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Bonny Rockette-Wagner, Rachel G. Miller, Yvonne L. Eaglehouse, Vincent C. Arena, M. Kaye Kramer, and Andrea M. Kriska

Time spent in activities with low energy expenditure performed while sitting or lying down has been termed sedentary behaviors . 1 These behaviors have been shown to increase the risk of diabetes and cardiovascular disease. 2 , 3 More than 10 years after the Diabetes Prevention Program (DPP

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Corliss Bean, Tineke Dineen, and Mary Jung

). Landmark intervention trials in individuals with prediabetes (e.g., the Diabetes Prevention Program, Finnish Diabetes Prevention Study, and Da Qing IGT) demonstrated that increasing physical activity and improving diet were effective in preventing T2D ( Diabetes Prevention Program Research, 2002

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Steven Loy

3 WINS Fitness is a student-delivered free exercise program for the community delivered in public parks. We believe this program, which operates without external funding and has been sustained for 6 years, is one significant solution to reducing the level of physical inactivity in the United States. The operative 3 WINS in our program are participant health, community health, and student professional development. The primary focus has been underserved communities, and our current eight programs in Los Angeles, serve over 300 participants regularly. Three challenges to the program are student empowerment, faculty understanding and involvement, and establishing the relationship between university and parks, which represent a vital partnership. However, the accomplishment of undergraduate students having such a dynamic impact on public health underscores the need for encouraging this sustainable and innovative strategy to increase the physical activity levels of communities across America.

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Barry Braun

The concept that participation in exercise/physical activity reduces the risk for a host of chronic diseases is undisputed. Along with adaptations to habitual activity, each bout of exercise induces beneficial changes that last for a finite period of time, requiring subsequent exercise bouts to sustain the benefits. In this respect, exercise/physical activity is similar to other “medications” and the idea of “Exercise as Medicine” is becoming embedded in the popular lexicon. Like other medications, exercise has an optimal dose and frequency of application specific to each health outcome, as well as interactions with food and other medications. Using the prevention of type-2 diabetes as an exemplar, the application of exercise/physical activity as a medication for metabolic “rehabilitation” is considered in these terms. Some recommendations that are specific to diabetes prevention emerge, showing the process by which exercise can be prescribed to achieve health goals tailored to individual disease prevention outcomes.

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Erica Rosenberger Hale, David C. Goff, Scott Isom, Caroline Blackwell, Melicia C. Whitt-Glover, and Jeffery A. Katula

Background:

Physical inactivity contributes to metabolic syndrome (MetS) in overweight/obesity. However, little is known about this relationship in prediabetes.

Methods:

The study purpose is to examine relationships between physical activity (PA) and MetS in prediabetes. The Healthy Living Partnerships to Prevent Diabetes tested a community translation of the Diabetes Prevention Program (DPP). Three hundred one overweight/obese prediabetics provided walking minutes/week (WM) and total activity minutes/week (AM) via the International Physical Activity Questionnaire. MetS was at least 3 of waist (men ≥ 102 cm, women ≥ 88 cm), triglycerides (≥150 mg·dl), blood pressure (≥130·85 mm Hg), glucose (≥100mg·dl), and HDL (men < 40mg·dl, women < 50mg·dl).

Results:

The sample was 57.5% female, 26.7% nonwhite/Hispanic, 57.9 ± 9.5 years and had a body mass index (BMI) 32.7 ± 4 kg·m2. Sixty percent had MetS. Eighteen percent with MetS reported at least 150 AM compared with 29.8% of those without MetS. The odds of MetS was lower with greater AM (P trend = .041) and WM (P trend = .024). Odds of MetS with 0 WM were 2.08 (P = .046) and with no AM were 2.78 (P = .009) times those meeting goal. One hour additional WM led to 15 times lower MetS odds.

Conclusions:

Meeting PA goals reduced MetS odds in this sample, which supported PA for prediabetes to prevent MetS.

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Astrid Steinbrecher, Eva Erber, Andrew Grandinetti, Claudio Nigg, Laurence N. Kolonel, and Gertraud Maskarinec

Background:

Physical inactivity is an established risk factor for diabetes; however, little is known about this association across ethnic groups with different diabetes risk. Therefore, we evaluated the association between physical activity and diabetes and potential effect modification by ethnicity in the Hawaii component of the Multiethnic Cohort.

Methods:

Participants, aged 45 to 75 years, were enrolled by completing a questionnaire on demographics, diet, and self-reported weekly hours of strenuous sports, vigorous work, and moderate activity. Among the 74,913 participants (39% Caucasian, 14% Native Hawaiian, 47% Japanese American), 8561 incident diabetes cases were identified by self-report, a medication questionnaire, and through health plan linkages. Cox regression was applied to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) while adjusting for known confounders.

Results:

Engaging in strenuous sports was inversely related to diabetes risk with HRs (4+ hours/week vs. never) of 0.67 (95%CI: 0.57–0.79) in women and 0.80 (95%CI: 0.72–0.88) in men. In stratified analyses, the inverse association was consistent across ethnic groups. The inverse association of vigorous work with diabetes was limited to men, while beneficial effects of moderate activity were observed only in Caucasians.

Conclusions:

These findings support a role of high-intensity physical activity and ethnic-specific guidelines in diabetes prevention.

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Ashley B. West, Adam R. Konopka, Kelli A. LeBreton, Benjamin F. Miller, Karyn L. Hamilton, and Heather J. Leach

designed to improve dietary habits and increase physical activity (PA) ( Cowie et al., 2009 ; Penn et al., 2009 ; Rossen et al., 2015 ). Interventions that include PA demonstrate as much as 50% reductions in the likelihood of developing Type II diabetes ( Colberg et al., 2010 ; Diabetes Prevention

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Steven Loy

evolution), and we have developed our program to serve 4 different fitness levels, including a falls prevention group, and deliver a free diabetes program modified from the National Diabetes Prevention Program. The 3 WINS Fitness program is sustainable, affordable, replicable, and scalable. The problem of

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Vernon M. Grant, Emily J. Tomayko, Ronald J. Prince, Kate Cronin, and Alexandra Adams

findings, cross-sectional research reports conflicting findings that appear to be dependent on the population. For instance, plant workers were found to have an inverse association between PA and stress, 25 while no association was found between these variables for Diabetes Prevention Program participants

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Scherezade K. Mama, Lorna H. McNeill, Erica G. Soltero, Raul Orlando Edwards, and Rebecca E. Lee

a result of participating in SALSA. High self-efficacy is typically associated with increased physical activity in diverse samples of women ( Delahanty, Conroy, Nathan, & Diabetes Prevention Program Research, 2006 ; Fjeldsoe, Miller, & Marshall, 2013 ; Tavares, Plotnikoff, & Loucaides, 2009