Physical Inactivity from Youth to Adulthood and Risk of Impaired Glucose Metabolism

ABSTRACTIntroductionPhysical activity (PA) is important in the prevention and treatment of impaired glucose metabolism. However, association of physical inactivity during the transition between childhood and adulthood with glucose metabolism is unknown. Therefore, we studied the association of persistent physical inactivity since childhood with glucose metabolism in adulthood.MethodsData were drawn from the ongoing, Cardiovascular Risk in Young Finns Study with repeated follow-ups between 1980-2011 (baseline age 3-18 years, n=3596). Impaired glucose metabolism was defined as having impaired fasting glucose (6.1-6.9mmol/l) or type 2 diabetes in adulthood. Leisure-time PA habits were repeatedly collected with a standardized questionnaire and expressed as a PA index (PAI). Using PAI, four groups were formed (n=2000): 1) persistently low PA, 2) decreasingly active, 3) increasingly active and 4)persistently active subjects. Poisson regression model was used to examine the association between PA groups and impaired glucose metabolism.ResultsThe proportion of the sample with impaired glucose metabolism was 16.1% in individuals with persistently low PA, 14.5% in decreasingly active, 6.8% in increasingly active and 11.1% in persistently active. Compared to individuals with persistently low PA, age and sex adjusted risk for impaired glucose metabolism was lower in those who increased PA (RR=0.47 CI=0.29–0.76) and in those who were persistently active (RR=0.70 CI=0.51–0.97), but similar in those who decreased PA (RR=0.93 CI=0.66–1.36).ConclusionPersistently physically inactive lifestyle from youth to adulthood is associated with increased risk of impaired glucose metabolism in adulthood. Importantly, a moderate increase in PA lowered the risk. The results highlight the importance of avoiding physically inactive lifestyle at all stages of life. Introduction Physical activity (PA) is important in the prevention and treatment of impaired glucose metabolism. However, association of physical inactivity during the transition between childhood and adulthood with glucose metabolism is unknown. Therefore, we studied the association of persistent physical inactivity since childhood with glucose metabolism in adulthood. Methods Data were drawn from the ongoing, Cardiovascular Risk in Young Finns Study with repeated follow-ups between 1980-2011 (baseline age 3-18 years, n=3596). Impaired glucose metabolism was defined as having impaired fasting glucose (6.1-6.9mmol/l) or type 2 diabetes in adulthood. Leisure-time PA habits were repeatedly collected with a standardized questionnaire and expressed as a PA index (PAI). Using PAI, four groups were formed (n=2000): 1) persistently low PA, 2) decreasingly active, 3) increasingly active and 4)persistently active subjects. Poisson regression model was used to examine the association between PA groups and impaired glucose metabolism. Results The proportion of the sample with impaired glucose metabolism was 16.1% in individuals with persistently low PA, 14.5% in decreasingly active, 6.8% in increasingly active and 11.1% in persistently active. Compared to individuals with persistently low PA, age and sex adjusted risk for impaired glucose metabolism was lower in those who increased PA (RR=0.47 CI=0.29–0.76) and in those who were persistently active (RR=0.70 CI=0.51–0.97), but similar in those who decreased PA (RR=0.93 CI=0.66–1.36). Conclusion Persistently physically inactive lifestyle from youth to adulthood is associated with increased risk of impaired glucose metabolism in adulthood. Importantly, a moderate increase in PA lowered the risk. The results highlight the importance of avoiding physically inactive lifestyle at all stages of life. Corresponding author: Petri Kallio, MD, Paavo Nurmi Centre & Department of Health and Physical Activity, University of Turku, Turku, Finland, Kiinamyllynkatu 10, 20520 Turku, Finland. petri.kallio@utu.fi. Tel +358(50)5391907 The Cardiovascular Risk in Young Finns Study was financially supported by the Suomen Akatemia (Academy of Finland) (grants 286284 [to T.L.]; 134309 [Eye]; 126925, 121584, 124282, and 129378 [Salve]; 117787 [Gendi]; 41071 [Skidi]; 275595 [to K.P.]); Social Insurance Institution of Finland; Kuopio, Tampere, and Turku University Hospital Medical Funds (grant X51001 to T.L.); Juho Vainio Foundation; Paavo Nurmi Foundation; Finnish Foundation of Cardiovascular Research; Finnish Cultural Foundation; Sigrid Juselius Foundation; Tampere Tuberculosis Foundation; Emil Aaltonen Foundation; and Yrjö Jahnsson Foundation. This work was also partly funded by the National Heart Foundation of Australia Future Leader Fellowship (grant 100849 to C.G.M.) and the National Health and Medical Research Council Project (grant APP1098369). The authors made every attempt to present the results of the study clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. The authors also acknowledge that the present study does not constitute endorsement by the American College of Sports Medicine. The authors declare that they have no competing interests. There are no conflict of interests to disclose for any of the authors. Accepted for Publication: 18 December 2017 © 2018 American College of Sports Medicine

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