Independent and combined effects of physical activity and body mass index on the development of Type 2 Diabetes – a meta-analysis of 9 prospective cohort studies

Abstract

BackgroundThe aim of this harmonized meta-analysis was to examine the independent and combined effects of physical activity and BMI on the incidence of type 2 diabetes.MethodsOur systematic literature review in 2011 identified 127 potentially relevant prospective studies of which 9 fulfilled the inclusion criteria (total N = 117,878, 56.2 % female, mean age = 50.0 years, range = 25–65 years). Measures of baseline physical activity (low, intermediate, high), BMI-category [BMI < 18.4 (underweight), 18.5–24.9 (normal weight), 25.0–29.9 (overweight), 30+ (obese)] and incident type 2 diabetes were harmonized across studies. The associations between physical activity, BMI and incident type 2 diabetes were analyzed using Cox regression with a standardized analysis protocol including adjustments for age, gender, educational level, and smoking. Hazard ratios from individual studies were combined in a random-effects meta-analysis.ResultsMean follow-up time was 9.1 years. A total of 11,237 incident type 2 diabetes cases were recorded. In mutually adjusted models, being overweight or obese (compared with normal weight) and having low physical activity (compared with high physical activity) were associated with an increased risk of incident type 2 diabetes (hazard ratios 2.33, 95 % CI 1.95–2.78; 6.10, 95 % CI: 4.63–8.04, and 1.23, 95 % CI: 1.09–1.39, respectively). Individuals who were both obese and had low physical activity had 7.4-fold (95 % CI 3.47–15.89) increased risk of type 2 diabetes compared with normal weight, high physically active participants.ConclusionsThis harmonized meta-analysis shows the importance of maintaining a healthy weight and being physically active in diabetes prevention.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-015-0304-3) contains supplementary material, which is available to authorized users.

Different domains of self-reported physical activity and risk of type 2 diabetes in a population-based Swedish cohort: the Malmö diet and Cancer study

“…Physical activity has been associated with reduced risk of T2D in different populations [5][6][7][8][9][10][11][12][13][14][15][16], and the World Health Organization (WHO) recommends at least 150 min per week of moderate physical activity for health benefits [17]. Although many studies have demonstrated this inverse relationship between physical activity and risk of T2D, they have applied different metrics in quantifying physical activity and also used different domains (e.g., occupational, leisure-time, domestic and commuting), dimensions (e.g., type, rate, intensity and duration) and different modes of assessment, either quantitative or qualitative or a combination of both [10,16,[18][19][20][21][22][23].…”

Factores relacionados al sobrepeso y obesidad en pacientes atendidos en la Unidad de Medicina Complementaria del Hospital II Vitarte.

“…La relación entre diabetes y obesidad/sobrepeso esta ya bien establecida por estudios anteriores; como el de Cloostermans et al (29) , HR: 7.4 (IC95% 3,47-15,89 e Hyppönen et al (30) , RR: 22,9 (IC 95%12-42). Así, las relaciones encontradas en estudios anteriores son mucho más contundentes en comparación con este estudio, lo que podría ser explicado por el tipo de selección de los pacientes (por conveniencia) y que, en su mayoría, las personas que acuden a los servicios de medicina complementaria ya poseen enfermedades crónicas establecidas y, probablemente, en tratamiento (17,23) , lo que hace que sea más probable encontrar obesidad que sobrepeso.…”

Effects of Exercise on Type 2 Diabetes Mellitus-Related Cognitive Impairment and Dementia

“…Type 2 diabetes mellitus (T2DM) is also a potentially modifiable risk factor for dementia [5], with estimates that nearly 200,000 cases of dementia could be prevented if there was a 25% reduction in T2DM [6]. Importantly, physical inactivity is one of the main causes of T2DM [7]. It has been well documented that regular exercise plays a major role in its prevention and management [8].…”