Benefits of leisure-related physical activity and association between sedentary time and risk for hypertension and type 2 diabetes

Introduction: Lifestyle modifications can reduce the risk of type 2 diabetes mellitus (T2DM) and hypertension. Our study investigated whether domain-specific physical activity (such as work, transport and leisure) and sedentary behaviour were associated with T2DM and hypertension, and whether these associations were moderated by sex and age. Method: For this cross-sectional study, data were obtained from a population survey in Singapore (n=2,867) conducted from February 2019 to March 2020. T2DM and hypertension were self-reported. Global physical activity questionnaire was used to assess domain-specific physical activity (in metabolic equivalent of task [MET]-minutes) and sedentary time (in hours). Logistic regression models were generated to examine the abovementioned associations, and adjusted for age, sex, education, ethnicity, personal income, body mass index, diet and hypertension/diabetes. Interaction terms were included individually to investigate whether age and sex moderated the associations. Results: Individuals with >826 MET-minutes of leisure-related physical activity had lower odds of having T2DM (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.24–0.86) and hypertension (OR 0.59, 95% CI 0.37–0.94) than those with no leisure-related physical activity. Individuals with >8 hours of sedentary time had higher odds of having hypertension (OR 1.69, 95% CI 1.06–2.69) than those with 0–5 hours of sedentary time. Logistic regression models including interaction terms showed that the association between leisure-related physical activity and hypertension was significant for those aged 18–34 (OR 0.15, 95% CI 0.03–0.66) and 50–64 years (OR 0.44, 95% CI 0.21–0.91). The association between sedentary time and hypertension was significant for those aged 18–34 years (OR 15.07, 95% CI 1.69–133.92). Conclusion: Our results support the widespread promotion of an active lifestyle to lower the prevalence of diabetes and hypertension in Singapore. Keywords: Active lifestyle, domain-specific physical activity, global physical activity questionnaire

[1]  S. Chong,et al.  Barriers and facilitators for adopting a healthy lifestyle in a multi-ethnic population: A qualitative study , 2022, PloS one.

[2]  F. Müller-Riemenschneider,et al.  Prevalence and patterns of physical activity, sedentary behaviour, and their association with health-related quality of life within a multi-ethnic Asian population , 2021, BMC Public Health.

[3]  Gopala Krishna Alaparthi,et al.  Low Physical Activity Levels Are Linked to Early Hypertension Risk in College-Going Young Adults , 2021, Healthcare.

[4]  Jihee Min,et al.  Association between domain-specific physical activity and diabetes in Korean adults , 2021, Scientific Reports.

[5]  R. V. van Dam,et al.  The Association of Different Types of Leisure Time Physical Activities with Cardiometabolic Outcomes in Singapore—Findings from the Multi-Ethnic Cohort Study , 2020, International journal of environmental research and public health.

[6]  R. V. van Dam,et al.  Study protocol for a nationwide Knowledge, Attitudes and Practices (KAP) survey on diabetes in Singapore’s general population , 2020, BMJ Open.

[7]  H. Kimm,et al.  Analysis of Association of Occupational Physical Activity, Leisure-Time Physical Activity, and Sedentary Lifestyle with Hypertension according to the Adherence with Aerobic Activity in Women Using Korea National Health and Nutrition Examination Survey 2016-2017 Data , 2020, International journal of hypertension.

[8]  Jiang He,et al.  The global epidemiology of hypertension , 2020, Nature Reviews Nephrology.

[9]  G. Santulli,et al.  Pathophysiological mechanisms underlying the beneficial effects of physical activity in hypertension , 2020, Journal of clinical hypertension.

[10]  Anna A. Divney,et al.  Diabetes Prevalence by Leisure-, Transportation-, and Occupation-Based Physical Activity Among Racially/Ethnically Diverse U.S. Adults , 2019, Diabetes Care.

[11]  G. Curfman,et al.  Hypertension-A Public Health Challenge of Global Proportions. , 2018, JAMA.

[12]  C. Whitton,et al.  Relative validity and reproducibility of dietary quality scores from a short diet screener in a multi-ethnic Asian population , 2018, Public Health Nutrition.

[13]  F. Müller-Riemenschneider,et al.  Domain-Specific Adult Sedentary Behaviour Questionnaire (ASBQ) and the GPAQ Single-Item Question: A Reliability and Validity Study in an Asian Population , 2018, International journal of environmental research and public health.

[14]  J. Shaw,et al.  IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. , 2018, Diabetes research and clinical practice.

[15]  A. Marques,et al.  The association between physical activity and chronic diseases in European adults , 2018, European journal of sport science.

[16]  I. Benseñor,et al.  Leisure-time and commuting physical activity and high blood pressure: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) , 2017, Journal of Human Hypertension.

[17]  S. Sim,et al.  Leisure sedentary time is differentially associated with hypertension, diabetes mellitus, and hyperlipidemia depending on occupation , 2017, BMC Public Health.

[18]  T. Mizoue,et al.  Leisure-time, occupational, and commuting physical activity and risk of type 2 diabetes in Japanese workers: a cohort study , 2015, BMC Public Health.

[19]  Falk Müller-Riemenschneider,et al.  Reliability and Validity of the Self- and Interviewer-Administered Versions of the Global Physical Activity Questionnaire (GPAQ) , 2015, PloS one.

[20]  Tien Yin Wong,et al.  Forecasting the burden of type 2 diabetes in Singapore using a demographic epidemiological model of Singapore , 2014, BMJ Open Diabetes Research and Care.

[21]  H. van den Bussche,et al.  Agreement between self-reported and general practitioner-reported chronic conditions among multimorbid patients in primary care - results of the MultiCare Cohort Study , 2014, BMC Family Practice.

[22]  Sanjay Kinra,et al.  Associations between Active Travel to Work and Overweight, Hypertension, and Diabetes in India: A Cross-Sectional Study , 2013, PLoS medicine.

[23]  A. Ramahi,et al.  Prevalence and risk factors of obesity and hypertension among students at a central university in the West Bank , 2012, The Libyan journal of medicine.

[24]  P. Kearney,et al.  The cumulative effect of core lifestyle behaviours on the prevalence of hypertension and dyslipidemia , 2008, BMC public health.

[25]  F. Bull,et al.  Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ) , 2006, Journal of Public Health.

[26]  S. Ulijaszek.  Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation. WHO Technical Report Series 894. Pp. 252. (World Health Organization, Geneva, 2000.) SFr 56.00, ISBN 92-4-120894-5, paperback. , 2003 .

[27]  F. Hu,et al.  Dietary patterns and risk of hypertension, type 2 diabetes mellitus, and coronary heart disease , 2002, Current atherosclerosis reports.

[28]  Hirofumi Tanaka,et al.  Regular Aerobic Exercise Prevents and Restores Age-Related Declines in Endothelium-Dependent Vasodilation in Healthy Men , 2000, Circulation.

[29]  H A Keizer,et al.  Exercise and Insulin Sensitivity: A Review , 2000, International journal of sports medicine.

[30]  P Oja,et al.  Agreement between questionnaire data and medical records of chronic diseases in middle-aged and elderly Finnish men and women. , 1997, American journal of epidemiology.