Nutrients · 8 authors, 3 centres
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This cross-sectional study of 1685 Brazilian adults found that physical inactivity during leisure time was associated with a 2.62-fold higher odds of having high HbA1c levels (≥6.5%), and 26.87% of this association was mediated by being overweight. The study's cross-sectional design limits causal inference, and physical activity was self-reported.
The COVID-19 pandemic led to increased physical inactivity, which may contribute to weight gain and adverse glycemic control. This study aimed to evaluate the association between leisure-time physical inactivity and high HbA1c levels, and to test if being overweight mediates this association. Methods: A cross-sectional study was conducted in October-December 2020 among 1685 adults in Brazil using stratified, multistage probability cluster sampling. Physical activity was self-reported and categorized as active or inactive based on WHO guidelines. HbA1c was measured via immunoturbidimetry, with ≥6.5% indicating glycemic changes. Overweight (BMI ≥25 kg/m² for <60 years, ≥28 kg/m² for ≥60 years) was the mediating variable. Analyses included multivariate logistic regression and mediation analysis using the Karlson–Holm–Breen method, adjusted for sex, age, race/ethnicity, family income, and reported morbidities. Key Results: The mean HbA1c was 5.68% (95% CI: 5.58–5.77). 69.2% of participants were physically inactive, and 7.1% had high HbA1c. Physically inactive individuals had 2.62 times higher odds of high HbA1c (OR: 2.62, 95% CI: 1.29–5.33). Mediation analysis showed 26.87% of this association was mediated by overweight (OR: 1.30, 95% CI: 1.06–1.57). Limitations: The cross-sectional design cannot establish causality. Physical activity was self-reported, and dietary intake was not assessed. Implications: The findings suggest that physical inactivity is associated with higher HbA1c, partly through overweight, highlighting the importance of promoting physical activity for glycemic control, especially during periods of restricted mobility.
