Clinical research studyPhysical Activity, Body Mass Index, and Diabetes Risk in Men: A Prospective Study
Section snippets
Study Population
The Physicians' Health Study was a randomized, controlled trial of aspirin and beta-carotene in the primary prevention of cardiovascular disease and cancer. Details on the Physicians' Health Study design and recruitment have been reported.13 The original cohort of 22,071 US male physicians aged 40 to 84 years at enrollment has been followed continuously since 1982 via annual questionnaires, with approval from the Institutional Review Board at the Brigham and Women's Hospital (Boston, MA). The
Results
After a median follow-up of 23.1 years (431,126 person-years) among initially nondiabetic men with an average baseline age of 53 years, there were 1836 new cases of diabetes occuring in 8.9% of the population, with incidence rates for men in the normal, overweight, and obese groups of 2.4, 6.1, and 15.0 cases per 1000 person-years, respectively. Men who reported vigorous activity at least weekly had a diabetes incidence rate of 3.7 per 1000 person-years, compared with 5.8 per 1000 in those who
Conclusions
In this prospective cohort study of 20,757 men, weekly vigorous activity reduced the hazards of type 2 diabetes for those who were normal weight or overweight when studied as a combined exposure. Although regular activity showed the strongest overall association in obese men when studied as an isolated exposure, the joint analysis of regular activity and BMI together revealed that in the setting of elevated BMI, vigorous physical activity does not attenuate the harm of excess body weight to a
Acknowledgments
We are indebted to the thousands of participants of the Physicians' Health Study for their outstanding commitment and to the entire Physicians' Health Study staff for their expertise and assistance.
References (29)
- et al.
Physical activity and incidence of non-insulin-dependent diabetes mellitus in women
Lancet
(1991) - et al.
The relative contributions of different levels of overweight and obesity to the increased prevalence of diabetes in the United States: 1976-2004
Prev Med
(2007) - et al.
Validity of physicians' self-reports of cardiovascular disease risk factors
Ann Epidemiol
(1993) - et al.
Validity and reliability of a physical activity recall instrument among overweight and non-overweight men and women
J Sci Med Sport
(2003) - et al.
Lifetime risk for diabetes mellitus in the United States
JAMA
(2003) - et al.
Early release of selected estimates based on data from the January–March 2007 National Health Interview Survey
(2007) - et al.
Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus
N Engl J Med
(1991) - et al.
Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study
JAMA
(1999) - et al.
Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men
Diabetes Care
(1994) - et al.
Weight gain as a risk factor for clinical diabetes mellitus in women
Ann Intern Med
(1995)
Joint effects of physical activity and body weight on diabetes and cardiovascular disease
Exerc Sport Sci Rev
Walking compared with vigorous exercise for the prevention of cardiovascular events in women
N Engl J Med
Relationship of physical activity vs body mass index with type 2 diabetes in women
JAMA
The joint effects of physical activity and body mass index on coronary heart disease risk in women
Arch Intern Med
Cited by (28)
Effect of parental history of diabetes on markers of inflammation, insulin resistance and atherosclerosis in first degree relatives of patients with type 2 diabetes mellitus
2018, Diabetes and Metabolic Syndrome: Clinical Research and ReviewsCitation Excerpt :All subjects were asked about frequency of doing exercise vigorously enough to work up a sweat. We considered participants reporting vigorous exercise at least once weekly to be active [13]. Only normoglycemic healthy adults were included in the study.
‘Mendelian randomization’: an approach for exploring causal relations in epidemiology
2017, Public HealthCitation Excerpt :GWASs have helped in identifying genetic correlates of modifiable traits like smoking23 and cardiometabolic traits like lipid levels, glycemic and anthropometric traits.24–26 These traits sometimes also act as confounders while evaluating the associations between the exposures and disease outcomes e.g. body mass index (BMI) may act as a confounder for studying the association of physical activity and diabetes.27 The detection of new genetic variants by GWAS has improved to some extent the risk prediction of diseases and their related traits.28,29
Determinants of new-onset diabetes in older adults-Results of a national cohort study
2015, Clinical NutritionCitation Excerpt :In a prospective study examining the relative contributions and joint association of physical activity with NOD in a cohort of 37,878 women, Weinstein et al. [3] found that although physical inactivity and excessive body weight are independent predictors of incident diabetes, and physical activity has a modulating effect on the impact of excessive body weight on NOD, in combined analyses, the magnitude of the association of NOD with BMI was greater than with physical activity [3]. In fact, BMI was found to be the key driver of diabetes risk, while physical activity can modestly attenuate the risk [19]. On the other hand, longer sitting time which may often mean less physical activity, has been observed to be positively associated with higher risk of type-2 diabetes [20].
Effects of auricular stimulation in the cavum conchae on glucometabolism in patients with type 2 diabetes mellitus
2014, Complementary Therapies in MedicineCitation Excerpt :We could not find a statistically significant reduction on post-treatment mean value of FBG and P2BG. It may be related to the fact that blood glucose can fluctuate by daily dietary intake of carbohydrate or physical activities.18–21 Larger sample size may be needed to detect whether the auricular acupuncture can reduce FBG and P2BG.
Obesity and risk factors for cardiovascular disease and type 2 diabetes: Investigating the role of physical activity and sedentary behaviour in mid-life in the 1958 British cohort
2014, AtherosclerosisCitation Excerpt :For type 2 diabetes, a review of 8 studies found that obese groups who were physically inactive had an increased risk greater than the additional effect of each factor (obesity and inactivity) separately [19], whilst an earlier study had reported stronger protective effects of activity among obese individuals [9]. Yet, not all studies show greater benefits of activity amongst obese groups for type 2 diabetes [20] or coronary heart disease [2,5]. Research is scarce on whether benefits of activity vary for obese and non-obese groups across multiple CVD and diabetes biomarkers and whether there are corresponding patterns for sedentary behaviour.
Funding: The Physicians' Health Study is supported by grants CA-34944 and CA-40360 and CA-097193 from the National Cancer Institute and grants HL-26490 and HL-34595 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland. Dr Siegel received support from the Office of Research and Development, Cooperative Studies Program, Department of Veterans Affairs.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.