Exercise Perceptions, Physical Fitness, And Body Composition In Adolescents With Diabetes Or Obesity

Youth with diabetes, as well as those who are obese, have known cardiovascular risks. Identifying factors that influence their perceptions about exercise can assist in determining strategies for promoting exercise adherence to minimize these risks. PURPOSE: For adolescents with diabetes or diagnosed as obese who enrolled in a personalized exercise program, the purpose of this investigation was to examine whether baseline exercise perceptions were associated with gender, cardiovascular (CV) fitness, or body composition. METHODS: We included 46 adolescents (mean age 14.6 ± 1.8 yrs.); 22 with type 1 diabetes (T1DM), 13 with type 2 diabetes (T2DM), and 11 obese. There were 19 males, 27 females; 65% were Hispanic. Glycemic control (A1c) was determined by the DCA 2000®; CV fitness was measured using graded ergometry (VO2peak); and body composition was evaluated using the Quantum X™. Exercise perceptions were obtained with validated self-report questionnaires on exercise self-efficacy, immediate competing preferences, and benefits and barriers to exercise. RESULTS: There was no significant difference in A1c for those with T1DM vs. T2DM. Mean (SD) BMI percentiles were as follows: T1DM (75 ± 27); T2DM (98 ± 1.7); obese (99 ± 1.0). As expected, the T1DM group had significantly lower mean BMI percentile and higher percent fat free mass (FFM) and VO2peak than the T2DM or obese groups (P <.001). The T2DM group expressed the greatest barriers to exercise (P <.01). For the total sample, greater barriers were associated with lower self-efficacy (r = - 0.48, P <.001), percent FFM (r = - 0.30, P <.05), and VO2peak (r = - 0.29, P <.05), but not BMI percentile. Females with T2DM had lower self-efficacy and benefits to exercise and more competing preferences to exercise than males (P <.05). CONCLUSIONS: Although BMI is frequently used as a clinical indicator that youth may be more averse to exercise, our findings indicate that adiposity may be a better indicator of those who perceive greater barriers to exercise. This finding is particularly salient for adolescents with T2DM. Females with T2DM show evidence of the need for intervention approaches that target improving exercise self-efficacy and benefits, as well as setting priorities for increasing preferences for a more active lifestyle.