運動與蔬果攝取對預防台灣中老年人新發糖尿病的組合效應

The Combined Effect of Physical Activity and Fruit-Vegetable Consumption on New-Onset Diabetes in Older Taiwanese

陳奕儒(Yi-Ru Chen) ； 蔡仲弘(Alan C. Tsai) ； 王俊毅(Jiun-Yi Wang)

《台灣公共衛生雜誌》 32卷6期 (2013/12) Pp. 551-561

https://doi.org/10.6288/TJPH201332102052

摘要

Objectives: Many factors impact the onset of diabetes. Higher levels of physical activity and fruit-vegetable (FV) consumption are considered to be effective in reducing the risk; however, the combined effect is largely unknown. This study attempted to determine the combined effect of a higher level of physical activity and higher FV consumption on the subsequent risk of new diabetes. Methods: Data for this analysis were taken from the 1999 and 2003 datasets of the ”Taiwan Longitudinal Survey on Aging”. A total of 4,400 participants (≥ 53 years old) completed the survey in 1999. After excluding those who had diabetes, heart disease, cancer, BMI＜18.5, or incomplete data at baseline, those who died during 1999-2003, and those who failed to complete the 2003 survey, the net N was 2,243. Multivariate binary logistic regression analysis was performed to determine the independent or combined effect of physical activity and FV consumption on the risk of new diabetes four years later. Results: When the combination of high physical activity and high FV consumption was compared to no physical activity and low FV consumption, the risk of having new diabetes four years later was reduced to 39% (OR=0.39, 95% CI=0.20-0.76, p=0.006). All other combinations were not significant. When analyzed independently, only high physical activity was significant, high FV consumption was not. Conclusions: The combination of high physical activity and high FV consumption was highly effective in reducing the risk of new-onset diabetes in older Taiwanese. High physical activity alone was significant but high FV consumption alone was not. These results highlight the importance of having both daily physical activity and FV intake. Our results could provide the basis for a national policy on diabetes prevention.

關鍵字

中老年人 ； 糖尿病 ； 運動 ； 蔬果攝取 ； 組合效應

並列摘要

Objectives: Many factors impact the onset of diabetes. Higher levels of physical activity and fruit-vegetable (FV) consumption are considered to be effective in reducing the risk; however, the combined effect is largely unknown. This study attempted to determine the combined effect of a higher level of physical activity and higher FV consumption on the subsequent risk of new diabetes. Methods: Data for this analysis were taken from the 1999 and 2003 datasets of the ”Taiwan Longitudinal Survey on Aging”. A total of 4,400 participants (≥ 53 years old) completed the survey in 1999. After excluding those who had diabetes, heart disease, cancer, BMI＜18.5, or incomplete data at baseline, those who died during 1999-2003, and those who failed to complete the 2003 survey, the net N was 2,243. Multivariate binary logistic regression analysis was performed to determine the independent or combined effect of physical activity and FV consumption on the risk of new diabetes four years later. Results: When the combination of high physical activity and high FV consumption was compared to no physical activity and low FV consumption, the risk of having new diabetes four years later was reduced to 39% (OR=0.39, 95% CI=0.20-0.76, p=0.006). All other combinations were not significant. When analyzed independently, only high physical activity was significant, high FV consumption was not. Conclusions: The combination of high physical activity and high FV consumption was highly effective in reducing the risk of new-onset diabetes in older Taiwanese. High physical activity alone was significant but high FV consumption alone was not. These results highlight the importance of having both daily physical activity and FV intake. Our results could provide the basis for a national policy on diabetes prevention.

並列關鍵字

elderly ； diabetes ； physical activity ； fruit and vegetable intake ； combined effects

參考文獻

Hu FB, Sigal RJ, Rich-Edwards JW, et al. Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA 1999;282:1433-9. doi:10.1001/jama.282.15.1433.

Hu FB, Li TY, Colditz GA, Willett WC, Manson JE. Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 2003;289:1785-91. doi:10.1001/ jama.289.14.1785.

Jefferis BJ, Whincup PH, Lennon L, Wannamethee SG. Longitudinal associations between changes in physical activity and onset of type 2 diabetes in older British men: the influence of adiposity. Diabetes Care 2012;35:1876-83. doi:10.2337/dc11-2280.

Lynch J, Helmrich SP, Lakka TA, et al. Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of noninsulin- dependent diabetes mellitus in middleaged men. Arch Intern Med 1996;156:1307-14. doi:10.1001/archinte.156.12.1307.

Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS Jr. Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 1991;325:147-52. doi:10.1056/ NEJM199107183250302.