Abstract

Background: Physical activity is a crucial component of diabetes prevention and management, yet participation varies across populations. Differences by country of birth may reflect cultural, socioeconomic, and structural factors that influence health behaviors among individuals with diabetic conditions. Objective: To examine the relationship between country of birth, diabetes status, and physical activity, and to assess whether country of birth is associated with diabetes prevalence. Methods: A cross-sectional analysis was conducted using U.S.-nationally representative data from the National Health and Nutrition Examination Survey (NHANES). Adults were categorized as having diabetes/prediabetes or no diabetes based on self-reported diagnosis. Physical activity was assessed using self-reported levels of moderate and vigorous leisure-time physical activity (LTPA). Sociodemographic characteristics were compared across groups. Stratified analyses were conducted to evaluate differences by country of birth and statistical tests were used to identify significant associations between diabetes status, physical activity, and sociodemographic variables. Results: Significant differences in sociodemographic characteristics were observed across diabetes status groups, particularly by age. There was no significant difference in physical activity levels between adults with diabetes compared to those without. Individuals with diabetes reported higher levels of sedentary time before adjustment for sociodemographic factors. Differences in physical activity behaviors were also observed in unadjusted analyses by country of birth, with foreign-born groups demonstrating lower levels of vigorous activity. Conclusions: Physical activity disparities exist among adults in the United States with diabetes and prediabetes and differ by country of birth, although they can be largely explained by sociodemographic factors. These findings highlight the need for culturally and socioeconomically tailored interventions to promote physical activity and support chronic disease management in diverse populations.

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