Physical activity fails to protect against diabetes in non-Hispanic black patients

Physical activity was protective against type 2 diabetes in patients from several racial and ethnic groups, but not among non-Hispanic black patients, according to meta-analysis findings.

“The prevalence of type 2 diabetes among adults in the United States is estimated to be anywhere from 9.3% to 14.5%, depending upon the dataset and diagnostic criteria,” William R. Boyer, MSH, of the department of kinesiology, recreation and sports studies at the University of Tennessee, Knoxville, and colleagues wrote. “Furthermore, by the year 2050, the type 2 diabetes prevalence in the U.S. is projected to reach upward of 21% to 33%. … Physical activity is an important component of type 2 diabetes prevention initiatives and has been shown to reduce the risk of type 2 diabetes. However, the extent of type 2 diabetes protection associated with [physical activity] has yet to be fully examined in regards to effect modification by race-ethnicity.”

Boyer and colleagues searched PubMed and Embase through June 2016 for studies focusing on diabetes, physical activity and race or ethnicity, ultimately including 27 studies in their analysis. The researchers used comprehensive meta-analysis software to calculate RRs.

The researchers identified white patients as the most physically active group, and Asian patients as the least active. Physical activity had a significantly protective summary effect across several groups: in non-Hispanic white patients (RR = 0.71, 95% CI, 0.6-0.85), as well as American Indian patients (RR = 0.73; 95% CI, 0.6-0.88), Asian patients (RR = 0.76; 95% CI, 0.67-0.85) and Hispanic patients (RR = 0.75; 95% CI, 0.64-0.89). However, physical activity was not significantly protective in non-Hispanic black patients (RR = 0.91, 95% CI, 0.76-1.08).

According to Boyer and colleagues, the study was limited by possible publication bias, as well as the fact that physical activity was self-reported. Furthermore, race and ethnicity were not consistently defined across all studies, and relatively few studies evaluated the relationship between physical activity and type 2 diabetes.

“In conclusion, with the exception of [non-Hispanic black patients], [physical activity] plays a significant role in reducing the risk for type 2 diabetes across race-ethnic groups,” the researchers wrote. “Furthermore, the current study illustrates the need to continue investigating effect modification of relationship by race-ethnicity, as well as the need to examine the effect modification between the current aerobic [physical activity] guideline and type 2 diabetes risk by race-ethnicity.” – by Andy Polhamus

Disclosures: The researchers report no relevant financial disclosures.