Physical activity (PA) may decrease the risk of type 2 diabetes and other metabolic diseases. This cross-sectional analysis assessed the association between PA, outdoor play, and the prevalence of prediabetes in children (7-11 y).


Baseline data were used from 1,106 primarily Hispanic 3rd to 5th grade students from 16 elementary schools across the Austin, TX, area participating in TX Sprouts, 1-year gardening, nutrition, and cooking randomized controlled trial. The following baseline measures were collected:weight, height, waist circumference, percent body fat via bioelectrical impedance, and fasting plasma glucose (FPG). Demographics, participation in moderate-vigorous physical activity (MVPA), and outdoor play the prior day were collected via validated questionnaires. Prediabetes was defined according to American Diabetes Association guidelines for prediabetes as FPG of 100-125 mg/dL. Generalized linear mixed models were used, accounted for the school-level cluster effect, to determine the association between physical activity and prediabetes risk, controlling for child age, sex, race/ethnicity, and BMI percentile.


Participants were 53% male, 69% Hispanic, with a mean age of 9.3 years. Approximately 25% of the participants had prediabetes and 50% indicated that they had not participated in either 30 minutes of MVPA or outdoor play the prior day. Compared to participants with normal FPG, those with prediabetes were less likely to have engaged in 30 minutes of outdoor play (OR=0.32, 95%CI: 0.01-0.63, p=0.04). However, the relationship between prediabetes and MVPA was attenuated. Weight, waist circumference, race/ethnicity, BMI percentile were also independently associated with the risk of prediabetes (p<0.05).


These findings suggest that outdoor play is inversely associated with the prevalence of prediabetes in school-aged children and may provide valuable information to help develop future interventions targeting prediabetes and type 2 diabetes.