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Relationship of walking to mortality among US adults with diabetes.
Arch Intern Med. 2003 Jun 23; 163(12):1440-7.AI

Abstract

BACKGROUND

Walking is associated with reduced diabetes incidence, but few studies have examined whether it reduces mortality among those who already have diabetes.

OBJECTIVE

To estimate the association between walking and the risk for all-cause and cardiovascular disease (CVD) mortality among persons with diabetes.

DESIGN

Prospective cohort study of a representative sample of the US population.

SETTING

Interviewer-administered survey in the general community.

PARTICIPANTS

We sampled 2896 adults 18 years and older with diabetes as part of the 1990 and 1991 National Health Interview Survey.

MAIN OUTCOME MEASURE

All-cause and CVD mortality for 8 years.

RESULTS

Compared with inactive individuals, those who walked at least 2 h/wk had a 39% lower all-cause mortality rate (hazard rate ratio [HRR], 0.61; 95% confidence interval [CI], 0.48-0.78; 2.8% vs 4.4% per year) and a 34% lower CVD mortality rate (HRR, 0.66; 95% CI, 0.45-0.96; 1.4% vs 2.1% per year). We controlled for sex, age, race, body mass index (calculated as weight in kilograms divided by the square of height in meters), smoking, and comorbid conditions. The mortality rates were lowest for persons who walked 3 to 4 h/wk (all-cause mortality HRR, 0.46; 95% CI, 0.29-0.71; CVD mortality HRR, 0.47; 95% CI, 0.24-0.91) and for those who reported that their walking involved moderate increases in heart and breathing rates (all-cause mortality HRR, 0.57; 95% CI, 0.41-0.80; CVD mortality HRR, 0.69; 95% CI, 0.43-1.09). The protective association of physical activity was observed for persons of varying sex, age, race, body mass index, diabetes duration, comorbid conditions, and physical limitations.

CONCLUSIONS

Walking was associated with lower mortality across a diverse spectrum of adults with diabetes. One death per year may be preventable for every 61 people who could be persuaded to walk at least 2 h/wk.

Authors+Show Affiliations

Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. edg7@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12824093

Citation

Gregg, Edward W., et al. "Relationship of Walking to Mortality Among US Adults With Diabetes." Archives of Internal Medicine, vol. 163, no. 12, 2003, pp. 1440-7.
Gregg EW, Gerzoff RB, Caspersen CJ, et al. Relationship of walking to mortality among US adults with diabetes. Arch Intern Med. 2003;163(12):1440-7.
Gregg, E. W., Gerzoff, R. B., Caspersen, C. J., Williamson, D. F., & Narayan, K. M. (2003). Relationship of walking to mortality among US adults with diabetes. Archives of Internal Medicine, 163(12), 1440-7.
Gregg EW, et al. Relationship of Walking to Mortality Among US Adults With Diabetes. Arch Intern Med. 2003 Jun 23;163(12):1440-7. PubMed PMID: 12824093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship of walking to mortality among US adults with diabetes. AU - Gregg,Edward W, AU - Gerzoff,Robert B, AU - Caspersen,Carl J, AU - Williamson,David F, AU - Narayan,K M Venkat, PY - 2003/6/26/pubmed PY - 2003/7/8/medline PY - 2003/6/26/entrez SP - 1440 EP - 7 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 163 IS - 12 N2 - BACKGROUND: Walking is associated with reduced diabetes incidence, but few studies have examined whether it reduces mortality among those who already have diabetes. OBJECTIVE: To estimate the association between walking and the risk for all-cause and cardiovascular disease (CVD) mortality among persons with diabetes. DESIGN: Prospective cohort study of a representative sample of the US population. SETTING: Interviewer-administered survey in the general community. PARTICIPANTS: We sampled 2896 adults 18 years and older with diabetes as part of the 1990 and 1991 National Health Interview Survey. MAIN OUTCOME MEASURE: All-cause and CVD mortality for 8 years. RESULTS: Compared with inactive individuals, those who walked at least 2 h/wk had a 39% lower all-cause mortality rate (hazard rate ratio [HRR], 0.61; 95% confidence interval [CI], 0.48-0.78; 2.8% vs 4.4% per year) and a 34% lower CVD mortality rate (HRR, 0.66; 95% CI, 0.45-0.96; 1.4% vs 2.1% per year). We controlled for sex, age, race, body mass index (calculated as weight in kilograms divided by the square of height in meters), smoking, and comorbid conditions. The mortality rates were lowest for persons who walked 3 to 4 h/wk (all-cause mortality HRR, 0.46; 95% CI, 0.29-0.71; CVD mortality HRR, 0.47; 95% CI, 0.24-0.91) and for those who reported that their walking involved moderate increases in heart and breathing rates (all-cause mortality HRR, 0.57; 95% CI, 0.41-0.80; CVD mortality HRR, 0.69; 95% CI, 0.43-1.09). The protective association of physical activity was observed for persons of varying sex, age, race, body mass index, diabetes duration, comorbid conditions, and physical limitations. CONCLUSIONS: Walking was associated with lower mortality across a diverse spectrum of adults with diabetes. One death per year may be preventable for every 61 people who could be persuaded to walk at least 2 h/wk. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/12824093/Relationship_of_walking_to_mortality_among_US_adults_with_diabetes_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/vol/163/pg/1440 DB - PRIME DP - Unbound Medicine ER -