JOINT EFFECTS OF OBESITY AND PHYSICAL INACTIVITY ON

JOINT EFFECTS OF OBESITY AND PHYSICAL INACTIVITY ON CARDIOVASCULAR DISEASE RISK AMONG HISPANICS WITH TYPE 2 DIABETESRanjita Misra, Steve Riechman, Julio Guerrero, Roxana Valdes-Ramos, Sukho Lee, Linda Castillo, Ivonne Vizcarra-Bordi, Martha Kaufer-Horwitz

The purpose of this study was to investigate the joint associations of physical inactivity and obesity with CVD risk factors among Hispanic adults with diabetes

Physical inactivity seems to have an independent effect on CVD risk.

Obesity increases the risk partly through the modification of other risk factors.

The increasing Mexican-American population and high rates of obesity and diabetes should motivate health professionals to focus on primary prevention for this ethnic group.

Obesity among individuals with type 2 diabetes leads to cardiovascular disease (a macro-vascular complication of diabetes). Obesity is a

multifactorial

disease requiring a comprehensive preventive approach.

26.9% of Americans are obese, including 29.3% of Hispanics (CDC, 2009).

Hispanics (15% of the U.S. population) are the largest and fastest-growing ethnic minority group; 53% do not perform the recommended amount of physical activity.

Prevalence of diabetes (12.4%) is very high among Mexican-Americans (twice as much as non-Hispanic Whites).

Demographics

- age, gender,

country of residence,

educational level,

age of diabetes onset

Health Behaviors

– smoking, diet, physical activity

Psychosocial Variables

–

Social support

Depression

Acceptance of diabetes

Anthropometric

measurements height, weight, blood pressure, Body Mass Index (BMI).Clinical Variables – blood pressure, total cholesterol, high- and low-density lipoproteins, triglycerides, glycosylated hemoglobin (HbA1c).

Rationale/Purpose

Results

Measures

Introduction

Table 1

: Demographics

Discussion and Conclusion

s

s

Variable

Frequency

Percent

Nationality & Gender

Mexicans

male

female

Mexican-Americans

maleFemale151361151082484 58.3%23.8%76.2%41.7%22.2%77.8%

Methods

The sample comprised of 259 Mexican and Mexican American adults with type 2 diabetes.Survey data were collected by trained and ethnically similar interviewers on the following parameters.Physical activity was measured by the Rapid Assessment Physical Activity scale (English and Spanish). Obesity was measured by the Body Mass Index.Respondents were placed into four distinct obesity-physical activity groups: non-obese active, non-obese inactive, obese active, and obese inactive.Social support was measured by the Multidimensional Scale for Perceived Social Support. Depression was measured by the Center for Epidemiologic Studies Depression Scale. Dietary intake was measured by the nutrition subscale of the revised Health Promotion Lifestyle Profile II. Acceptance of diabetes was measured by the Revised Ideas About Diabetes scale. Data was analyzed using SPSS program (SPSS Inc., Chicago, IL).

Physical inactivity and obesity had a strong and independent association with CVD risk in both genders.Non-obese active individuals had the lowest risk for CVD (total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein, and systolic and diastolic blood pressure) followed by obese active individuals, non-obese inactive, and obese inactive Hispanics.Regression analysis showed adjustment for the obesity-related risk factors did not weaken the associations between obesity/inactivity and CVD risk.Psychosocial factor [e.g., acceptance of diabetes], nutrition behavior, education, blood pressure and obesity/inactivity predicted CVD risk (total cholesterol) in this sample [R2=.20; p<.01].Although obesity was higher among Mexican Americans, Mexicans had poor glycemic control and higher CVD risk than their counterparts in the United States.

** Significant differences between the groups for dietary habits and social support is p <.001, and depression is p=.038

** Significant differences existed between the groups in their total cholesterol (p<.001), triglyceride (p=.038), HDL (non-sig), HbA1c (p<.001), systolic blood pressure (p=.009), diastolic blood pressure (p<.001).

Variable

Mean

SD

Systolic Blood Pressure (mm HG)MexicansMexican-Americans125.1136.7± 16.8± 21.5Diastolic Blood Pressure (mm HG)MexicansMexican-Americans75.383.5± 10.6± 11.7Body Mass Index (kg/m2)MexicansMexican-Americans29.134.7± 4.9± 8.6

Table 2: Anthropometric Variables

Table 3: Clinical Measures

VariableMeanSDSocial SupportMexicansMexican-Americans5.15.7± 1.5± 1.1Confidence (Acceptance of Diabetes)MexicansMexican-Americans4.14.3± 0.9± 0.5Inhibition (Acceptance of Diabetes)MexicansMexican-Americans2.62.2± 0.8± 0.8Nutrition BehaviorMexicansMexican-Americans2.51.7± 0.5± 0.5DepressionMexicansMexican-Americans28.516.3± 13.6± 11.2

VariableMeanSDTriglycerides (mg/dl)MexicansMexican-Americans220.4196.1± 137.7± 129.0High-density Lipoproteins (mg/dl)MexicansMexican-Americans42.942.6± 12.0± 9.5Low-density Lipoproteins (mg/dl)MexicansMexican-Americans117.1105.4± 36.8± 31.1Total Cholesterol (mg/dl)MexicansMexican-Americans199.4182.6± 49.4± 42.4HbA1cMexicansMexican-Americans8.57.5± 2.5± 1.7

Table 4: Psychosocial & Behavioral Measures

** Significant differences existed between the groups in their acceptance of the disease (outlook – not significant, Inhibition, p=.050, confidence, p=.005).

This project was funded by la

Programa

de

Investigacion en Migracion Y Salud (PIMSA) Grant