Sedentary Time and Prescription Medication Use Among US Adults: 2017-2018 National Health and Nutrition Examination Survey.

BACKGROUND: Prescription medication usage has been used as a predictor of disease prevalence and overall health status. Evidence suggests an inverse relationship exists between polypharmacy, which is the use of 5 or more medications, and physical activity participation. However, there is limited evidence examining the relationship between sedentary time and polypharmacy in adults. The aim of this study was to examine the associations between sedentary time and polypharmacy in a large nationally representative sample of US adults. METHODS: Study sample (N = 2879) included nonpregnant adult (≥20 y old) participants from the 2017-2018 National Health and Nutrition Examination Survey. Self-reported minutes per day of sedentary time were converted to hours per day. The dependent variable was polypharmacy (≥5 medications). RESULTS: Analysis revealed that for every hour of sedentary time, there was 4% greater odds of polypharmacy (odds ratio, 1.04; 95% confidence interval, 1.00-1.07, P = .04) after adjusting for age, race/ethnicity, education, waist circumference, and the interaction term between race/ethnicity and education. CONCLUSION: Our findings suggest increased sedentary time is associated with an increased risk of polypharmacy among a large nationally representative sample of US adults.

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.

Mode of Physical Activity Participation in US Adults: A Regional Perspective.

OBJECTIVE: Examine the mode of physical activity (PA) participation in United States adults by US Census region. METHODS: The study sample (N = 323,435) included adult (18 years of age and older) participants from the 2019 Behavioral Risk Factor Surveillance System. Participants reported meeting both aerobic and muscle strengthening activity (MSA) guidelines, the aerobic-only guideline, the MSA only guideline, or neither. RESULTS: The greatest prevalence estimate of meeting the mutually exclusive aerobic and MSA guideline was found in the West Census Region (24.3, 95% confidence interval 23.6-24.9) and the greatest prevalence estimate of meeting neither aerobic nor MSA guideline was found in the South Census Region (38.1%, 95% confidence interval 37.5-38.7). Physical and mental health were found to be positively associated with PA and non-Hispanic Blacks and Hispanics reported the greatest levels of meeting neither federal PA recommendation. CONCLUSIONS: These data suggest that mode of PA participation varies by demographics and census region in US adults. State and local health departments should communicate between and within regions and disseminate information to raise awareness of the health benefits of meeting the federal PA guidelines.

Practical School Nutrition Program May Reduce Food Neophobia.

The study's purpose was to evaluate an intervention to reduce fruit and vegetable food neophobia and influence attitudes and behaviors among children using a four-month, non-experimental, before-and-after intervention. Participants were children aged 5-11 years in an intervention school (IS) and a control school (CS). Children were offered fruit or vegetable samples weekly utilizing school-specific psychosocial and educational practices to encourage participation. The outcomes of interest included attitudes measured using a written survey-based food neophobia scale (FNS), behavioral observations, and an oral survey. The post-intervention IS FNS score was significantly lower compared to pre-intervention (p = 0.04). Repeated-measures ANOVA revealed a statistically significant overall effect of time (p = 0.006). School type-time interaction was not significant (p = 0.57). Pre-intervention observational data showed the proportions finishing and taking another fruit and vegetable sample were higher in the CS (p < 0.001 for both). Post-intervention, the proportions taking the vegetable (p = 0.007) and the fruit (p < 0.001) were higher in the IS. The percentage tasting the vegetable was higher in the CS (p = 0.009). Offering samples of produce in school lunchrooms may reduce food neophobia. This intervention is an inexpensive program that volunteers can quickly implement.

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.

Epilepsy and Physical Activity in US Adults.

OBJECTIVES: To examine the prevalence of self-reported aerobic leisure-time physical activity (LTPA) and muscle-strengthening activity (MSA) participation using a representative sample of US adults (18 years old and older) with a seizure disorder or epilepsy. METHODS: Data from the 2010, 2013, and 2015 National Health Interview Survey cycles were used to examine the prevalence and odds of meeting the 2018 PA guidelines with a nationally representative sample of US adults. Descriptive analyses and logistic regression were used in calculating estimates. RESULTS: Overall, the prevalence of adults with a seizure disorder or epilepsy reporting no (0 min), insufficient (<150 min), sufficient (150-300 min [meets recommendations]), or high volumes of LTPA (>300 min [meets recommendations]) were 45.1%, 20.0%, 10.8%, and 24.1% (P < 0.001), respectively, and had a 43% (odds ratio 0.57, 95% confidence interval 0.50-0.66) lower odds of meeting the 2018 federal guidelines for aerobic LTPA. In addition, 17.7% of adults with a seizure disorder reported meeting the MSA recommendation and were 32% (odds ratio 0.68, 95% confidence interval 0.57-0.80) less likely to preform MSA ≥2 days/week (P < 0.05). CONCLUSIONS: Adults reporting a seizure disorder or epilepsy also indicate their ability to participate in both LTPA and MSA; however, this population was found to have a significantly lower odds of meeting current federal aerobic LTPA and MSA recommendations.

Sedentary Time and Cumulative Risk of Preserved and Reduced Ejection Fraction Heart Failure: From the Multi-Ethnic Study of Atherosclerosis.

BACKGROUND: This study examined the relationship between self-reported sedentary time (ST) and the cumulative risk of heart failure with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF) in a diverse cohort of U.S. adults 45-84 years of age. METHODS AND RESULTS: Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we identified 6,814 subjects, all free of baseline cardiovascular disease. Cox regression was used to calculate the hazard ratios (HR) associated with risk of HFpEF and HFrEF. Weekly ST was dichotomized based on the 75th percentile (1890 min/wk). During ∼11.2 years of follow-up there were 178 first incident HF diagnoses: 74 HFpEF and 69 HFrEF. Baseline ST >1890 min/wk was significantly associated with an increased risk of HFpEF (HR 1.87, 95% confidence interval [CI] 1.13-3.09, P = .01), but not of HFrEF. The relationship with HFpEF remained significant in fully adjusted models including physical activity and waist circumference (HR 2.16, 95% CI 1.23-3.78, P < .01). In addition, every 60-minute increase in weekly ST was associated with a 3% increased risk of HFpEF (HR 1.03, 95% CI 1.01-1.05, P < .01). CONCLUSIONS: Sedentary time >1890 min/wk (∼4.5 h/d) is a significant predictor of HFpEF, independently from physical activity and adiposity.

Exploring the association between polycyclic aromatic hydrocarbons and diabetes among adults in the United States.

OBJECTIVE: To explore the association between polycyclic aromatic hydrocarbons (PAHs) and diabetes and to determine whether effects are heterogeneous when examined by body mass index (BMI). METHODS: Cross-sectional data from 8664 participants were analyzed from the National Health and Nutrition Examination Survey for years 2005-2014. Multivariable logistic regression was used to explore the association between urinary biomarkers of PAHs and diabetes. All models were adjusted for age, sex, race, poverty-income ratio, and serum cotinine. RESULTS: When compared with the lowest quintiles of exposure, the highest quintiles of exposure to 2-hydroxynaphthalene, 2-hydroxyfluorene, 9-hydroxyfluorene, 2-hydroxyphenanthrene, and a summed variable of all low molecular weight PAHs (aOR = 1.73; 95% CI: 1.17-2.55) showed a positive association with diabetes. Stratified analyses by BMI indicated that the positive association between PAHs and diabetes was found among both normal weight and obese participants. CONCLUSIONS: High levels of exposure to PAHs are positively associated with diabetes in the U.S. general population and these effects are modified by BMI. These findings suggest the importance of strong environmental regulation of PAHs to protect population health.

Mode of physical activity participation by body mass index: 2015 behavioural risk factor surveillance system.

Body mass index (BMI) continues to be used as a marker of health due its strong correlation with adiposity and health. Physical activity (PA) has been shown to be favourably associated with a desirable BMI. Few studies have examined mode of PA participation across BMI indices with a mutually exclusive underweight BMI range. The purpose of this study was to examine the relationship between modes of PA and BMI. Data from the 2015 Behavioral Risk Factor Surveillance System was analysed. Underweight, overweight, and obese BMI categories possessed 35, 20, and 46% lower odds of meeting current PA guidelines. The obese BMI group was found to have lower odds of meeting the aerobic only and strength only guidelines. Underweight, overweight, and obese groups possessed 63, 18, and 76% greater odds of meeting neither PA guideline, respectively.

Physical Activity, Body Mass Index, and Clustered Metabolic Risk in U.S. Adolescents: 2007-2012 Nhanes.

BACKGROUND: While studies to date have shown that children and adolescents who meet the current physical activity (PA) recommendations and maintain a healthy body weight demonstrate significantly lower cardiometabolic risk, there are some studies that suggest that the relationship between PA and metabolic risk may be mediated by adiposity. The aim of the present study was to examine variation in clustered metabolic risk (cMetS) in adolescents classified as not overweight/active (NOA), not overweight/not active (NONA), overweight/active (OA), and overweight/not active (ONA). METHODS: The sample included adolescent participants (n = 875; 12-17 years) of the 2007-2012 National Health and Nutrition Examination Survey (NHANES). The cMetS score included triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, and mean arterial pressure. Age- and sex-specific body mass index (BMI) percentiles were utilized; overweight was defined as BMI percentile ≥85th. Activity data included self-reported frequency of moderate-to-vigorous PA. Adolescents reporting ≥60 min/day of PA were considered "active." General linear models, adjusted for age, sex, and race-ethnicity, were used. A 6-year fasting sample weight was applied to the analyses to ensure representativeness of the data. RESULTS: The cMetS scores were significantly (P < 0.05) higher in OA and ONA adolescents compared to NOA (ß = 1.08 and ß = 1.57, respectively). In ONA males, cMetS was significantly (P < 0.01) higher compared to NOA males. In OA and ONA females, cMetS scores were significantly higher compared to the referent group (P < 0.01 for both). CONCLUSIONS: The cMetS scores were increased in overweight adolescents compared to those who were not overweight, regardless of their reported activity level.

Associations between mental distress and physical activity in US adults: a dose-response analysis BRFSS 2011.

Background: To examine the associations between levels of severity of mental distress (MD) and meeting the 2008 physical activity (PA) recommendations using the MD Severity Index (MDSI). Methods: Participants (n = 431 313) were adults (≥18 years of age) who responded to the 2011 Behavioral Risk Factor Surveillance System (BRFSS). MD was categorized into five levels of severity: 0-4, 5-10, 11-16, 17-22 and ≥23 days/month. The dependent variable was self-reported PA volume of at least 150 min/wk (or vigorous equivalent, 75 min/wk). Results: Following adjustment for age, gender, race/ethnicity, education and body mass index, the odds of reporting meeting the PA recommendations were significantly lower among those reporting the following days per month of MD: 5-10 (odds ratio [OR] = 0.92, 95% confidence interval [CI]: 0.87-0.96), 11-16 (OR = 0.76, 95% CI: 0.71-0.82), 17-22 (OR = 0.69, 95% CI: 0.62-0.76) and ≥23 (OR = 0.64, 95% CI: 0.60-0.67). An inverse dose-response (P < 0.01) was observed between the severity of MD and meeting the current PA recommendations. Conclusions: An inverse dose-response relationship was found between the severity of MD and volumes of PA meeting the 2008 recommendation. These findings lend support for the epidemiological utility of the MDSI when examining the relationship between MD and PA.

Associations of Metabolic Syndrome, Elevated C-Reactive Protein, and Physical Activity in U.S. Adolescents.

PURPOSE: The aim was to estimate the prevalence of metabolic syndrome (MetS) criteria, elevated C-reactive protein (CRP), and physical activity (PA) as well as the odds of MetS criteria in those active versus inactive utilizing a representative sample of U.S. adolescents. METHODS: The study sample (n = 676) included male and female adolescent (12-17 years) participants in the 2007-2010 National Health and Nutrition Examination Survey. The criteria analyzed were based on a modified definition of MetS using the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Current adult cut points were used to determine elevated CRP. Activity was estimated using reported days per week and minutes per day of moderate/vigorous PA. RESULTS: The MetS criteria with the highest and lowest overall prevalence estimates were elevated fasting glucose and elevated blood pressure (20.7% [95% confidence interval, 17.02-24.38] and 5.7% [95% confidence interval, 3.70-7.70], respectively). The prevalence of elevated CRP was 7.1% (6.3% and 7.8% in males and females, respectively; p = .42). The prevalence of insufficient PA was 75.0%. Odds of low high-density lipoprotein cholesterol were significantly lower in active adolescents when compared with inactive adolescents (odds ratio = .39, p < .05). CONCLUSIONS: In a representative sample of U.S. adolescents, elevated fasting glucose is the most prevalent MetS criterion. One out of five U.S. adolescents has elevated fasting glucose, and three out four do not meet the daily federal PA recommendations. Adolescents meeting the federal PA recommendation demonstrate approximately 60% lower odds of having low high-density lipoprotein cholesterol.

Associations Between Low Back Pain and Muscle-strengthening Activity in U.S. Adults.

STUDY DESIGN: This was a cross-sectional study. OBJECTIVE: The primary aim of the study was to examine the association between low back pain (LBP) and muscle-strengthening activity (MSA) among U.S. adults using gender-stratified analyses. SUMMARY OF BACKGROUND DATA: LBP is a common medical condition that impacts quality of life and professional productivity and increases the financial burden on the health care system by augmenting medical treatment costs. Previous studies analyzing gender-dependent relationships between MSA and LBP have produced mixed results. METHODS: Our sample included 12,721 participants from the 1999 to 2004 National Health and Nutrition Examination Survey (NHANES). Participants were categorized into one of three levels of self-reported MSA: no MSA, insufficient MSA (1 day/wk), or meeting the 2008 Department of Health and Human Services (DHHS) recommendation for MSA (≥2 days/wk). RESULTS: Gender-stratified analyses revealed significantly lower odds of reporting LBP among women [odds ratio (OR) 0.82, 95% confidence interval (CI) 0.70-0.96, P = 0.03] and men (OR 0.86; 95% CI 0.70-0.96, P = 0.01) who reported amounts of MSA that met the DHHS recommendation compared with those reporting no MSA. Following adjustment for smoking status, the odds remained significant among women (P = 0.03) but not among men (P = 0.21). CONCLUSION: These findings indicate that engaging in MSA at least 2 days/wk is associated with lower odds of LBP and that smoking may be an important mediating factor that should be considered in future LBP research. LEVEL OF EVIDENCE: 4.

Historical Data Analysis of Hospital Discharges Related to the Amerithrax Attack in Florida.

Interrupted time-series analysis (ITSA) can be used to identify, quantify, and evaluate the magnitude and direction of an event on the basis of time-series data. This study evaluates the impact of the bioterrorist anthrax attacks ("Amerithrax") on hospital inpatient discharges in the metropolitan statistical area of Palm Beach, Broward, and Miami-Dade counties in the fourth quarter of 2001. Three statistical methods-standardized incidence ratio (SIR), segmented regression, and an autoregressive integrated moving average (ARIMA)-were used to determine whether Amerithrax influenced inpatient utilization. The SIR found a non-statistically significant 2 percent decrease in hospital discharges. Although the segmented regression test found a slight increase in the discharge rate during the fourth quarter, it was also not statistically significant; therefore, it could not be attributed to Amerithrax. Segmented regression diagnostics preparing for ARIMA indicated that the quarterly data time frame was not serially correlated and violated one of the assumptions for the use of the ARIMA method and therefore could not properly evaluate the impact on the time-series data. Lack of data granularity of the time frames hindered the successful evaluation of the impact by the three analytic methods. This study demonstrates that the granularity of the data points is as important as the number of data points in a time series. ITSA is important for the ability to evaluate the impact that any hazard may have on inpatient utilization. Knowledge of hospital utilization patterns during disasters offer healthcare and civic professionals valuable information to plan, respond, mitigate, and evaluate any outcomes stemming from biothreats.

Body Mass Index and Physical Inactivity: 2013 BRFSS.

OBJECTIVES: Examine the odds of adults reporting physical inactivity (PI) across six body mass index (BMI) categories. METHODS: We used data from the 2013 Behavioral Risk Factor Surveillance System. Six BMI categories were used. RESULTS: The odds of reporting PI in underweight men and men in the class I, II, and III obesity categories were 1.65 (95% confidence interval [CI] 1.35-2.02), 1.30 (95% CI 1.21-1.39), 1.73 (95% CI 1.58-1.90), and 2.44 (95% CI 2.17-2.75), respectively, compared with men of desirable weight (odds ratio [OR] 1.00, 18.5-24.9 kg/m2; referent, OR 1.00). The odds of reporting PI in underweight men were similar to class II and class III obese men. The odds of reporting PI in underweight women, overweight women, and women in the class I, II, and III obesity categories were 1.57 (95% CI 1.36-1.81), 1.20 (95% CI 1.14-1.27), 1.65 (95% CI 1.56-1.75), 2.23 (95% CI 2.07-2.40), and 2.89 (95% CI 2.66-3.15), respectively, compared with women of desirable weight (≥18.5-24.9 kg/m2; referent, OR 1.00). The odds of reporting PI were similar in underweight and class I obese women. Women were found to have greater odds than men of reporting PI in four of the five nondesirable BMI categories (P < 0.05). CONCLUSIONS: The within- and between-sex differences in the odds of reporting PI vary significantly by BMI category. Future research needs to include the underweight BMI category when investigating PI and sedentary time because of the potential clinical relevance.

The Associations Between Increasing Degrees of HOMA-IR and Measurements of Adiposity Among Euglycemic U.S. Adults.

BACKGROUND: The purpose of this study was to examine the associations between increasing degrees of insulin resistance (using the homeostatic model assessment of insulin resistance [HOMA-IR]) and two measures of adiposity in a nationally representative sample of euglycemic U.S. adults. MATERIALS AND METHODS: Sample included adult participants (≥ 20 years of age) [N = 1586 (body mass index, BMI model), N = 1577 (waist circumference, WC model)] from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). HOMA-IR was categorized into quartiles. BMI and WC were examined continuously as the dependent variables. RESULTS: Following adjustment for covariates, those with HOMA-IR values in the second, third, and fourth quartiles had significantly higher BMIs (P < 0.001) compared with subjects in the first quartile. In the model using WC, significantly higher WCs were found in subjects in the second, third, and fourth quartiles of HOMA-IR (P < 0.001) compared with those in the first quartile. A significant moderate correlation was found between HOMA-IR and BMI (R(2) = 0.4171, P < 0.001), as well as HOMA-IR and WC (R(2) = 0.4826, P < 0.001). CONCLUSIONS: Having a higher HOMA-IR value is associated with higher BMI and WC values in euglycemic subjects.

Vigorous Intensity Physical Activity and C-Reactive Protein in U.S. Adults.

BACKGROUND: Several studies have revealed inverse associations between physical activity (PA) and C-reactive protein (CRP). However, few studies have examined associations between vigorous intensity PA (VIPA) and CRP using nationally representative samples. METHODS: The sample (n = 14,461) included adults (≥20 years of age) who participated in the 1999-2006 National Health and Nutrition Examination Survey. Reported VIPA was categorized into none, insufficient (<500 MET·min·wk(-1)), and meeting the 2008 Department of Health and Human Services PA recommendation (≥500 MET·min·wk(-1)). The dependent variable was elevated CRP (3

Care Utilization Patterns and Diabetes Self-Management Education Duration.

Objective. Previous studies have shown that receiving diabetes self-management education (DSME) is associated with increased care utilization. However, the relationship between DSME duration and care utilization patterns remains largely unexamined. Our purpose is to characterize DSME duration and examine the relationship between DSME duration and clinical- and self-care utilization patterns. Methods. The study sample included 1,446 adults who were ≥18 years of age, had diabetes, and had participated in the 2008 Florida Behavioral Risk Factor Surveillance System survey. Clinical- and self-care outcomes were derived using responses to the survey's diabetes module and were based on minimum standards of care established by the American Diabetes Association. The outcomes examined included self-monitoring of blood glucose at least once per day; receiving at least one eye exam, one foot exam, A1C tests, and an influenza vaccination in the past year; and ever receiving a pneumococcal vaccination. DSME duration was categorized as no DSME, >0 to <4 hours, 4-10 hours, and >10 hours. Results. After adjusting for sociodemographic variables, compared to those who did not receive DSME, those who had 4-10 or 10+ hours of DSME were more likely to receive two A1C tests (odds ratio [95% CI] 2.69 [1.30-5.58] and 2.63 [1.10-6.31], respectively) and have a pneumococcal vaccination (1.98 [1.03-3.80] and 1.92 [1.01-3.64], respectively). Those receiving 10+ hours of DSME were 2.2 times (95% CI 1.18-4.09) as likely to have an influenza vaccination. Conclusion. These data reveal a positive relationship between DSME duration and utilization of some diabetes clinical care services.

The associations between increasing degrees of homeostatic model assessment for insulin resistance and muscular strengthening activities among euglycaemic US adults.

PURPOSE: To examine the associations between the homeostatic model assessment for insulin resistance and self-reported muscular strengthening activity in a nationally representative sample of euglycaemic US adults. METHODS: Sample included euglycaemic adults (⩾20 years of age (n = 2009)) from the 1999 to 2004 National Health and Nutrition Examination Survey. Homeostatic model assessment for insulin resistance was categorized into quartiles and was the primary independent variable of interest. No reported muscular strengthening activity was the dependent variable. RESULTS: Following adjustment for covariates, those with homeostatic model assessment for insulin resistance values in fourth (odds ratio: 2.04, 95% confidence interval: 1.35-3.06, p < 0.001) quartile were found to have significantly greater odds of reporting no muscular strengthening activity. Following further adjustment for non-muscular strengthening activity specific aerobic leisure-time physical activity, results remained significant for the fourth (odds ratio: 2.30, 95% confidence interval: 1.50-3.52, p < 0.001) quartile. A significant trend was seen across quartiles of homeostatic model assessment for insulin resistance for increasing prevalence of no muscular strengthening activity (p < 0.001). CONCLUSION: Having a higher homeostatic model assessment for insulin resistance value is associated with greater odds of reporting no muscular strengthening activity among euglycaemic US adults. This implies that subjects with an increasing degree of insulin resistance are more likely to not engage in muscular strengthening activity, an exercise modality that has been shown to reduce the risk of several cardiometabolic diseases and improve glycaemic status.

Gender Differences in C-Reactive Protein and Muscle Strengthening Activity.

BACKGROUND: Few studies have examined the gender differences between C-reactive protein (CRP) and muscle strengthening activity (MSA). METHODS: The sample (n = 7533) included U.S. adult (≥20 years of age).participants in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). Created categories of MSA participation included no MSA (referent group), some MSA (≥1 to <2 days/week), and meeting the 2008 Department of Health and Human Services (DHHS) recommendation (≥2 days/week). The dependent variable was elevated CRP (>3 to 10 mg/L). RESULTS: Analysis revealed significantly lower odds of having elevated CRP for women reporting some MSA (OR 0.64; 95% CI 0.44-0.93, P = .0191). Significantly lower odds of men having elevated CRP was observed in those reporting MSA volumes meeting the DHHS recommendation (OR 0.72; 95% CI 0.59-0.88, P = .0019). Following adjustment for waist circumference (WC) these odds remained significant in men but not women. CONCLUSIONS: These results suggest that WC may mediate the associations between MSA and CRP and this relationship may be stronger in women.