Physical Activity Types, Physical Activity Levels and Risk of Diabetes in General Adults: The NHANES 2007–2018

Background: Recreational activities show benefits for diabetes prevention, but work-related activity and the total amount of individual physical activity is rarely discussed. Purpose: The purpose of this study was to evaluate the participation in five typical physical activities (vigorous work activity, vigorous recreational activities, moderate work activity, moderate recreational activities, and walk/bicycle for transportation), as well as the weekly distribution of total physical activity intensity, and to explore the relationships between physical activity types, physical activity levels, and risk of diabetes. Study design: Cross-sectional study. Methods: The self-reported physical activity data on specific domains of physical activity were acquired from individuals in the 2007–2018 National Health and Nutrition Examination Survey (NHANES) using the Physical Activity Questionnaire (PAQ). Diabetes status was assessed by self-reported medical diagnosis or medication usage, or a fasting glucose concentration ≥ 126 mg/dL (fasting is defined as no caloric intake for at least 8 h) or HbA1c ≥ 6.5%. Weighted logistic regression was used to investigate the associations between physical activity types, physical activity levels, and risk of diabetes. Results: Diabetes was less prevalent in people who participated in physical activity and the risk of diabetes reduced progressively as total physical activity levels increased. Younger adults (20–44 years) and males reported a higher proportion of high-intensity physical activity participation. Conclusions: Our findings highlight the importance of a physically active lifestyle for preventing diabetes. Distinct types of physical activity had different effects on the risk of diabetes. A greater total physical activity level was related to a substantial reduction in diabetes risk.