Long Gráinne H, Brage Søren, Wareham Nicholas J, van Sluijs Esther M F, Sutton Stephen, Griffin Simon J, Simmons Rebecca K
MRC Epidemiology Unit, University of Cambridge, Institute of Public Health, Cambridge, UK.
BMC Public Health. 2013 Jul 24;13:678. doi: 10.1186/1471-2458-13-678.
Physical activity (PA) levels in type 2 diabetes mellitus (T2DM) patients are generally low. Poor PA perception may impede healthy behaviour change in this high risk group. We describe (i) objective PA levels, (ii) the difference between objective and self-reported PA ('PA disparity') and the correlates of (iii) PA disparity and (iv) overestimation in recently diagnosed T2DM patients.
Cross-sectional analysis of 425 recently diagnosed T2DM patients aged 42 to 71, participating in the ADDITION-Plus study in Eastern England, UK. We define 'PA disparity' as the non-negative value of the difference (in mathematical terms the absolute difference) between objective and self-reported physical activity energy expenditure (PAEE in kJ · kg-1 · day-1). 'Overestimators' comprised those whose self-reported- exceeded objective-PAEE by 4.91 kJ · kg-1 · day-1(the equivalent of 30 minutes moderate activity per day). Multivariable linear regression examined the association between PA disparity (continuous) and socio-demographic, clinical, health behaviour, quality of life and psychological characteristics. Logistic regression examined the association between PA overestimation and individual characteristics.
Mean objective and self-reported PAEE levels ± SD were 34.4 ± 17.0 and 22.6 ± 19.4 kJ · kg-1·day-1, respectively (difference in means =11.8; 95% CI=9.7 to 13.9 kJ · kg-1 · day-1). Higher PA disparity was associated with male sex, younger age, lower socio-economic status and lower BMI. PA overestimators comprised 19% (n=80), with those in routine/manual occupations more likely to be overestimators than those in managerial/professional occupations.
T2DM patients with poor physical activity perception are more likely to be male, younger, from a lower socio-economic class and to have a lower BMI. PA overestimators were more likely to be in lower socio-economic categories. Self-monitoring and targeted feedback, particularly to those in lower socio-economic categories, may improve PA perceptions and optimise interventions in T2DM patients. Our findings suggest that strategies for enabling realistic assessment of physical activity levels, through self-monitoring or feedback, warrant further investigation and may help refine and improve physical activity interventions.
2型糖尿病(T2DM)患者的身体活动(PA)水平普遍较低。较差的PA认知可能会阻碍这一高危群体的健康行为改变。我们描述了(i)客观PA水平,(ii)客观PA与自我报告PA之间的差异(“PA差异”)以及(iii)PA差异和(iv)新诊断T2DM患者高估情况的相关因素。
对425名年龄在42至71岁之间、参与英国东英格兰ADDITION-Plus研究的新诊断T2DM患者进行横断面分析。我们将“PA差异”定义为客观和自我报告的身体活动能量消耗(PAEE,单位为kJ·kg-1·天-1)之间差异的非负值(数学上为绝对差异)。“高估者”包括那些自我报告的PAEE超过客观PAEE 4.91 kJ·kg-1·天-1的人(相当于每天30分钟的中等强度活动)。多变量线性回归分析了PA差异(连续变量)与社会人口统计学、临床、健康行为、生活质量和心理特征之间的关联。逻辑回归分析了PA高估与个体特征之间的关联。
客观和自我报告的PAEE平均水平±标准差分别为34.4±17.0和22.6±19.4 kJ·kg-1·天-1(均值差异=11.8;95%CI=9.7至13.9 kJ·kg-1·天-1)。较高的PA差异与男性、较年轻、社会经济地位较低和BMI较低有关。PA高估者占19%(n=80),从事常规/体力职业的人比从事管理/专业职业的人更有可能高估。
身体活动认知较差的T2DM患者更有可能是男性、较年轻、来自社会经济阶层较低且BMI较低。PA高估者更有可能属于社会经济类别较低的人群。自我监测和有针对性的反馈,特别是针对社会经济类别较低的人群,可能会改善PA认知并优化对T2DM患者的干预措施。我们的研究结果表明,通过自我监测或反馈实现对身体活动水平进行现实评估的策略值得进一步研究,可能有助于完善和改进身体活动干预措施。