Self-reported and objectively measured physical activity levels among Hispanic/Latino adults with type 2 diabetes

Abstract

Objective: In the USA, minority populations face a disproportionate burden from type 2 diabetes (T2D), in whom physical activity (PA) is recommended. The aim of this study was to determine levels of PA among a community of free-living Hispanic/Latino adults with T2D using a research accelerometer, a consumer device and a pictogram self-assessment questionnaire.

Research design and methods: This was a cross-sectional, observational study. Participants (57 women and 31 men, body mass index (kg/m2) 32.2±7.9 and 29.9±4.5, waist circumference 97.1±30.1 and 93.7±33.0 cm and hemoglobin A1c 8.0±2.0 and 8.1%±1.8%, respectively) wore an ActiGraph (AG) on the hip and a Fitbit (FB) on the wrist for 1 week to estimate daily steps and energy expenditure (EE). Participants reported type and intensity of PA using English-language or Spanish-language pictograms and a 10-point Likert scale (1='not active' to 10='very, very active').

Results: Steps per day were not normally distributed; AG median steps/weekday (Monday-Friday) was 6990 (range 1091-25 884) compared with 9329 (288-31 669) using FB (p≤0.01). Both devices recorded significantly more steps on weekdays versus weekends (p≤0.05). EE was also higher during the week. AG and FB were highly correlated to each other (p<0.01). Men were more active than women and maintained their PA throughout the week, whereas women decreased theirs on weekends. Spanish-language pictograms were preferred and self-reported PA matched objective assessments by both devices. Participants perceived themselves to be active (7.1±2.0) due to work.

Conclusions: Both objectively measured and self-reported levels of PA in Hispanic/Latino adults with T2D challenge the assumption that lack of PA may be commonplace for this group. AG and FB are different in their measurement of PA but are significantly correlated. New strategies, including use of pictograms, for interventions need to be considered if further increases or changes in PA are to be used as T2D therapy.

Trial registration number: NCT03736486.

Keywords: Hispanic; exercise; physical activity and health; type 2 diabetes.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1

Fitbit steps per day vs ActiGraph steps per day.

Figure 2

Comparison of step counts using Fitbit and ActiGraph over 7 days. Data are shown as median values.

Figure 3

Physical activity assessed by ActiGraph and showing the median number of steps per day and the associated activity pictograms. *P≤0.05 differences between ‘sedentary rest’ and ‘housework and manual work’ for 06:00–12:00 hours, between ‘sedentary rest’ and ‘manual work’ for 12:00–18:00 hours, between ‘sedentary rest’ and ‘manual work and exercise not work’ for 18:00–24:00 hours. †P≤0.05 difference between ‘manual work’ and ‘exercise not work’.