{"doi":"10.2337/dc21-1202","title":"Associations of Daily Steps and Step Intensity With Incident Diabetes in a Prospective Cohort Study of Older Women: The OPACH Study","abstract":"OBJECTIVE: The primary aim was to assess associations between total steps per day and incident diabetes, whereas the secondary aim was to assess whether the intensity and/or cadence of steps is associated with incident diabetes. RESEARCH DESIGN AND METHODS: Women without physician-diagnosed diabetes (n = 4,838; mean [SD] age 78.9 [6.7] years) were followed up to 6.9 years; 395 developed diabetes. Hip-worn ActiGraph GT3X+ accelerometers worn for 1 week enabled measures of total, light-intensity, and moderate- to vigorous-intensity (MV-intensity) steps per day. Using Cox proportional hazards analysis we modeled adjusted change in the hazard rate for incident diabetes associated with total, light-intensity, and MV-intensity steps per day. We further estimated the proportion of the steps-diabetes association mediated by BMI. RESULTS: On average, participants took 3,729 (SD 2,114) steps/day, of which 1,875 (791) were light-intensity steps and 1,854 ± 1,762 were MV-intensity. More steps per day were associated with a lower hazard rate for incident diabetes. Confounder-adjusted models for a 2,000 steps/day increment yielded hazard ratio (HR) 0.88 (95% CI 0.78-1.00; P = 0.046). After further adjustment for BMI, HR was 0.90 (95% CI 0.80-1.02; P = 0.11). BMI did not significantly mediate the steps-diabetes association (proportion mediated = 17.7% [95% CI -55.0 to 142.0]; P = 0.09]). The relationship between MV-intensity steps per day (HR 0.86 [95% CI 0.74-1.00]; P = 0.04) and incident diabetes was stronger than for light-intensity steps per day (HR 0.97 [95% CI 0.73-1.29]; P = 0.84). CONCLUSIONS: These findings suggest that for older adults, more steps per day are associated with lower incident diabetes and MV-intensity steps are most strongly associated with a lower hazard of diabetes. This evidence supports that regular stepping is an important risk factor for type 2 diabetes prevention in older adults.","journal":"Diabetes Care","year":2022,"id":238428,"datarank":2.090307399560704,"base_score":4.007333185232471,"endowment":4.007333185232471,"self_citation_contribution":0.6010999777848708,"citation_network_contribution":1.4892074217758335,"self_endowment_contribution":0.6010999777848708,"citer_contribution":1.4892074217758335,"corpus_percentile":89.81975709754776,"corpus_rank":1317,"citation_count":54,"citer_count":38,"citers_with_citation_signal":28,"citers_with_endowment":28,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.709,"is_data_producer":true,"deposit_databanks":{"figshare":["10.2337/figshare.17004046"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":302270,"name":"Andrea Z. LaCroix","orcid":"0000-0002-9532-976X","position":1,"is_corresponding":false},{"id":61604,"name":"Michael J. Lamonte","orcid":"0000-0002-6669-5242","position":2,"is_corresponding":false},{"id":485371,"name":"David W. Dunstan","orcid":"0000-0003-2629-9568","position":3,"is_corresponding":false},{"id":231463,"name":"Kelly R. Evenson","orcid":"0000-0002-3720-5830","position":4,"is_corresponding":false},{"id":717716,"name":"Guangxing Wang","orcid":"0000-0002-5419-4547","position":5,"is_corresponding":false},{"id":334533,"name":"Chongzhi Di","orcid":"0000-0002-1371-581X","position":6,"is_corresponding":false},{"id":656818,"name":"Benjamin T. Schumacher","orcid":"0000-0002-3099-3387","position":7,"is_corresponding":false},{"id":302266,"name":"John Bellettiere","orcid":"0000-0002-7167-3048","position":8,"is_corresponding":false},{"id":862215,"name":"Alexis C. Garduno","orcid":"0000-0003-4453-8817","position":0,"is_corresponding":true}],"reference_count":44,"raw_metadata":null,"created_at":"2026-07-19T00:22:26.932537Z","pmid":"35050362","pmcid":"PMC8914434","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}