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Combined Associations of Work and Leisure Time Physical Activity on Incident Diabetes Risk

  • Aviroop Biswas
    Correspondence
    Address correspondence to: Aviroop Biswas, PhD, Institute for Work & Health, 400 University Avenue, Suite 1800, Toronto, Ontario M5G 1S5, Canada.
    Affiliations
    Institute for Work & Health, Toronto, Ontario, Canada

    Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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  • Mahée Gilbert-Ouimet
    Affiliations
    Institute for Work & Health, Toronto, Ontario, Canada

    Department of Health Sciences, Université du Québec à Rimouski, Rimouski, Québec, Canada
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  • Cameron A. Mustard
    Affiliations
    Institute for Work & Health, Toronto, Ontario, Canada

    Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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  • Richard H. Glazier
    Affiliations
    Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada

    ICES, Toronto, Ontario, Canada

    Department of Family and Community Medicine, University of Toronto and St Michael's Hospital, Toronto, Ontario, Canada

    Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
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  • Peter M. Smith
    Affiliations
    Institute for Work & Health, Toronto, Ontario, Canada

    Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada

    Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Published:November 25, 2020DOI:https://doi.org/10.1016/j.amepre.2020.09.017

      Introduction

      This study examines the separate and combined relationships between occupational physical activity (characterized by nonaerobic activities such as heavy lifting and prolonged standing) and leisure time physical activity on future diabetes incidence.

      Methods

      Data from Ontario respondents aged 35–74 years from the 2003 Canadian Community Health Survey (N=40,507) were prospectively linked to the Ontario Diabetes Database for diabetes cases until 2017, with statistical analysis performed in 2019. Leisure time physical activity was self-reported and occupational physical activity estimated from occupation titles. The analytical sample consisted of 7,026 employed people without previous diabetes diagnoses, with 846 diabetes cases recorded. Cox proportional hazard models were constructed to evaluate relationships over a median follow-up time of 13.7 years.

      Results

      No relationships were observed between occupational physical activity and diabetes. High leisure time physical activity was associated with lower diabetes risk for low occupational physical activity and stationary jobs (hazard ratio=0.63, 95% CI=0.47, 0.85). No association was found for high leisure time physical activity on diabetes risk for high occupational physical activity (hazard ratio=1.07, 95% CI=0.73, 1.56) or low occupational physical activity with movement (hazard ratio=0.92, 95% CI=0.55, 1.55).

      Conclusions

      This study suggests that physical activity recommendations exclusively recommending increased physical activity may only be effective for the sedentary part of the working population in reducing diabetes risk. Findings await confirmation in comparable prospective studies in other populations.
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