Association of obesity and diabetes with physical activity and fruit and vegetable consumption in stroke survivors

Abstract

Background: Engaging in unhealthy behaviours [poor diet, insufficient physical activity (PA)] increases risk for recurrent stroke and can be compounded by obesity and diabetes, but the association of obesity and diabetes with poor diet and insufficient PA in stroke survivors is unknown.

Objective: The purpose of this study was to compare prevalences of low fruit and vegetable consumption (low FV consumption, <1 fruit and <1 vegetable daily) and low physical activity (low PA, <150 minutes of weekly moderate-intensity PA) in stroke survivors, stratified by obesity-diabetes status (neither condition, obesity only, diabetes only, both conditions).

Methods: Cross-sectional data from 32 876 non-institutionalized, US stroke survivors aged ≥45 years from the 2015 and 2017 Behavioral Risk Factor Surveillance System were examined. Weighted, age-adjusted prevalence estimates and adjusted odds ratios (AORs) of the investigated unhealthy behaviours (adjusted for sex, age, race, income, education and marital status) and 95% confidence intervals (CIs) were calculated.

Results: Prevalences of low FV consumption and low PA exceeded 50% across all obesity-diabetes categories. Compared with respondents with neither obesity nor diabetes, AORs for low PA were increased for respondents with both obesity and diabetes (2.02, 95% CI: 1.72-2.37) and respondents with obesity only (1.31, 1.13-1.53); AORs for low FV consumption did not differ across obesity-diabetes categories.

Conclusions: Results indicated a joint effect of obesity and diabetes with low PA among stroke survivors. Regardless of obesity-diabetes status, however, prevalence of low FV consumption and low PA exceeded 50%. Targeted interventions that modify these unhealthy behaviours among stroke survivors should be explored.

Keywords: Diabetes; diet; obesity; physical activity; primary care; stroke.