Diabetes risk status and meeting the US physical activity recommendations in reproductive-aged women: 2011, 2013, 2015 and 2017 Behavioral Risk Factor Surveillance System.

BACKGROUND: Women at increased risk for type 2 diabetes, due to recognized prediabetes (PD) or previous gestational diabetes (GD), stand to benefit from meeting U.S. physical activity (PA) recommendations. This study examined the association of diabetes risk status with meeting aerobic activity (AA), muscle strengthening activity (MSA) and both recommendations. METHODS: Non-pregnant women, 18-44, free of recognized diabetes, who participated in the 2011, 2013, 2015, or 2017 U.S. Behavioral Risk Factor Surveillance System survey (N = 211,114) were categorized as no diabetes (ND; n = 202,766, referent) versus at-risk for diabetes (RD; n = 8348). Logistic regression models generated odds ratios (ORs) and 95% confidence intervals (95% CIs), adjusted for demographics and BMI. Tests for multiplicative interactions were performed for BMI category and race and ethnicity. RESULTS: There were lower odds of meeting AA, MSA and both recommendations in the RD group (referent = ND; OR 0.95 [5% CI 0.78, 0.97], 0.83 [95% CI 0.91, 0.98] and 0.87 [95% CI 0.78, 0.97], respectively). Effect modification by BMI category was detected for models assessing MSA (p = 0.10), both (p = 0.07) and neither recommendation (p = 0.005), but not for AA. Among those with a BMI in the healthy and overweight groups, RD had decreased odds of meeting MSA recommendations (referent = ND; 0.69 [95% CI 0.58, 0.81] and 0.78 [95% CI 0.65, 0.93], respectively); among the healthy BMI, RD had 24% decreased odds of meeting both recommendations (referent = ND; 95% CI 0.63, 0.91). There was no difference in meeting PA recommendations among groups in the obese category, but the increased odds of meeting the AA recommendation among the RD group were approaching significance (referent = ND; [95% CI 1.00, 1.29], p = 0.06]. CONCLUSION: Reproductive-aged women with previous GD or recognized PD stand to benefit from increasing PA, especially MSA, the least often met recommendation.

Diabetes risk status and physical activity in pregnancy: U.S. BRFSS 2011, 2013, 2015, 2017.

BACKGROUND: Pregnant women without complications are advised to engage in physical activity (PA) to mitigate adverse outcomes. Differences may exist among pregnant women of diverging diabetes status in meeting national PA recommendations. We sought to examine differences in aerobic activity (AA) and muscle strengthening activity (MSA) by diabetes risk status (DRS) among pregnant women in the United States. METHODS: The sample (n = 9,597) included pregnant women, age 18-44 years, who participated in the 2011, 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System. Levels of DRS include: no diabetes (ND), high risk for diabetes (HRD) due to self-reported gestational diabetes or pre-diabetes, and overt diabetes due to self-reported, clinically diagnosed diabetes (DM). Odds ratios (ORs) and 95% confidence intervals (CI) for meeting PA recommendations were obtained. Covariates included age, race, education, household child count, alcohol consumption, and smoking status. RESULTS: Findings revealed that on average, DM had 46.5 fewer minutes of weekly AA compared to ND. Furthermore, a significantly lower OR (0.39; CI 0.19-0.82) for meeting both recommendations was observed in DM as compared to ND after adjustment. CONCLUSIONS: We observed that pregnant women with overt diabetes had a lower odds of engaging in PA, while those at high risk were similar in their PA engagement to ND. Future studies aimed at assessing determinants of PA behavior may help guide efforts to promote exercise in pregnant women with diabetes.

Elevated Serum Uric Acid and Self-Reported Heart Failure in US Adults: 2007-2016 National Health and Nutrition Examination Survey.

INTRODUCTION: There is limited evidence examining the relationship between elevated serum uric acid (sUA) concentration and heart failure (HF) in United States (US) adults. The aim of the present study was to examine the association(s) between elevated sUA and HF using a nationally representative sample of US adults. METHODS: The final sample with complete data for this analysis (n = 17,349) included men and women aged ≥40 years who participated in the 2007-2016 National Health and Nutrition Examination Survey. Self-reported diagnosis of HF was assessed via interview. Elevated sUA was defined as values >6.0 mg/dL for women and >7.2 mg/dL for men. Multivariable gender-stratified logistic regression was utilized to examine the odds of self-reported HF. RESULTS: The estimated prevalence of HF was 3.9 and 3.4% among men and women, respectively. Age-adjusted analysis revealed significantly increased odds of HF in men (OR 2.79; 95% CI 2.15-3.84, p < 0.01) and women (OR 3.24; 95% CI 2.37-4.44, p < 0.01) with elevated sUA. This relationship remained statistically significant following adjustment for age, race, education, income, alcohol consumption, smoking status, blood pressure, diabetes, physical activity level, cholesterol, creatinine level, and body mass index in men (OR 1.70; 95% CI 1.13-2.57 p < 0.05) and women (OR 1.74; 95% CI 1.18-2.58, p < 0.05). CONCLUSIONS: In a representative sample of US adults, having an elevated sUA concentration was associated with significantly increased odds of HF when compared to adults with normal sUA.