Physical Activity in a Randomized Culturally Adapted Lifestyle Intervention

Faiza Siddiqui; Robert W Koivula; Azra Kurbasic; Ulf Lindblad; Peter M Nilsson; Louise Bennet

doi:10.1016/j.amepre.2018.04.016

Physical Activity in a Randomized Culturally Adapted Lifestyle Intervention

Am J Prev Med. 2018 Aug;55(2):187-196. doi: 10.1016/j.amepre.2018.04.016.

Authors

Faiza Siddiqui¹, Robert W Koivula², Azra Kurbasic³, Ulf Lindblad⁴, Peter M Nilsson¹, Louise Bennet⁵

Affiliations

¹ Department of Clinical Sciences, Lund University, Malmö, Sweden.
² Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom.
³ Genetic and Molecular Epidemiology Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
⁴ Department of Community Medicine/Primary Health Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁵ Department of Clinical Sciences, Lund University, Malmö, Sweden; Center for Primary Health Care Research, Region Skåne and Lund University, Malmö, Sweden. Electronic address: louise.bennet@med.lu.se.

PMID: 30031454
DOI: 10.1016/j.amepre.2018.04.016

Abstract

Introduction: Middle Eastern immigrants exhibit high levels of physical inactivity and are at an increased risk for Type 2 diabetes. The primary aim of this study was to examine the changes in objectively assessed physical activity levels following a culturally adapted lifestyle intervention program. The secondary aim was to examine the association between objectively assessed physical activity and insulin sensitivity.

Study design: RCT conducted over 4 months in 2015.

Participants: Iraqi immigrants residing in Malmö, Sweden, exhibiting one or more risk factors for Type 2 diabetes.

Intervention: The intervention group (n=50) was offered a culturally adapted lifestyle intervention comprising seven group sessions including a cooking class. The control group (n=46) received usual care.

Main outcome measures: Raw accelerometry data were processed by validated procedures and daily mean physical activity intensity, vector magnitude high-pass filtered (VM-HPF), was inferred. Further inferences into the number of hours/day spent in sedentary (VM-HPF <48 milli-Gs [mGs] where G=9.8 m/sec²) and light- (48- <163 mGs); moderate- (163- <420 mGs); and vigorous-intensity (≥420 mGs) activities were also calculated (year of analysis was 2016-2017).

Results: No difference was observed between the two groups in terms of change over time in VM-HPF. There was a significant increase in the number of hours/day spent in light intensity physical activity in the intervention group compared with the control group (β=0.023, 95% CI=0.001, 0.045, p=0.037). The intervention group also increased the time spent in sedentary activities, with the highest VM-HPF (36- <48 mGs) within the sedentary behavior (B=0.022, 95% CI=0.002, 0.042, p=0.03). Higher VM-HPF was significantly associated with a higher insulin sensitivity index (β=0.014, 95% CI=0.0004, 0.025, p=0.007).

Conclusions: The findings favor the culturally adapted intervention approach for addressing low physical activity levels among Middle Eastern immigrants. Replacing sedentary time with light-intensity activities could be an achievable goal and will have potential beneficial effects for diabetes prevention among this sedentary group of immigrants.

Trial registration: This study was registered at www.clinicaltrials.gov NCT01420198.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Accelerometry
Adult
Aged
Behavior Therapy / methods*
Blood Glucose
Diabetes Mellitus, Type 2 / prevention & control*
Exercise*
Female
Humans
Insulin Resistance
Iraq / ethnology
Life Style*
Male
Middle Aged
Sedentary Behavior
Sweden

Substances

Blood Glucose

Associated data

ClinicalTrials.gov/NCT01420198