Physical activity distribution during pregnancy from Actigraph’s GT1M recording.

<p>Physical activity distribution during pregnancy from Actigraph’s GT1M recording.</p

Physical activity levels as self-reported by the PPAQ.

*<p><i>P</i><0.05.</p

Assessing and targeting key lifestyle cardiovascular risk factors at the workplace: Effect on hemoglobin A1c levels

<div><p></p><p><b>Purpose</b> Despite the key role played by lifestyle habits in the epidemic of type 2 diabetes (T2D), nutritional quality and physical activity are not systematically considered in clinical practice. The project was conducted to verify whether assessing/targeting lifestyle habits could reduce hemoglobin A1c (HbA1c) levels of employees. <b>Methods</b> The intervention consisted of a 3-month competition among teams of five employees to favor peer-based support in the adoption of healthier lifestyle habits (Eat better, Move more, and Quit smoking) (n = 900). A comprehensive cardiometabolic/cardiorespiratory health assessment was conducted before and after the contest (nutrition/physical activity questionnaires, blood pressure, anthropometric measurements, lipid profile, HbA1c, fitness). HbA1c levels were used to identify individuals with prediabetes (5.7%–6.4%) or T2D (≥6.5%). <b>Results</b> At baseline, 51% of the employees had increased HbA1c levels (≥5.7%). The HbA1c levels were associated with waist circumference, independently of body mass index. Subjects with prediabetes showed a higher waist circumference as well as a more deteriorated cardiometabolic profile compared to workers with normal HbA1c levels. After the intervention, employees with elevated HbA1c significantly reduced their HbA1c levels. <b>Conclusion</b> Results suggest that assessing/targeting key lifestyle correlates of the cardiometabolic profile represents a relevant approach to target abdominal obesity and fitness with a significant impact on HbA1c levels. </p><p></p><p>Key Messages</p><p></p><p>The prevalence of employees with prediabetes or undiagnosed type 2 diabetes (T2D) was rather high in our cohort, suggesting that, from a public health standpoint, identification of those individuals is not optimal.</p><p></p><p></p><p>Employees with prediabetes or T2D showed a higher waist circumference and a more deteriorated cardiometabolic risk profile compared to those with normal HbA1c levels.</p><p></p><p></p><p>The significant reduction in HbA1c levels observed in response to the 3-month intervention supports the notion that a program which assesses and manages cardiometabolic risk at the workplace by also focusing on key lifestyle factors (nutritional quality and physical activity levels) represents an interesting option to reduce the risk of developing diabetes among high-risk individuals or to improve glycemic control and related cardiometabolic risk in patients with T2D.</p><p></p><p></p><p></p></div

Mean (SD) GT1M values across tertiles of total energy expenditure based on the PPAQ.

*<p>Jonckheere-Terpstra.</p

Accuracy of the PPAQ.

*<p>Including only women who were still working in the past trimester.</p

Objectively measured physical activity levels throughout pregnancy.

<p>Black lozenge: exercise group. White square: control group. Fig 2a. Daily time spent at moderate and vigorous physical activity in bouts of at least 10 min; Fig 2b. Total activity per day, expressed as the daily number of accelerometry counts; Fig 2c. Number of steps per day. P-value is for time-group interaction significance; * Indicates a significant difference (p<0.05) between groups at a specific time point; Different capital letters (A, B, C, D, E) within a group indicate significant differences between time points.</p

Physical activity levels throughout the study.

<p>MVPA = moderate and vigorous physical activity; PA = physical activity</p><p>^asignificant group effect, p = 0.014; values significantly higher in the exercise vs control group at all time</p><p>^bsignificant time effect, p = 0.028; values significantly lower at time 3 compared with time 2 in both groups (adjusted p = 0.027)</p><p>^csignificant time effect, p = 0.012; values significantly lower at time 3 compared with time 1 in both groups (adjusted p = 0.012)</p><p>^dsignificant time effect, p = 0.007; values significantly lower at time 3 vs time 1 and time 2 in both groups (adjusted p = 0.001 and p = 0.010).</p><p>Physical activity levels throughout the study.</p

Maternal fitness, anthropometry and nutritional intakes at 14 and 28 weeks of gestation.

<p>VO₂ AT = oxygen consumption at the anaerobic threshold</p><p>^an = 24</p><p>^bn = 22</p><p>^cp<0.05, Wilcoxon rank sum test</p><p>^dn = 22 and 24 at baseline, and n = 19 and 20 at 28 weeks in exercise and control groups, respectively</p><p>^ep<0.05, Student t test.</p><p>Maternal fitness, anthropometry and nutritional intakes at 14 and 28 weeks of gestation.</p

Self-reported physical activity and rate of weekly weight gain throughout pregnancy.

<p>Black section: exercise group. White section: control group. Fig 3a. Energy expenditure spent at sports and exercise in the previous month, from the PPAQ; Fig 3b. Energy expenditure spent at vigorous intensity activity in the past month, from the PPAQ; Fig 3c. Rate of weekly gestational weight gain, in kg. P-value is for time-group interaction significance; * Indicates a significant difference (p<0.05) between groups at a specific time point; Different capital letters (A, B, C, D, E) within a group indicate significant differences between time points.</p

Participants’ characteristics at 14 weeks (Visit 1).

<p>^aStudent t-test (other continuous variables evaluated using Wilcoxon rank sum test)</p><p>^bFisher exact test (other categorical variables evaluated using χ²).</p><p>Participants’ characteristics at 14 weeks (Visit 1).</p