Physical fitness and activity changes after a 24-week soccer-based adaptation of the U.S diabetes prevention program intervention in Hispanic men

Abstract

Purpose: One third of the U.S. adult population is estimated to have prediabetes. Hispanics have a 50% higher type 2 diabetes (T2DM) death rate compared to non-Hispanic whites, yet low participation in lifestyle change programs, making this subgroup an important target for prevention efforts. The purpose of this study was to determine the effects of an exercise intervention implementing the Center for Disease Control and Prevention National Diabetes Prevention Program (NDPP) plus recreational soccer (RS) in Hispanic men.

Methods: Overweight and obese Hispanic men, aged 30-57 years with prediabetes at screening were recruited from the community. Trained soccer coaches led 30-min facilitated discussion of the NDPP modules after each RS session, with two weekly sessions delivered over 12 wks, then once a wk until 24 wks. The 1-h RS sessions followed the Football Fitness curriculum structure. Standardized study assessments included objectively measured physical activity via fitness tracker, physical fitness via validated field tests, global positional system soccer specific metrics and behavior change questionnaires. Mixed models assessed the outcomes as a function of time and cohort and incorporated an unstructured covariance structure to examine the difference between baseline, 12 and 24 wks. All analyses were conducted as intent-to-treat and generated using SAS v 9.4.

Results: Hispanic males (n = 41; mean age 41.9 [6.2 SD] years) were obese at baseline (mean BMI 32.7, standard error [0.7]). After 24 wks of the NDPP+RS intervention, there were significant beneficial changes in vertical jump (2.8 [1.3] cm; p = 0.048), agility and lower extremity muscular power (figure 8-run) at 12 wks (-4.7% change; p = 0.001) and 24 wks (-7.2% change; p < 0.0001), predicted VO₂ max (12 wks: 1.9%; p = 0.007; 24 wks 1.0%; p = 0.036), modified push-ups increased 22% (p < 0.0001) at 12 wks and 31% (p < 0.0001) at 24 wks, dynamic sit-ups increased 10% (p = 0.005) at 12 wks and 15% (p < 0.0001) at 24 wks.

Conclusion: Among middle-aged Latino men, broad-ranging significant improvements in physical fitness were observed after 24 wks participating in lifestyle education plus RS in a single arm feasibility trial.

Keywords: Exercise; Fitness; Football; Recreational sport; Soccer.

Figure 1

Objectively measured physical activity measurements at baseline, 12 and 24 wk time points. Panel A – Average change in daily steps measured by Garmin Vivofit 3; Panel B – Average change in daily sedentary and sleep time in hs; Panel C – Average change in daily light physical activity in mins; Panel D – Average change in wkly average moderate to vigorous physical activity in mins.

Figure 2

Aerobic fitness measurements at baseline, 12 and 24 wk time points. Panel A – Average change in agility figure 8 run test in s; Panel B – Average change in predicted VO₂ max (ml/kg/min).

Figure 3

Muscle strength measurements at baseline, 12 and 24 wk time points. Panel A – Average change in handgrip strength in the dominant hand measured in kilograms; Panel B – Average change in dynamic sit ups in repetitions; Panel C – Average change in modified push-ups in repetitions; Panel D – Average change in vertical jump in centimeters.

Figure 4

Soccer specific GPS metrics at baseline, 12 and 24 wk time points. Panel A – Average change in session duration in mins; Panel B – Average change in total distance during a session in kilometers; Panel C – Average change in sprint distance in meters; Panel D – Average change in energy expenditure in kilocalories during a session.

Figure 5

Soccer specific GPS metrics at baseline, 12 and 24 wk time points. Panel A – Average change in total distance per min; Panel B – Average change in player load; Panel C – Average change in power score in watts per kilogram; Panel D – Average change in work ratio as a percentage; Panel E – Average change in power play (count); Panel F – Average change in top speed in meters per second.

Figure 6

Results from the Behavior Regulation in Exercise Questionnaire at all time points showing the progression from amotivation to intrinsic regulation among Hispanic Men.