Low-intensity physical activity is associated with reduced risk of incident type 2 diabetes in older adults: evidence from the English Longitudinal Study of Ageing

AimsTo evaluate the effects of habitual leisure-time physical activity (LTPA) on incident type 2 diabetes in a prospective cohort of Chinese adults with impaired fasting glucose (IFG).Methods44 828 Chinese adults aged 20–80 years with newly detected IFG but free from cardiovascular and cerebrovascular disease were recruited and followed up from 1996 to 2014. Incident type 2 diabetes was identified by fasting plasma glucose ≥7 mmol/L. The participants were classified into four categories based on their self-reported weekly LTPA: inactive, low, moderate, or high. Hazard ratios (HRs) and population attributable fractions (PAFs) were estimated with adjustment for established diabetic risk factor.ResultsAfter 214 148 person-years of follow-up, we observed an inverse dose–response relationship between LTPA and diabetes risk. Compared with inactive participants, diabetes risk in individuals reporting low, moderate and high volume LTPA were reduced by 12% (HR 0.88, 95% CI 0.80 to 0.99; P=0.015), 20% (HR 0.80, 95% CI 0.71 to 0.90; P<0.001), and 25% (HR 0.75, 95% CI 0.67 to 0.83; P<0.001), respectively. At least 19.2% (PAF 19.2%, 95% CI 5.9% to 30.6%) of incident diabetes cases could be avoided if the inactive participants had engaged in WHO recommendation levels of LTPA. This would correspond to a potential reduction of at least 7 million diabetic patients in the Greater China area.ConclusionsOur results show higher levels of LTPA are associated with a lower risk of diabetes in IFG subjects. These data emphasise the urgent need for promoting physical activity as a preventive strategy against diabetes to offset the impact of population ageing and the growing obesity epidemic.

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Physical activity and incident type 2 diabetes mellitus: a systematic review and dose–response meta-analysis of prospective cohort studies

Diabetologia ◽

10.1007/s00125-016-4079-0 ◽

2016 ◽

Vol 59 (12) ◽

pp. 2527-2545 ◽

Cited By ~ 98

Author(s):

Andrea D. Smith ◽

Alessio Crippa ◽

James Woodcock ◽

Søren Brage

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Systematic Review ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Meta Analysis ◽

Incident Type ◽

Prospective Cohort Studies ◽

Incident Type 2 Diabetes

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Serum γ-glutamyltransferase as an independent predictor for incident type 2 diabetes in middle-aged and older adults: Findings from the KoGES over 12 years of follow-up

Nutrition Metabolism and Cardiovascular Diseases ◽

10.1016/j.numecd.2020.04.027 ◽

2020 ◽

Vol 30 (9) ◽

pp. 1484-1491

Author(s):

Jun-Hyuk Lee ◽

Hye Sun Lee ◽

Yong-Jae Lee

Keyword(s):

Type 2 Diabetes ◽

Older Adults ◽

Independent Predictor ◽

Middle Aged ◽

Incident Type ◽

Incident Type 2 Diabetes

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Association of Serum 25(OH)D Levels with Incident Type 2 Diabetes in Chinese adults: A Prospective Cohort Study

10.21203/rs.3.rs-814158/v1 ◽

2021 ◽

Author(s):

Zhiyong Hu ◽

Xueyuan Zhi ◽

Jinxiu Wang ◽

Jiafu Li

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Type 2 Diabetes ◽

Cohort Study ◽

Incident Type ◽

Incident Type 2 Diabetes ◽

Insufficient Physical Activity ◽

Conventional Risk Factors ◽

Low Serum

Abstract Although many cross-sectional studies that have examined the relationship of Serum 25-hydroxyvitamin D [25(OH)D] levels with incident type 2 diabetes (T2D), there are very few reports for cohort studies. Here, we performed an a prospective cohort study to investigate the effect modification of traditional risk factors on association of serum 25(OH)D with T2D and to determine if addition of serum 25(OH)D improve the risk prediction of T2D. A total of 1926 adults without diabetes were prospectively followed for 36 months in China. During a mean of 36 months of follow-up, 114 participants (5.9%) developed incident T2D. Although no significant relationship was found in total population, stratified analyses indicated that low 25(OH)D levels was associated with increased T2D risk among individuals who were male, overweight/obese, with insufficient physical activity, or normal fasting plasma glucose at baseline. Additive interaction analysis showed that low 25(OH)D levels and insufficient physical activity interacts to increase the risk of T2D (RERI = 0.875, 95% CI: 0.204–1.545). Addition of low serum 25(OH)D significantly improved the predictive performance of T2D beyond conventional risk factors (NRI = 0.205, 95% CI:0.019–0.391). Our results suggest that low serum 25(OH)D and insufficient physical activity interact synergistically to influence the risk of T2D in Chinese adult population. Adding serum 25(OH)D to conventional risk factors improves the risk prediction of T2D.

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Long-Term Physical Activity Participation and Subsequent Incident Type 2 Diabetes Mellitus: A Population-Based Cohort Study

Frontiers in Endocrinology ◽

10.3389/fendo.2021.769549 ◽

2021 ◽

Vol 12 ◽

Author(s):

Chenglong Li ◽

Yanjun Ma ◽

Rong Hua ◽

Fanfan Zheng ◽

Wuxiang Xie

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Population Based ◽

Physical Activity Participation ◽

Activity Participation ◽

Incident Type ◽

Incident Type 2 Diabetes

BackgroundUncertainty remains concerning association between long-term physical activity and incident type 2 diabetes mellitus (DM). We intended to evaluate physical activity participation over a 6-year span and assess association with subsequent 10-year incident DM risk, as well as examine mediation role by obesity.MethodsA total of 9757 community-dwelling adults aged ≥ 50 years in England were included in the population-based cohort. Physical activity participation, including trajectories and cumulative participation were assessed using weighted Z score over a 6-year span from wave 1 (2002–2003) to wave 4 (2008–2009). Incident DM recorded over a 10-year span from wave 4 (2008–2009) to wave 9 (2018–2019) was outcome.Results5 distinct activity trajectories were identified, including persistently low (N=3037, incident DM=282), initially low then improving (1868, 90), initially high then declining (325, 20), persistently moderate (2489, 170), and persistently high (2038, 108). Compared with persistently low, participants of initially low then improving, persistently moderate and high were associated with lower incident DM risk, with multivariable-adjusted hazard ratios (HR) of 0.41 (95% confidence interval [CI]: 0.32 to 0.53, P<0.001), 0.70 (95% CI: 0.56 to 0.89, P=0.004) and 0.49 (95% CI: 0.37 to 0.65, P <0.001), respectively. Elevated cumulative activity was also associated with lower DM risk, with each quintile increment in cumulative weighted Z score corresponding to HR of 0.76 (95% CI: 0.71 to 0.82, P <0.001). Mediation analysis found that body mass index, waist circumference and change in body mass index mediate 10% (P <0.001), 17% (P <0.001) and 9% (P <0.001) of the observed association between activity and incident DM, respectively.ConclusionsFor middle aged and older adults, both gradually improved and persistently active participation in physical activity were associated with subsequent lower risk of incident DM, with obesity playing a potential mediator. Strategies focusing on improving and maintaining active participation in physical activity might be beneficial from DM prevention perspective.

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Incident Type 2 Diabetes in a Large Australian Cohort Study: Does Physical Activity or Sitting Time Alter the Risk Associated With Body Mass Index?

Journal of Physical Activity and Health ◽

10.1123/jpah.2016-0184 ◽

2017 ◽

Vol 14 (1) ◽

pp. 13-19 ◽

Cited By ~ 7

Author(s):

Binh Nguyen ◽

Adrian Bauman ◽

Ding Ding

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Body Mass Index ◽

Body Mass ◽

Sitting Time ◽

Healthy Weight ◽

Incident Type ◽

Incident Type 2 Diabetes

Purpose:To examine the combined effects of body mass index (BMI), physical activity (PA) and sitting on incident type 2 diabetes mellitus (T2DM) among Australian adults.Methods:A sample of 29,572 adults aged ≥45 years from New South Wales, Australia, completed baseline (2006–2008) and follow-up (2010) questionnaires. Incident T2DM was defined as self-reported, physician-diagnosed diabetes at follow-up. BMI was categorized as normal/overweight/obese. PA was tertiled into low/medium/ high. Sitting was dichotomized as higher/lower sitting (≥ 8 hours/day or < 8 hours/day). Odds ratios (OR) were estimated for developing T2DM using logistics regression for individual and combined risk factors, and data stratified by BMI categories.Results:During a mean 2.7 (SD: 0.9) years of follow-up, 611 (2.1%) participants developed T2DM. In fully adjusted models, BMI was the only independent risk factor for incident T2DM. In stratified analyses, the association between BMI and T2DM did not differ significantly across sitting or PA categories. Overweight/obese individuals with high PA and lower sitting had higher odds of incident T2DM than normal counterparts with low PA and higher sitting.Conclusions:High PA/low sitting did not attenuate the risk of T2DM associated with overweight/obesity. Maintaining a healthy weight, by adopting healthy lifestyle behaviors, is critical for T2DM prevention.

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