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Diabetologia
Published in: Diabetologia 12/2016

Open Access 01-12-2016 | Meta-Analysis

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

Authors: Andrea D. Smith, Alessio Crippa, James Woodcock, Søren Brage

Published in: Diabetologia | Issue 12/2016

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Abstract

Aims/hypothesis

Inverse associations between physical activity (PA) and type 2 diabetes mellitus are well known. However, the shape of the dose–response relationship is still uncertain. This review synthesises results from longitudinal studies in general populations and uses non-linear models of the association between PA and incident type 2 diabetes.

Methods

A systematic literature search identified 28 prospective studies on leisure-time PA (LTPA) or total PA and risk of type 2 diabetes. PA exposures were converted into metabolic equivalent of task (MET) h/week and marginal MET (MMET) h/week, a measure only considering energy expended above resting metabolic rate. Restricted cubic splines were used to model the exposure–disease relationship.

Results

Our results suggest an overall non-linear relationship; using the cubic spline model we found a risk reduction of 26% (95% CI 20%, 31%) for type 2 diabetes among those who achieved 11.25 MET h/week (equivalent to 150 min/week of moderate activity) relative to inactive individuals. Achieving twice this amount of PA was associated with a risk reduction of 36% (95% CI 27%, 46%), with further reductions at higher doses (60 MET h/week, risk reduction of 53%). Results for the MMET h/week dose–response curve were similar for moderate intensity PA, but benefits were greater for higher intensity PA and smaller for lower intensity activity.

Conclusions/interpretation

Higher levels of LTPA were associated with substantially lower incidence of type 2 diabetes in the general population. The relationship between LTPA and type 2 diabetes was curvilinear; the greatest relative benefits are achieved at low levels of activity, but additional benefits can be realised at exposures considerably higher than those prescribed by public health recommendations.
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Metadata
Title
Physical activity and incident type 2 diabetes mellitus: a systematic review and dose–response meta-analysis of prospective cohort studies
Authors
Andrea D. Smith
Alessio Crippa
James Woodcock
Søren Brage
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 12/2016
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-016-4079-0

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