Diabetes Risk Behaviors Are Higher among Sexual Minority U.S. High School Students

Low physical activity (PA) and high sedentary behavior (SB) are associated with increased type 2 diabetes risk among youth. We investigated PA and SB among Youth Risk Behavior Survey (YRBS) respondents to determine if sexual minority youth may be at increased diabetes risk compared to heterosexual youth. Weighted city and state YRBS data were pooled across 44 jurisdictions biennially from 2009-2015, resulting in a sample size of 97 jurisdiction-years (350,673 students). Respondents had a median age of 16 years, were 50.3% male, and 46.8% white. Overall, 88.4% identified as heterosexual, 2.1% as gay/lesbian, 5.7% as bisexual, and 3.7% as unsure; more female (15.3%) than male (7.7%) students reported a non-heterosexual identity. Among females, bisexual and unsure (but not lesbian) youth reported significantly more hours per day of SB compared to heterosexual peers. We found no significant differences in SB among males. Both female and male sexual minority youth reported significantly fewer days per week of PA compared to sex-matched heterosexual peers. All unadjusted PA and SB findings remained significant after adjusting for age, BMI, race/ethnicity, and survey year, except among lesbian youth. Studies of type 2 diabetes and risk factors among youth need to assess and account for sexual identity to ensure sexual minority populations are a priority target for prevention.