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Incident Type 2 Diabetes in a Large Australian Cohort Study: Does Physical Activity or Sitting Time Alter the Risk Associated With Body Mass Index?

Binh Nguyen, Adrian Bauman, and Ding Ding

Purpose:

To examine the combined effects of body mass index (BMI), physical activity (PA) and sitting on incident type 2 diabetes mellitus (T2DM) among Australian adults.

Methods:

A sample of 29,572 adults aged ≥45 years from New South Wales, Australia, completed baseline (2006–2008) and follow-up (2010) questionnaires. Incident T2DM was defined as self-reported, physician-diagnosed diabetes at follow-up. BMI was categorized as normal/overweight/obese. PA was tertiled into low/medium/ high. Sitting was dichotomized as higher/lower sitting (≥ 8 hours/day or < 8 hours/day). Odds ratios (OR) were estimated for developing T2DM using logistics regression for individual and combined risk factors, and data stratified by BMI categories.

Results:

During a mean 2.7 (SD: 0.9) years of follow-up, 611 (2.1%) participants developed T2DM. In fully adjusted models, BMI was the only independent risk factor for incident T2DM. In stratified analyses, the association between BMI and T2DM did not differ significantly across sitting or PA categories. Overweight/obese individuals with high PA and lower sitting had higher odds of incident T2DM than normal counterparts with low PA and higher sitting.

Conclusions:

High PA/low sitting did not attenuate the risk of T2DM associated with overweight/obesity. Maintaining a healthy weight, by adopting healthy lifestyle behaviors, is critical for T2DM prevention.

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Utilizing Behavioral Economics to Understand Adherence to Physical Activity Guidelines Among a Low-Income Urban Community

Kerem Shuval, Xia Si, Binh Nguyen, and Tammy Leonard

Background:

Behavioral economics studies have found that individuals with more patient time preferences (ie, greater willingness to forgo current costs for future benefits) are more likely to save money. Although research has observed significant relationships between time preferences and health-promoting behaviors, scant evidence exists with physical activity as an outcome.

Methods:

We examined the association between monetary saving behaviors and physical activity among adults of low-income who reside in an urban community. Specifically, we assessed the relationship between saving behaviors (checking/saving account, monthly savings, and planning family finances), and future orientation to physical activity as a dichotomous (meeting guidelines) and continuous (total and domain specific) endpoint.

Results:

In multivariable regression, being future-oriented and having a checking/saving account were related to a 1.3 and 2.1 times higher (respectively) likelihood of meeting physical activity guidelines (P < .05). When examining physical activity continuously, all measures were significantly related to leisure-time activity (P < .05).

Conclusions:

Our study findings establish a relationship between future time preferences and increased levels of physical activity among low-income adults. Future research should prospectively explore the efficacy of various schemes that help individuals overcome impatient time preferences to determine a causal relationship.

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A Holistic Way to Understand the Determinants of Physical Activity in Urban New South Wales, Australia: A Codesigned Systems Mapping Project

Mengyun Luo, Binh Nguyen, Tracy Nau, Simon K. Chiu, Adrian Bauman, Louise Freebairn, William Bellew, Lucie Rychetnik, David T. Burns, Elizabeth A. Calleja, Lucy Corbett, Jennifer L. Kent, David R. Lubans, Anthony D. Okely, Catherine Sherrington, Anne Tiedemann, and Ding Ding

Background: To meet the World Health Organization goal of reducing physical inactivity by 15% by 2030, a multisectoral system approach is urgently needed to promote physical activity (PA). We report the process of and findings from a codesigned systems mapping project to present determinants of PA in the context of urban New South Wales, Australia. Methods: A participatory conceptual mapping workshop was held in May 2023 with 19 participants working in education, transportation, urban planning, community, health, and sport and recreation. Initial maps were developed and refined using online feedback from the participants. Interviews were conducted with 10 additional policymakers from relevant sectors to further refine the maps. Results: Two systems maps were cocreated, identifying over 100 variables influencing PA and their interconnections. Five settings emerged from the adults’ map—social and community, policy, built environment and transportation, health care, and workplace—and 4 for the young people’s map—family, school, transportation, and community and environment. The maps share similarities, such as regarding potential drivers within the transportation, community, and built environment sectors; however, the young people’s map has a specific focus on the school setting and the adults’ map on workplace and health care settings. Interviews with policymakers provided further unique insights into understanding and intervening in the PA system. Conclusions: This codesigned participatory systems mapping process, supplemented by stakeholder interviews, provided a unique opportunity to bring together stakeholders across sectors to understand the complexity within the PA system and begin to identify leverage points for tackling physical inactivity in New South Wales.