Leisure-time physical activity and sedentary behavior trajectories during middle and late adulthood in relation to...

Leisure-time physical activity (LTPA) and sedentary behavior (SB) are considered important modifiable risk factors for Type 2 diabetes mellitus (T2DM). However, the associations of long-term trajectories of LTPA and LTSB with T2DM risk remains uncertain.

Leveraging prospective cohort data from the China Health and Nutrition Survey (CHNS), we identified the long-term trajectories of LTPA and LTSB among 7,188 participants from 2004 (31 to 77 years) to 2015 (42 to 88 years) by group-based trajectory modeling. Cox regression was used to assess the associations of LTPA and LTSB trajectories with T2DM.

During a mean follow-up of 9.13 years, 715 new-onset T2DM were identified. Three distinct trajectories were identified for both LTPA and LTSB, respectively. Participants in the high decreasing trajectory, but still remains at a relatively high level of LTPA had a 45% lower risk of T2DM (HR: 0.55; 95% CI: 0.30-0.99), relative to those in the inactive stable trajectory. Conversely, compared with the low stable trajectory, the high increasing trajectory of LTSB had a 130% higher risk of T2DM (HR: 2.30; 95% CI: 1.03-5.10).

This prospective study suggests that maintaining higher levels of LTPA and lower levels of LTSB may reduce the risk of T2DM during middle and late adulthood.