Physical Activity and Nutrition Behaviors Among Kansas Adults at Increased Risk of Developing Type 2 Diabetes (T2DM) – 2013 Kansas Behavioral Risk Factor Surveillance System (BRFSS)

BACKGROUND:  The American Diabetes Association (ADA) Diabetes Risk Test (DRT) assesses an individual’s risk of diabetes based on their age, sex, history of gestational diabetes (among women), family history of diabetes, hypertension status, physical activity, and weight status. The Kansas BRFSS is uniquely positioned to estimate diabetes risk among Kansas adults due to the inclusion of state-added questions on family history of diabetes and delivery of a macrosomic infant (among women). In 2013, 41% of Kansas adults were at increased risk of developing T2DM. Significantly higher prevalence of increased risk for T2DM was estimated among Non-Hispanic (NH) whites, NH African Americans, those with less education, those living with a disability, and those residing in rural counties. The current study examines physical activity (PA) and nutrition behaviors among Kansas adults at increased risk of developing T2DM.  

METHODS:  2013 Kansas BRFSS data were analyzed to estimate prevalence of meeting overall, aerobic and muscle-strengthening PA guidelines; consuming fruits and vegetables (F+V) ≥1 times per day; watching their salt intake; buying low-sodium foods within the past month; and consuming sugar-sweetened beverages (SSB) ≥1 times per day among Kansas adults at increased risk of developing T2DM (i.e. diagnosed prediabetes or DRT score ≥5) compared to those at low risk (DRT<5).  Logistic regression models were implemented using SAS complex survey procedures to compare the prevalence odds of selected PA and nutrition behaviors among Kansas adults at increased versus low risk of developing T2DM, while controlling for race/ethnicity, education, disability status, and county population density.

RESULTS:  Among Kansas adults at increased risk for developing T2DM in 2013, 10.0% met overall PA guidelines, 47.2% consumed F+V ≥1 times per day, 54.4% were watching their salt intake, 40.2% bought “low salt” labeled food within the past month and 70.5% consumed SSB ≥1 times per day. Compared with Kansas adults at low risk, those at increased risk of developing T2DM demonstrated lower prevalence of meeting PA guidelines and consuming SSB ≥1 times per day and higher prevalence of watching salt intake and buying “low salt” labeled food. These associations between T2DM risk status and selected PA and nutrition behaviors remained statistically significant even after controlling for socio-demographic characteristics.

CONCLUSIONS:  Poor PA and nutrition behaviors among Kansas adults at increased risk of developing T2DM underscores the need to design and implement population-based prevention strategies, such as participation in the Diabetes Primary Prevention Program or other lifestyle change programs.