Association Between Leisure Time Physical Activity and Insulin Resistance: Analysis of NHANES 2007-2018

Leisure time physical activity (LTPA) is a modifiable factor in the prevention and treatment of type 2 diabetes. While studies show LTPA reduces insulin resistance (IR), metabolic syndrome, and diabetes risk, the specific relationship between LTPA levels and IR needs further investigation. Participants were from the National Health and Nutrition Examination Survey between 2007 and 2018 (N = 11,143 adults aged 49.4 ± 17.6, male). LTPA was assessed using the Global Physical Activity Questionnaire. IR was dichotomized using the homeostatic model assessment with a threshold 2.5. Survey-weighted logistic regression and restricted cubic spline analyses examined LTPA-insulin resistance relationships. Statistical analyses were survey-weighted and adjusted for covariates. Analyses were performed using the R, and P-values ≤0.05 were considered statistically significant. Compared to inactive individuals, participants who met LTPA≥300 min/week showed significantly lower IR risk (OR = 0.68; 95% CI:0.57-0.82), while weekend warriors showed no benefit (OR = 1.01, P = 0.950). A significant overall association was observed between LTPA and IR risk (P-overall <0.001), with a non-linear dose-response pattern (P-non-linear = 0.022), with benefits plateauing at 450 min/week. Regular LTPA of 300-450 min/week may be optimal for preventing insulin resistance. These findings highlight the importance of engaging in regular LTPA for 300-450 min/week to maintain insulin sensitivity and reduce the risk of diabetes.