US Hispanics/Latinos are the largest US minority group, constituting over 15% of the US population and growing to one-third of the US population by 2050. Hispanics match or exceed any other race-ethnicity group in having a high burden of diabetes and pre-diabetes. Especially given the relatively young age of US Hispanics, the group with prediabetes (e.g.,fasting plasma glucose 100-125 mg/dl) are of immense public health importance because 15-30% of people with prediabetes will develop diabetes within five years. Physical activity (PA) is an effective preventive behavior in the battle to prevent diabetes as suggested by the Diabetes Prevention Program. In this context, the Hispanic population presents a paradox. Particularly among males, Hispanics have higher moderate-to-vigorous activity levels than non-Hispanics and light intensity PA is higher and sedentary behavior (SB) is lower among Hispanics than other groups. There is also an apparent contradiction (Hispanic paradox) between a high risk of prediabetes/diabetes among Hispanics, while at the same time Hispanics have favorable mortality rates vs. others and may also have lower incidence of cardiovascular disease (CVD). The present application will leverage the Hispanic Community Health Study/Study of Latino Hispanics as well as the Framingham Heart Study (FHS) Third Generation and Omni Gen 2 (FHS Gen3/Omni2) cohorts of multiple race/ethnic groups. This approach not only increases generalizability of our findings to the US mainstream population, but also helps us understand what is unique about Hispanics. In all, 5500 individuals with confirmed prediabetes will be studied, all of whom had 7-day baseline Actical accelerometry measurements (2008-2011) which will be repeated during 2017-2020. This approach will allow us to understand the relationship among PA, SB, onset of diabetes and CVD in a large, representative population study of prediabetics.
Increasing physical activity and reducing sedentary behavior can provide a potentially low-cost and powerful strategy to enhance overall health of society at large. We propose to examine this question longitudinally and cross-sectionally with respect to conversion from prediabetes to diabetes and cardiovascular outcomes by adding a second accelerometer measure in two cohort studies with both mainstream and minority representation.
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