Physical Activity Intensity and Type 2 Diabetes: Isotemporal Substitution Models in the “Seguimiento Universidad de Navarra” (SUN) Cohort

Which intensity of physical activity (PA) is associated with type 2 diabetes (T2D) prevention remains unclear. Isotemporal substitution models assess the relationship of replacing the amount of time spent in one activity for another. We aimed to assess T2D incidence associated with light-to-moderate physical activity (LMPA) and vigorous physical activity (VPA) using isotemporal substitution models of one hour (1 h) sitting by 1 h of LMPA or VPA. Furthermore, we evaluated the effect on T2D of an isotemporal substitution of 1 h sitting by 1 h of slow (light physical activity) or brisk–very brisk walking (moderate physical activity). In total, 20,060 participants (both sexes) of the SUN cohort (Spain) initially free of T2D followed-up during a median of 12 years were included. Cox regression models were fitted to assess the association between the substitution of 1 h LMPA, VPA, slow and brisk–very brisk pace by 1 h sitting and T2D. The replacement of 1 h sitting time by 1 h of VPA was associated with an adjusted HR of 0.52 (95% CI: 0.34–0.80), not observed for the substitution by 1 h of LMPA (HR 0.93; 95% CI: 0.73–1.20). An apparent inverse association was observed for the replacement of 1 h sitting time by 1 h of brisk/very brisk walking (HR: 0.69; 95% CI: 0.46–1.04), not observed by 1 h of slow pace. From equal conditions of duration and frequency of PA, the higher the intensity of PA, the greater the T2D prevention.

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Neighbourhood greenspace and physical activity and sedentary behaviour among older adults with a recent diagnosis of type 2 diabetes: a prospective analysis

BMJ Open ◽

10.1136/bmjopen-2019-028947 ◽

2019 ◽

Vol 9 (11) ◽

pp. e028947

Author(s):

Shanley Chong ◽

Soumya Mazumdar ◽

Ding Ding ◽

Geoff Morgan ◽

Elizabeth Jean Comino ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Sedentary Behaviour ◽

New South ◽

Vigorous Physical Activity ◽

New South Wales ◽

Sitting Time ◽

Newly Diagnosed ◽

South Wales

ObjectivesGreenspace is one of the important factors that can promote an active lifestyle. Thus, greener surroundings may be a motivating factor for people with newly diagnosed diabetes to engage in more physical activity. Given that diagnosis of type 2 diabetes (T2D) may serve as a window opportunity for behavioural modification, we hypothesise that the association between neighbourhood greenspace and physical activity among people with newly diagnosed T2D may be greater than those not diagnosed with T2D. The aim of this study was to investigate the association between access to greenspace and changes in physical activity and sedentary behaviour, and whether these associations differed by T2D.DesignProspective cohort.SettingNew South Wales, Australia.MethodsWe used self-reported information from the New South Wales 45 and Up Study (baseline) and a follow-up study. Information on sitting, walking and moderate to vigorous physical activity was used as outcomes. The proportion of greenspace within 500 m, 1 km and 2 km road network buffers around participant’s residential address was generated as a proxy measure for access to greenspace. The association between the access to greenspace and the outcomes were explored among the newly diagnosed T2D group and those without T2D.ResultsAmong New T2D, although no significant changes were found in the amount of walking with the percentage of greenspace, increasing trends were apparent. There was no significant association between the percentage of greenspace and changes in amount of moderate to vigorous physical activity (MVPA). Among No T2D, there were no significant associations between the amount of MVPA and walking, and percentage of greenspace. For changes in sitting time, there were no significant associations with percentage of greenspace regardless of buffer size.ConclusionsIn this study, there was no association between access to greenspace at baseline and change in walking, MVPA and sitting time, regardless of T2D status.

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Walking Compared With Vigorous Physical Activity and Risk of Type 2 Diabetes in Women

JAMA ◽

10.1001/jama.282.15.1433 ◽

1999 ◽

Vol 282 (15) ◽

pp. 1433 ◽

Cited By ~ 495

Author(s):

Frank B. Hu ◽

Ronald J. Sigal ◽

Janet W. Rich-Edwards ◽

Graham A. Colditz ◽

Caren G. Solomon ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Vigorous Physical Activity

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Physical behaviors and chronotype in people with type 2 diabetes

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001375 ◽

2020 ◽

Vol 8 (1) ◽

pp. e001375

Author(s):

Joseph Henson ◽

Alex V Rowlands ◽

Emma Baldry ◽

Emer M Brady ◽

Melanie J Davies ◽

...

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Reference Group ◽

Vigorous Physical Activity ◽

Sleep Onset ◽

Sedentary Behaviors ◽

Intensity Gradient ◽

Average Acceleration ◽

Design And Methods

IntroductionPrevious investigations have suggested that evening chronotypes may be more susceptible to obesity-related metabolic alterations. However, whether device-measured physical behaviors differ by chronotype in those with type 2 diabetes (T2DM) remains unknown.Research design and methodsThis analysis reports data from the ongoing Chronotype of Patients with Type 2 Diabetes and Effect on Glycaemic Control (CODEC) observational study. Eligible participants were recruited from both primary and secondary care settings in the Midlands area, UK. Participants were asked to wear an accelerometer (GENEActiv, ActivInsights, Kimbolton, UK) on their non-dominant wrist for 7 days to quantify different physical behaviors (sleep, sedentary, light, moderate-to-vigorous physical activity (MVPA), intensity gradient, average acceleration and the acceleration above which the most active continuous 2, 10, 30 and 60 min are accumulated). Chronotype preference (morning, intermediate or evening) was assessed using the Morningness-Eveningness Questionnaire. Multiple linear regression analyses assessed whether chronotype preference was associated with physical behaviors and their timing. Evening chronotypes were considered as the reference group.Results635 participants were included (age=63.8±8.4 years, 34.6% female, body mass index=30.9±5.1 kg/m2). 25% (n=159) of the cohort were morning chronotypes, 52% (n=330) intermediate and 23% (n=146) evening chronotypes. Evening chronotypes had higher sedentary time (28.7 min/day, 95% CI 8.6 to 48.3) and lower MVPA levels (–9.7 min/day, –14.9 to –4.6) compared to morning chronotypes. The intensity of the most active continuous 2-60 min of the day, average acceleration and intensity gradient were lower in evening chronotypes. The timing of physical behaviors also differed across chronotypes, with evening chronotypes displaying a later sleep onset and consistently later physical activity time.ConclusionsPeople with T2DM lead a lifestyle characterized by sedentary behaviors and insufficient MVPA. This may be exacerbated in those with a preference for ‘eveningness’ (ie, go to bed late and get up late).

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Time-of-day moderate-to-vigorous physical activity and all-cause mortality in individuals with type 2 diabetes

Journal of Sports Sciences ◽

10.1080/02640414.2021.2009163 ◽

2021 ◽

pp. 1-7

Author(s):

Tongyu Ma ◽

Yao Jie Xie ◽

Thomas Bennett ◽

Chong-Do Lee

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Vigorous Physical Activity ◽

Time Of Day ◽

All Cause Mortality

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‘MOVEdiabetes’: a cluster randomized controlled trial to increase physical activity in adults with type 2 diabetes in primary health in Oman

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2018-000605 ◽

2018 ◽

Vol 6 (1) ◽

pp. e000605 ◽

Cited By ~ 7

Author(s):

Thamra S Alghafri ◽

Saud Mohamed Alharthi ◽

Yahya Al-Farsi ◽

Abdul Hakeem Alrawahi ◽

Elaine Bannerman ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Controlled Trial ◽

Health Centers ◽

Sitting Time ◽

Randomized Controlled ◽

Primary Health ◽

Cluster Randomized

ObjectiveThis study examined the impact of a multicomponent intervention to increase physical activity (PA) in adults with type 2 diabetes (T2D) in Oman.Research design and methodsThis is a cluster randomized controlled trial in eight primary health centers. Participants were physically inactive, aged ≥18 years, and with no contraindication to PA. Patients attending intervention health centers (n=4) received the ‘MOVEdiabetes’ intervention, which consisted of personalized, individual face-to-face consultations by dietitians. Pedometers and monthly telephone WhatsApp messages were also used. Patients attending comparison health centers received usual care. The primary outcome was change in PA [Metabolic Equivalent(MET).min/week] after 12 months assessed by the Global Physical Activity Questionnaire. The secondary outcomes were changes in daily step counts, sitting time, weight, body mass index, glycated hemoglobin, blood pressure and lipids.ResultsOf the 232 participants (59.1% female, mean (SD) age 44.2 (8.1) years), 75% completed the study. At 12 months, the mean change in MET.min/week was +631.3 (95% CI 369.4 to 893.2) in the intervention group (IG) vs +183.2 (95% CI 83.3 to 283.0) in the comparison group, with a significant between-group difference of +447.4 (95% CI 150.7 to 744.1). The odds of meeting PA recommendations were 1.9 times higher in the IG (95% CI 1.2 to 3.3). Significant between-group differences in favor of IG were detected for mean steps/day (+757, 95% CI 18 to 1531) and sitting time hours/ per day (−1.5, 95% CI −2.4 to −0.7). Clinical measures of systolic and diastolic blood pressure and triglycerides also showed significant intervention effects.Conclusions‘MOVEdiabetes’ was effective in increasing PA, the likelihood of meeting PA recommendations, and providing cardioprotective benefits in adults with T2D attending primary care.

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Association of physical activity and sedentary behavior with type 2 diabetes and glycemic traits: a two-sample Mendelian randomization study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001896 ◽

2020 ◽

Vol 8 (2) ◽

pp. e001896

Author(s):

Christa Meisinger ◽

Jakob Linseisen ◽

Michael Leitzmann ◽

Hansjoerg Baurecht ◽

Sebastian Edgar Baumeister

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Sedentary Behavior ◽

Mendelian Randomization ◽

Fasting Glucose ◽

Vigorous Physical Activity ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

A Genome

IntroductionObservational studies suggest that physical activity lowers and sedentary behavior increases the risk of type 2 diabetes. Despite of some supportive trial data for physical activity, it is largely unresolved whether these relations are causal or due to bias.ObjectiveWe investigated the associations between accelerometer-based physical activity and sedentary behavior with type 2 diabetes and several glycemic traits using two-sample Mendelian randomization analysis.Research design and methodsSingle nucleotide polymorphisms (SNPs) associated at p<5×10−8 with accelerometer-based physical activity average accelerations, vigorous physical activity (fraction of accelerations >425 milligravities), and sedentary behavior (metabolic equivalent task ≤1.5) in a genome-wide analysis of the UK Biobank served as instrumental variables.OutcomesType 2 diabetes, hemoglobin A1c (HbA1c), fasting glucose, homeostasis model assessment of beta-cell function (HOMA-B), and homeostasis model assessment of insulin resistance (HOMA-IR).ResultsPhysical activity and sedentary behavior were unrelated to type 2 diabetes, HbA1c, fasting glucose, HOMA-B, and HOMA-IR. The inverse variance weighted ORs per SD increment for the association between average accelerations and vigorous physical activity with type 2 diabetes were 1.00 (95% CI 0.94 to 1.07, p=0.948) and 0.83 (95% CI 0.56 to 1.23, p=0.357), respectively. These results were confirmed by sensitivity analyses using alternative MR-methods to test the robustness of our findings.ConclusionsBased on these results, genetically predicted objectively measured average or vigorous physical activity and sedentary behavior is not associated with type 2 diabetes risk or with glycemic traits in the general population. Further research is required to deepen the understanding of the biological pathways of physical activity.

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Depressive symptoms and all-cause mortality in people with type 2 diabetes: A focus on potential mechanisms

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.154781 ◽

2016 ◽

Vol 209 (2) ◽

pp. 142-149 ◽

Cited By ~ 13

Author(s):

Giesje Nefs ◽

Victor J. M. Pop ◽

Johan Denollet ◽

François Pouwer

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Survival Time ◽

Edinburgh Postnatal Depression Scale ◽

Cox Regression ◽

Depression Scale ◽

All Cause Mortality ◽

Mediating Mechanisms

BackgroundDepression has been associated with increased all-cause mortality in people with type 2 diabetes.AimsTo test whether anhedonia, dysphoria and anxiety are differentially associated with all-cause mortality and examine symptom-specific behavioural or pathophysiological mechanisms.MethodA total of 1465 people completed the Edinburgh Postnatal Depression Scale in 2005 and were followed until death or 31 December 2010. Cox regression analyses compared survival time for people with a low v. high baseline dysphoria/anhedonia/anxiety score and identified mediating mechanisms.ResultsAfter a mean follow-up of 1878 days (s.d. = 306), 139 participants had died. At all time points, people with anhedonia had an almost twofold increased mortality risk compared with those without anhedonia. Physical activity met criteria for mediation. Symptoms of dysphoria and anxiety were not associated with survival time.ConclusionsSymptoms of anhedonia predicted shorter survival time, whereas dysphoria/anxiety did not. Mechanistic pathways, in particular physical activity, should be explored further.

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Inverse association between plasma homocysteine, sulphonylurea exposure and physical activity: a community-based sample of type 2 diabetes patients in the Skaraborg hypertension and diabetes project

Diabetes Obesity and Metabolism ◽

10.1111/j.1463-1326.2004.00431.x ◽

2005 ◽

Vol 7 (4) ◽

pp. 421-429 ◽

Cited By ~ 9

Author(s):

M. Hellgren ◽

A. Melander ◽

C.-J Ostgren ◽

L. Rastam ◽

U. Lindblad

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Plasma Homocysteine ◽

Inverse Association ◽

Community Based ◽

Diabetes Patients

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Moderate-Vigorous Physical Activity and Clinical Parameters in Adults with Type 2 Diabetes Mellitus: A Report from the Walking with Diabetes Study

Romanian Journal of Diabetes Nutrition and Metabolic Diseases ◽

10.2478/rjdnmd-2019-0012 ◽

2019 ◽

Vol 26 (2) ◽

pp. 107-117

Author(s):

Novita Intan Arovah ◽

Bernadeta Maria Wara Kushartanti

Keyword(s):

Physical Activity ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Vigorous Physical Activity ◽

Control Group ◽

Clinical Parameters ◽

Protective Effects ◽

Activity Data

Abstract Background and aims: This study investigate the effects of increases in moderate-vigorous physical activity (MVPA) on several clinical parameters in Indonesian type 2 diabetes mellitus (T2DM) patients. Material and methods: This study used clinical and physical activity data of forty-two T2DM patients who completed a 6 month-free-living physical activity program, the Walking with Diabetes Study. Upon completion of the program, participants were categorised into a group with increases in MVPA (the MVPA+ group, n=24) or a group with steady/decreases in MVPA (the control group, n=18). High density lipoprotein, triglyceride, routine hematology profiles, blood pressure, body mass index, weight/hip ratio and self-reported MVPA, at baseline, 3 and 6 months were retrospectively analysed. Generalized estimating equation adjusted for age and sex were conducted to assess group and time effects on the clinical parameters. Results: Hemoglobin (p <0.01), erythrocytes (p<0.05), hematocrits (p<0.001) and thrombocytes (p<0.05) were higher in the MVPA+ group. The 1h and 2h-erythrocyte sedimentation rate (ESR) increased in both groups across time (p<0.001). No changes between groups across time were found for other parameters. Conclusions: Increases in MVPA improve several hematology parameters in T2DM patients, but it does not have protective effects in controlling systemic inflammation in T2DM patients.

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