressure factor, Obesity factor and Non-staple food factor, but lower risk in Staple food factor and Metabolic and physical activity factor (p&lt;0.001 for all), consistently between rural and urban. Higher per capital GDP was associated with lower risk in Non-staple food factor in urban and higher risk in Metabolic and physical activity factor in rural (p&lt;0.05 for both). The correlation between per capital GDP and Smoking and alcohol factor differed significantly between in rural and urban regions (p=0.042). Conclusions The geographical profile of CVD risk in China is complex - population risk levels varied substantially across regions, which were contributed by different risk factors. China needs geographically targeted intervention strategies considering environmental and socio-economic factors to control CVD risk and reduce the burden related to CVD. Geographical disparity of risk clusters Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The National Key Research and Development Program from the Ministry of Science and Technology of China; the CAMS Innovation Fund for Medical Science

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