Association of Physical Activity and Serum Insulin Concentrations in Two Populations at High Risk for Type 2 Diabetes but Differing by BMI

Kriska, Andrea M.; Pereira, Mark A.; Hanson, Robert L.; Courten, Maximilian P. de; Zimmet, Paul; Alberti, K. G. M. M.; Chitson, Pierrot; Bennett, Peter H.; Narayan, K.M. Venkat; Knowler, William C.

doi:10.2337/diacare.24.7.1175

Cited by 65 publications

(43 citation statements)

References 32 publications

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“…Fasting hyperglycemia predominantly reflects hepatic insulin resistance with normal muscle insulin sensitivity; postload hyperglycemia is characterized by moderate-to-severe skeletal muscle insulin resistance with normal or mildly reduced hepatic insulin sensitivity (34). This might explain the association with 2-h PG but not FPG in our study, since physical activity is directly associated with improved insulin sensitivity (35,36). Furthermore, the absence of an association with FPG concurs with the findings from controlled clinical studies in people with and without type 2 diabetes who have generally observed no changes in FPG following exercise training (37)(38)(39).…”

Section: Discussionsupporting

confidence: 59%

Beneficial Associations of Physical Activity With 2-h but Not Fasting Blood Glucose in Australian Adults

et al. 2006

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OBJECTIVE -We examined the associations of physical activity with fasting plasma glucose (FPG) and with 2-h postload plasma glucose (2-h PG) in men and women with low, moderate, and high waist circumference.RESEARCH DESIGN AND METHODS -The Australian Diabetes, Obesity and Lifestyle (AusDiab) study provided data on a population-based cross-sectional sample of 4,108 men and 5,106 women aged Ն25 years without known diabetes or health conditions that could affect physical activity. FPG and 2-h PG were obtained from an oral glucose tolerance test. Selfreported physical activity level was defined according to the current public health guidelines as active (Ն150 min/week across five or more sessions) or inactive (Ͻ150 min/week and/or less than five sessions). Sex-specific quintiles of physical activity time were used to ascertain dose response.RESULTS -Being physically active and total physical activity time were independently and negatively associated with 2-h PG. When physical activity level was considered within each waist circumference category, 2-h PG was significantly lower in active high-waist circumference women (␤ Ϫ0.30 [95% CI Ϫ0.59 to Ϫ0.01], P ϭ 0.044) and active low-waist circumference men (␤ Ϫ0.25 [Ϫ0.49 to Ϫ0.02], P ϭ 0.036) compared with their inactive counterparts. Considered across physical activity and waist circumference categories, 2-h PG levels were not significantly different between active moderate-waist circumference participants and active low-waist circumference participants. Associations between physical activity and FPG were nonsignificant.CONCLUSIONS -There are important differences between 2-h PG and FPG related to physical activity. It appears that 2-h PG is more sensitive to the beneficial effects of physical activity, and these benefits occur across the waist circumference spectrum. Diabetes Care 29:2598 -2604, 2006O ver half of the adult Australian population is overweight or obese (1). Obesity is a major risk factor for insulin resistance and glucose intolerance, acknowledged recently by the term "diabesity," which emphasizes the strong relationship between obesity and type 2 diabetes (2). However, despite the major public health and private sector interest in obesity, most adults have little success in maintaining long-term weight loss or preventing weight gain with aging (3).Epidemiological and experimental evidence strongly supports the role of physical activity in reducing the risk of developing insulin resistance and glucose intolerance (4). Prospective studies have consistently shown that healthy-weight men and women who are physically active are at the lowest risk for developing type 2 diabetes, while obese inactive men and women are at the highest risk (5-8). Less well understood, however, is the risk of developing hyperglycemia in those who are overweight or obese but physically active or who are inactive but have a healthy weight. Clinical trials that include moderate levels of physical activity have shown improved insulin sensitivity among overweight adults, even without c...

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Section: Discussionsupporting

confidence: 59%

Beneficial Associations of Physical Activity With 2-h but Not Fasting Blood Glucose in Australian Adults

et al. 2006

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“…In our study, physical activity was a significant determinant of the ISI only when not adjusted for either weight or percent body fat. This is in contrast to other studies that have reported associations between physical activity or fitness levels and measures of insulin sensitivity independent of various measures of body mass or body composition in adults (11,14,29) and children (12,13,28). None of the studies in children, however, used DLW to measure physical activity level but instead used VO 2max (12,28) and/or questionnaire variables (12,13).…”

Section: Changes In Insulin Sensitivity During Childhood In Pima Indianscontrasting

confidence: 49%

“…Dengel et al (11) reported that 10 months of aerobic training and weight loss had additive effects on improving glucose homeostasis in obese sedentary men, suggesting that physical activity and adiposity have independent mechanisms for altering insulin sensitivity. Crosssectional associations between insulin sensitivity and physical activity levels independent of adiposity have been reported in children and adolescents (12,13), and an association of physical activity with insulin levels independent of BMI was recently reported in Pima Indian adults (14). Considering the difficulty of treating childhood obesity, as well as the increase in adiposity that was observed in Pima Indian children between 5 and 10 years of age (6), it is important to determine whether changes in physical activity during this time had an independent impact on changes in insulin sensitivity.…”

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confidence: 99%

Weight, Adiposity, and Physical Activity as Determinants of an Insulin Sensitivity Index in Pima Indian Children

et al. 2003

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OBJECTIVE -To determine whether measures of physical activity are related to an insulin sensitivity index ([ISI] 10 4 /fasting insulin ϫ glucose) independent of weight or adiposity in children. RESEARCH DESIGN AND METHODS -We conducted a longitudinal study of 90Pima Indian children (39 boys and 51 girls) at 5 and 10 years of age measuring adiposity (dual-energy X-ray absorptiometry), physical activity behavior (questionnaire: number of activities per week [ACT], average hours per week [TIME]), and energy expenditure (doubly labeled water: physical activity level [PAL]).RESULTS -In cross-sectional analyses, ACT was correlated with ISI at 5 years of age (r ϭ 0.24, P ϭ 0.02) and at 10 years of age (r ϭ 0.21, P ϭ 0.05), but these relationships were not independent of weight or adiposity. PAL was correlated with ISI at 10 years of age (r ϭ 0.39, P ϭ 0.03) but was not independent of weight or adiposity. Longitudinally, ISI decreased from 5 to 10 years of age, and increases in weight and adiposity were associated with decreases in ISI (r ϭ Ϫ0.51 and Ϫ0.41, respectively; both P Ͻ 0.0001). ACT decreased from 5 to 10 years of age, but children who had smaller decreases in ACT had smaller decreases in ISI, independent of increases in weight or adiposity (partial r ϭ 0.22, P ϭ 0.04 adjusted for either weight or adiposity).CONCLUSIONS -These data suggest that early establishment and maintenance of an active lifestyle can have a beneficial effect on ISI that is partially independent of changes in weight or adiposity. This is particularly relevant considering the current epidemics of both obesity and type 2 diabetes in children. Diabetes Care 26:2524 -2530, 2003O besity is a well-documented risk factor for insulin resistance and type 2 diabetes in adults (1) and has also been associated with insulin resistance and the development of impaired glucose tolerance in children and adolescents (2). Among the Pima Indians, a population with the highest reported prevalence of type 2 diabetes in the world (3), many children are markedly overweight at both 5 and 10 years of age (4).Chronically low levels of physical activity are believed to contribute to the increasing prevalence of obesity in children (5). A recent report on Pima Indian children from our laboratory suggests that children who do not increase their physical activity energy expenditure (AEE) in proportion to weight gain during growth are at greater risk for obesity (6).Acute exercise is known to transiently improve insulin sensitivity (7), and exercise training studies have reported increases in insulin sensitivity along with decreases in body fat both in adults (8) and in children (9). Whether habitual levels of physical activity are associated with insulin sensitivity independent of adiposity is less clear, but physical activity has been proposed as a modifiable risk factor for development of type 2 diabetes (10). Dengel et al. (11) reported that 10 months of aerobic training and weight loss had additive effects on improving glucose homeostasis in obese sedentary men, s...

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“…The validity of this questionnaire has been measured among participants at risk for T2D (27) . In addition, the MAQ assesses both current and over-the-past-year leisure and occupational activities.…”

Section: Anthropometric Measurementmentioning

confidence: 99%

The Healthy Eating Index and the Alternate Healthy Eating Index as predictors of 10-year CHD risk in Cuban Americans with and without type 2 diabetes

Huffman

Zarini

McNamara

et al. 2011

Public Health Nutr.

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Objective: To examine the relationship between dietary patterns, as measured by the Healthy Eating Index (HEI) and the Alternate Healthy Eating Index (AHEI), and 10-year predicted CHD risk in Cuban Americans with and without type 2 diabetes (T2D). Design: In a cross-sectional study participants were selected from two randomly generated mailing lists of individuals with and without T2D. HEI and AHEI scores were calculated from a self-reported FFQ. CHD risk was determined using the 10-year CHD risk calculator of the Adult Treatment Panel III. Setting: Miami Dade and Broward Counties, FL, USA. Subjects: Cuban Americans (n 358) aged $30 years. Results: Participants with T2D had a higher waist circumference (P 5 0?001) and 10-year CHD risk score (P 5 0?008) compared with those without T2D. Participants without T2D had a higher energy intake (P 5 0?034), total blood cholesterol (P 5 0?007), HDL cholesterol (P 5 0?001) and HEI score (P 5 0?006) compared with participants with T2D. AHEI score was a significant predictor of 10-year CHD risk (F (1,351) 5 4?44, P 5 0?036). An association between AHEI and 10-year CHD risk was found only for participants with T2D (b 5 20?244, SE 5 0?049, P 5 0?001). Conclusion: The present study showed that only participants with T2D with significantly higher AHEI scores had lower scores for 10-year predicted CHD risk. No association was found between HEI score and CHD risk among Cuban Americans. Individuals with T2D are advised to follow the AHEI dietary pattern.

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Association of Physical Activity and Serum Insulin Concentrations in Two Populations at High Risk for Type 2 Diabetes but Differing by BMI

Cited by 65 publications

References 32 publications

Beneficial Associations of Physical Activity With 2-h but Not Fasting Blood Glucose in Australian Adults

Beneficial Associations of Physical Activity With 2-h but Not Fasting Blood Glucose in Australian Adults

Weight, Adiposity, and Physical Activity as Determinants of an Insulin Sensitivity Index in Pima Indian Children

The Healthy Eating Index and the Alternate Healthy Eating Index as predictors of 10-year CHD risk in Cuban Americans with and without type 2 diabetes

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