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Daily physical activity predicts degree of insulin resistance: a cross-sectional observational study using the 2003–2004 National Health and Nutrition Examination Survey

Rachael K Nelson1, Jeffrey F Horowitz1, Robert G Holleman2, Ann M Swartz3, Scott J Strath3, Andrea M Kriska4 and Caroline R Richardson25*

Author Affiliations

1 School of Kinesiology, University of Michigan, Ann Arbor, MI USA

2 VA Center for Clinical Management Research, VA HSR&D Center of Excellence, HSR&D/SMITREC (152), 2215 Fuller Rd, P.O. Box 130170, Ann Arbor, MI 48113-0170, USA

3 Department of Human Movement Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, 53201-0413, USA

4 Department of Epidemiology, Graduate School of Public Health, 505 B, University of Pittsburg, 130 DeSoto Street, Pittsburg, PA, 15261, USA

5 Department of Family Medicine, University of Michigan Medical School, 1018 Fuller St, Ann Arbor, MI 48104-1213, USA

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International Journal of Behavioral Nutrition and Physical Activity 2013, 10:10  doi:10.1186/1479-5868-10-10

Published: 28 January 2013



This study examined the independent association of objectively measured physical activity on insulin resistance while controlling for confounding variables including: cardiorespiratory fitness, adiposity, sex, age, and smoking status.


Data were obtained from National Health and Nutrition Examination Survey 2003–2004, a cross-sectional observational study conducted by the National Center for Health Statistics of the Centers for Disease Control that uses a stratified, multistage probability design to obtain a nationally representative sample of the U.S. population. The analysis included 402 healthy U.S. adults with valid accelerometer, cardiorespiratory fitness, and fasting plasma glucose and insulin concentrations. After controlling for relevant confounding variables we performed a multiple linear regression to predict homeostatic model of insulin resistance (HOMA-IR) based on average daily minutes of moderate-to-vigorous physical activity (MVPA).


In our bivariate models, MVPA, cardiorespiratory fitness and body fat percentage were all significantly correlated with log HOMA-IR. In the complete model including MVPA and relevant confounding variables, there were strong and significant associations between MVPA and log HOMA-IR (β= −0.1607, P=0.004). In contrast the association between cardiorespiratory fitness and log HOMA-IR was not significant.


When using an objective measure of physical activity the amount of time engaged in daily physical activity was associated with lower insulin resistance, whereas higher cardiorespiratory fitness was not. These results suggest that the amount of time engaged in physical activity may be an important determinant for improving glucose metabolism.

Ambulatory monitoring; Physical fitness; Glucose tolerance test; Adiposity