TY - JOUR
T1 - Change in physical activity, food choices and hemoglobin A1c among American Indians and Alaska Natives with type 2 diabetes
AU - Camplain, Ricky
AU - Teufel-Shone, Nicolette I.
AU - Jiang, Luohua
AU - Chang, Jennifer
AU - Manson, Spero M.
N1 - Funding Information:
The authors would like to express their gratitude to the Indian Health Service as well as the Indian health programs and participants involved in the Special Diabetes Program for Indians-Healthy Heart Program. The authors would also like to acknowledge the support and guidance from Carmen Licavoli Hardin and Karen Sheff of the IHS Division of Diabetes Treatment and Prevention. The SDPI-HH was supported by the IHS (S.M. Manson, grant number HHSI242200400049C). Manuscript preparation was supported in part by National Institute of Diabetes and Digestive and Kidney Diseases (R21DK108187, L. Jiang; and 1P30DK092923, S.M. Manson).
Funding Information:
The SDPI-HH was supported by the IHS (S.M. Manson, Grant No HHSI242200400049C). Manuscript preparation was supported in part by National Institute of Diabetes and Digestive and Kidney Diseases (R21DK108187, L. Jiang; and 1P30DK092923, S.M. Manson).
Publisher Copyright:
© 2022 The Authors
PY - 2022/10
Y1 - 2022/10
N2 - The prevalence of diabetes among American Indian and Alaska Native (AI/AN) adults is the highest of all United States racial/ethnic groups. Health behaviors, including regular physical activity and healthy food choices, are important components in the management of diabetes. We estimated the cross-sectional association between physical activity and healthy food scores, separately, and combined (PAHF) with hemoglobin A1c (HbA1c) over three years of the Special Diabetes Program for Indians-Healthy Heart demonstration project (SDPI-HH) intervention. The relationship between physical activity and food choices was also examined. Among 3,039 SDPI-HH participants at baseline, those reporting being physically active and having high healthy food scores had statistically significant lower HbA1c (mean = 7.67 ± 2.01) compared to inactive participants with low healthy food scores (7.90 ± 1.92). Among the 1,150 SDPI-HH participants who attended the three-year follow-up visit, participants who increased physical activity, consumption of healthy foods, or both had a larger decrease in HbA1c (β = -0.29, P = 0.03) over the study period compared to participants with no improvement in physical activity or increase in consuming healthy foods. This association was statistically significant among women (β = -0.35, P = 0.04) but not among men (β = -0.08, P = 0.70). Our findings indicated that an increase in healthier behaviors, including physical activity and healthy food choices, was associated with a small improvement in HbA1c in the subset of women who participated in the SDPI-HH through the three-year follow up. Although the decrease in HbA1c was small, physical activity and healthy food choices are important behaviors to incorporate into everyday life among AI/AN adults, particularly those with diabetes.
AB - The prevalence of diabetes among American Indian and Alaska Native (AI/AN) adults is the highest of all United States racial/ethnic groups. Health behaviors, including regular physical activity and healthy food choices, are important components in the management of diabetes. We estimated the cross-sectional association between physical activity and healthy food scores, separately, and combined (PAHF) with hemoglobin A1c (HbA1c) over three years of the Special Diabetes Program for Indians-Healthy Heart demonstration project (SDPI-HH) intervention. The relationship between physical activity and food choices was also examined. Among 3,039 SDPI-HH participants at baseline, those reporting being physically active and having high healthy food scores had statistically significant lower HbA1c (mean = 7.67 ± 2.01) compared to inactive participants with low healthy food scores (7.90 ± 1.92). Among the 1,150 SDPI-HH participants who attended the three-year follow-up visit, participants who increased physical activity, consumption of healthy foods, or both had a larger decrease in HbA1c (β = -0.29, P = 0.03) over the study period compared to participants with no improvement in physical activity or increase in consuming healthy foods. This association was statistically significant among women (β = -0.35, P = 0.04) but not among men (β = -0.08, P = 0.70). Our findings indicated that an increase in healthier behaviors, including physical activity and healthy food choices, was associated with a small improvement in HbA1c in the subset of women who participated in the SDPI-HH through the three-year follow up. Although the decrease in HbA1c was small, physical activity and healthy food choices are important behaviors to incorporate into everyday life among AI/AN adults, particularly those with diabetes.
KW - American Indian and Alaska Natives
KW - Health behaviors
KW - Health promotion
KW - Special Diabetes Program for Indians
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U2 - 10.1016/j.pmedr.2022.101945
DO - 10.1016/j.pmedr.2022.101945
M3 - Article
AN - SCOPUS:85136457008
SN - 2211-3355
VL - 29
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
M1 - 101945
ER -