Promoting Physical Activity in a Low-Income Multiethnic District: Effects of a Community Intervention Study to Reduce Risk Factors for Type 2 Diabetes and Cardiovascular Disease
A community intervention reducing inactivity
- Anne Karen Jenum, MD, MPH, PHD12,
- Sigmund A. Anderssen, PHD3,
- Kåre I. Birkeland, MD, PHD1,
- Ingar Holme, PHD3,
- Sidsel Graff-Iversen, MD, PHD2,
- Catherine Lorentzen, MSC4,
- Yngvar Ommundsen, PHD4,
- Truls Raastad, PHD5,
- Ann Kristin Ødegaard, BSC6 and
- Roald Bahr, MD, PHD3
- 1Diabetes Research Centre, Aker University Hospital, University of Oslo, Oslo, Norway
- 2Department of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
- 3Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
- 4Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
- 5Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
- 6City of Oslo, Grorud District, Oslo, Norway
- Address correspondence and reprint requests to Anne Karen Jenum, MD, MPh, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway. E-mail: anne.karen.jenum{at}fhi.no
Abstract
OBJECTIVE—The aim was to assess the net effects on risk factors for type 2 diabetes and cardiovascular disease of a community-based 3-year intervention to increase physical activity.
RESEARCH DESIGN AND METHODS—A pseudo-experimental cohort design was used to compare changes in risk factors from an intervention and a control district with similar socioeconomic status in Oslo, Norway, using a baseline investigation of 2,950 30- to 67-year-old participants and a follow-up investigation of 1,776 (67% of those eligible, 56% women, 18% non-Western immigrants) participants. A set of theory-based activities to promote physical activity were implemented and tailored toward groups with different psychosocial readiness for change. All results reported are net changes (the difference between changes in the intervention and control districts). At both surveys, the nonfasting serum levels of lipids and glucose were adjusted for time since last meal.
RESULTS—The increase in physical activity measured by two self-reported questionnaires was 9.5% (P = 0.008) and 8.1% (P = 0.02), respectively. The proportion who increased their body mass was 14.2% lower in the intervention district (P < 0.001), implying a 50% relative reduction compared with the control district, and was lower across subgroups. Beneficial effects were seen for triglyceride levels (0.16 mmol/l [95% CI 0.06–0.25], P = 0.002), cholesterol–to–HDL cholesterol ratio (0.12 [0.03–0.20], P = 0.007), systolic blood pressure (3.6 mmHg [2.2–4.8], P < 0.001), and for men also in glucose levels (0.35 mmol/l [0.03–0.67], P = 0.03). The net proportion who were quitting smoking was 2.9% (0.1–5.7, P = 0.043).
CONCLUSIONS—Through a theory-driven, low-cost, population-based intervention program, we observed an increase in physical activity levels, reduced weight gain, and beneficial changes in other risk factors for type 2 diabetes and cardiovascular disease.
Footnotes
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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- Accepted March 26, 2006.
- Received August 24, 2005.
- DIABETES CARE
