Physical activity as a moderator of the association between central obesity and Type 2 diabetes in Asian American older adults.

Background: Asian American older adults (65+) face elevated risks for central obesity and Type 2 diabetes mellitus (T2DM). This study tested whether moderate to vigorous physical activity (MVPA) moderates the association between central obesity and T2DM, hypothesizing that the odds of T2DM linked to central obesity would be lower at higher levels of MVPA. Methods: Generalized logistic regression models were used to test whether MVPA moderated the association between central obesity and T2DM, adjusting for demographic, cultural, and health-related covariates. Moderation was evaluated by comparing odds ratios from models using uncentered versus centered interaction terms. Results: MVPA significantly moderated the association between central obesity and T2DM risk in older Asian Americans. Among individuals with central obesity, achieving the recommended threshold of 150 min of MVPA per week was associated with 43 % lower odds of T2DM (p < 0.001), based on comparisons of regression models incorporating uncentered versus centered interaction terms. Conclusion: Increasing time spent in MVPA was associated with a lower likelihood of T2DM among Asian American older adults with central obesity. Further research examining these associations within specific Asian American subgroups will be critical for the development of culturally relevant recommendations and tailored lifestyle interventions with the potential to address diabetes-related health disparities in this population.