ESPE Abstracts

Background: Physical activity (PA) has been conclusively shown to reduce the incidence of diabetes in prior research. A 2,000 steps/day increment yielded hazard ratio (HR) 0.88 for incidence of diabetes 95% CI 0.78–1.00; P=0.046 (Garduno, 2022). Despite this, the role of different factors associated with higher adolescent after-school PA is understudied after the coronavirus pandemic, during which a greater proportion of parents worked remotely. This study aimed to evaluate statistically significant factors that are associated with higher adolescent PA vs sedentary behavior with the goal of identifying effective diabetes prevention interventions.

Methods: Study participants from Florida, U.S., aged 13-19 were enrolled and categorized into three groups based on the number of days of after-school exercise completed each week: 0 days of after-school exercise (No PA, n=214), 1-4 days of after-school exercise (moderate PA, n=245), and 5-7 days of after-school exercise (high PA, n=252). The statistical significance of the study factors associated with each PA group was assessed using two-tailed t-tests with a 95% confidence level.

Results: The participants’ mean age was 15.6±1.2 years. Among participants with high PA, moderate PA, and no PA, 19.4%, 26.4%, and 30.9% were affected by overweight or obesity respectively (P<0.05). PA was influenced by gender (81.7% of males had high PA, vs 59.5% of females, P<0.01). The incidence of high PA levels was greater among those participants whose parents were married (77.7% vs 58,8%, P<0.05) or those who were the oldest children in the family (85.1% vs 58.1%, P<0.05). In terms of modifiable factors, possibly due to a role-modeling parenting effect, high PA levels were more among participants who exercised together with parents (94.2% vs 49.1%, P<0.01), and if one of the parents had a healthy diet (74.1% vs 55.9%, P<0.05). High PA levels were also more prevalent in adolescents who read nutrition labels (86.6% vs 54.6%, P<0.01), who were concerned about protein content in food choices (90.5% vs 56.1%, P<0.05), who considered fiber (95.8% vs 64.4%, P<0.05), sugar (85.1% vs 62.8%, P<0.05), or whole food content (80.1% vs 65.8%, P<0.05).

Conclusion: A deeper understanding of the factors associated with physical activity can help design more effective interventions. Study findings provide insight into environmental and behavioral factors associated with physical activity and provide the rationale for family-level interventions aimed at improving modifiable variables that will assist in the reduction of diabetes burden.