Physical Activity and the Prevention of Type 2 Diabetes Mellitus (original) (raw)
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Physical Activity in the Prevention of Type 2 Diabetes
Diabetes, 2004
Clinical trials have demonstrated that lifestyle changes can prevent type 2 diabetes, but the importance of leisure-time physical activity (LTPA) is still unclear. We carried out post hoc analyses on the role of LTPA in preventing type 2 diabetes in 487 men and women with impaired glucose tolerance who had completed 12-month LTPA questionnaires. The subjects were participants in the Finnish Diabetes Prevention Study, a randomized controlled trial of lifestyle changes including diet, weight loss, and LTPA. There were 107 new cases of diabetes during the 4.1-year follow-up period. Individuals who increased moderate-to-vigorous LTPA or strenuous, structured LTPA the most were 63–65% less likely to develop diabetes. Adjustment for changes in diet and body weight during the study attenuated the association somewhat (upper versus lower third: moderate-to-vigorous LTPA, relative risk 0.51, 95% CI 0.26–0.97; strenuous, structured LTPA, 0.63, 0.35–1.13). Low-intensity and lifestyle LTPA and ...
Diabetes Care, 2020
OBJECTIVE Across the Diabetes Prevention Program (DPP) follow-up, cumulative diabetes incidence remained lower in the lifestyle compared with the placebo and metformin randomized groups and could not be explained by weight. Collection of self-reported physical activity (PA) (yearly) with cross-sectional objective PA (in follow-up) allowed for examination of PA and its long-term impact on diabetes prevention. RESEARCH DESIGN AND METHODS Yearly self-reported PA and diabetes assessment and oral glucose tolerance test results (fasting glucose semiannually) were collected for 3,232 participants with one accelerometry assessment 11–13 years after randomization (n = 1,793). Mixed models determined PA differences across treatment groups. The association between PA and diabetes incidence was examined using Cox proportional hazards models. RESULTS There was a 6% decrease (Cox proportional hazard ratio 0.94 [95% CI 0.92, 0.96]; P < 0.001) in diabetes incidence per 6 MET-h/week increase in t...
Prevention of type 2 diabetes by physical activity: what has history taught us?
Diabetes/Metabolism Research and Reviews, 2020
The relationship between physical activity and prevention of what was called over 25 years ago non-insulin dependent diabetes mellitus (NIDDM), nowadays type 2 diabetes (T2D) is described in groundbreaking epidemiological studies by Helmrich (1) and Manson (2) and in the excellent epidemiological overview by Kriska and Bennett (3). The ideas proposed have led to a new era of intervention studies of randomized control trials (RCTs) which have paved the way for proof that prevention of this disease is indeed feasible. These historical papers, though only observational research or reviews, can be considered important milestones in prevention research, because they, and in particular, the review by Kriska & Bennett, all pointed towards how to achieve scientific rigor: prospective epidemiological studies on large numbers, selection of individuals with impaired glucose tolerance (IGT), with proper data quantification and with correct evaluation of patient compliance in both genders. One innovation suggested was the use of questionnaires to subjectively evaluate the types of exercise and physical activity in different domains, leading to the Occupational and Leisure Time Physical Activity Assessment (4). They also suggested that energy expenditure too, should be verified by physical monitors, leading to the use of pedometers, accelerometers and other objectively measuring systems currently in use. Kriska and Bennett, in their evaluation of prior epidemiological studies, suggested that societies that change lifestyle, such as through migration, and become more sedentary, have a greater increase in T2D, as compared with counterparts. Their data supported the idea that persons with T2D are less active and more sedentary than non-diabetic people and hypothesized that there may be a relationship between obesity, fat distribution, physical activity and glucose tolerance. Hence physical activity as a means to prevent or delay the onset of T2D was indeed possible but meaningful answers could only be found in large-scale intervention trials which should be well-designed and use appropriate tools that objectively evaluate physical activity, as seen in intervention trials carried out in the following years. The present paper attempts to indicate the most salient studies that conform to the suggestions made in this trailblazing study for preventing or delaying T2D.
Association of Physical Activity with Risk of Type 2 Diabetes
Iranian Journal of Public Health, 2011
Physical activity has shown to prevent type diabetes 2. However, the type, intensity and amount of effective physical activity as well as individuals' needs according to level of their risk for type 2 diabetes have not been clarified comprehensively. This study investigated a relation between moderate aerobic physical activity ≥150 minuets/week with decreased risk of type 2 diabetes among obese and non-obese residents of south of Tehran, Iran. Methods: This study, which was a part of the Cardiovascular Risk Factors Survey in Tehran population Lab region, was designed and conducted based on MONICA/WHO project. Totally, 1552 adult inhabitants of 17th district of Tehran were enrolled in this cross-sectional study. Physical activity was assessed by MONICA Optional Study of Physical Activity questionnaire. Diabetes was defined as a history of a prior diagnosis of diabetes or fasting serum glucose ≥126 mg/dl. All data analyses were conducted using SPSS 17 software for Windows Results: In a multivariate model, moderate aerobic physical activity ≥150 minuets/week was significantly associated with decreased risk of type 2 diabetes in all and non-obese subjects [OR= 0.56; 95%CI: 0.35-0.91 and OR= 0.50; 95%CI: 0.26-0.94, respectively]. There was no significant relation between the physical activity and type 2 diabetes risk in obese subjects [OR=0.64; 95%CI: 0.30-1.39]. Conclusion: Moderate aerobic physical activity ≥150 minuets/week was significantly associated with decreased risk of type 2 diabetes in non-obese people and could be an acceptable exercise goal for these individuals. However, obese people should be investigated more to produce a tailored exercise guideline to this population at high risk of type 2 diabetes.
Diabetes Care, 2012
OBJECTIVE To examine the association of objectively measured participation in low levels of physical activity with incident type 2 diabetes. RESEARCH DESIGN AND METHODS The study population included participants free of diabetes and cardiovascular disease at baseline (n = 1,826) who participated in a follow-up examination. Generalized estimating equations were used to examine the association of steps per day with incident diabetes. RESULTS During 5 years of follow-up, 243 incident cases of diabetes were identified. When compared with participants in the lowest quartile of steps per day (<3,500 steps), participants in the upper three quartiles of steps per day had lower odds for diabetes, consistent with a threshold effect. Contrasting the three upper quartiles with the lowest quartile, the odds ratio of diabetes was 0.71 (95% CI 0.51–0.98). CONCLUSIONS Modest levels of physical activity are associated with a lower risk of incident diabetes, compared with lower levels of activity.
Physical Activity in the Prevention of Type 2 Diabetes: The Finnish Diabetes Prevention Study
Diabetes, 2005
Clinical trials have demonstrated that lifestyle changes can prevent type 2 diabetes, but the importance of leisure-time physical activity (LTPA) is still unclear. We carried out post hoc analyses on the role of LTPA in preventing type 2 diabetes in 487 men and women with impaired glucose tolerance who had completed 12month LTPA questionnaires. The subjects were participants in the Finnish Diabetes Prevention Study, a randomized controlled trial of lifestyle changes including diet, weight loss, and LTPA. There were 107 new cases of diabetes during the 4.1-year follow-up period. Individuals who increased moderate-to-vigorous LTPA or strenuous, structured LTPA the most were 63-65% less likely to develop diabetes. Adjustment for changes in diet and body weight during the study attenuated the association somewhat (upper versus lower third: moderate-to-vigorous LTPA, relative risk 0.51, 95% CI 0.26 -0.97; strenuous, structured LTPA, 0.63, 0.35-1.13). Lowintensity and lifestyle LTPA and walking also conferred benefits, consistent with the finding that the change in total LTPA (upper versus lower third: 0.34, 0.19 -0.62)
BMC Public Health, 2013
Background: The prevalence rates of physical inactivity and diabetes in the MENA region are among the highest in the world. However, studies that focus on factors that influence the pattern of physical activity in the region remain very scarce. This study aimed to determine the prevalence and correlates of physical activity in the general population and among subjects with and without diabetes in Lebanon, a small middle-income country in the MENA region. Methods: We conducted a cross-sectional nation-wide study of 2,195 randomly selected adults aged 25 years and older. Participants completed a comprehensive questionnaire based on the WHO-STEPwise guidelines. Physical activity was assessed using the International Physical Activity Questionnaire. Type 2 diabetes risk factors examined were age ≥ 45 years, BMI ≥ 25 kg/m 2 , hypertension, hyperlipidemia, cardiovascular disease and family history of diabetes.
Physical Activity in Individuals at Risk for Diabetes
Medicine & Science in Sports & Exercise, 2006
Purpose and Methods-Leisure physical activity was assessed using questionnaires with different time frames in the Diabetes Prevention Program (DPP) cohort of 3234 overweight individuals aged > 25 yr with impaired glucose tolerance (IGT) from 27 centers across the United States. The three questionnaires were the Modifiable Activity Questionnaire (MAQ; past year), the Low-Level Physical Activity Recall (LOPAR; past 7 d), and the Third National Health and Nutrition Examination Survey (NHANES III; past month). This provided the opportunity to examine the relationship between the three activity measures and to compare activity levels of the DPP sample with that of a national sample with IGT.
What's new since Hippocrates? Preventing type 2 diabetes by physical exercise and diet
Since the work of Eriksson and Lindgärde, published over two decades ago (Diabetologia 1991;34:891– 898), we have known that type 2 diabetes can be prevented or delayed by supervised lifestyle interventions (physical exercise and diet modification) in persons at risk of the disease. Here we discuss a novel, time-efficient approach to physical exercise prescription, low-volume, high-intensity interval training (LVHIT), and its efficacy for inducing a range of health benefits in a variety of populations at risk of inactivity-related diseases. We look to the future and suggest that current guidelines for exercise may need to be revised to include different training techniques to deliver the optimum exercise prescription. Indeed , we predict that subsequent exercise guidelines will include LVHIT as part of a comprehensive 'fitness menu' that allows individuals to select the exercise regimen that best fulfils their medical needs, is suited to their lifestyle and daily time restraints, and meets their personal goals.