2016/10/15 by Andrea Smith, Alessio Crippa, James Woodcock +1 · 4 citations
Medicine · Mathematics · #Physical Activity and Health #Diabetes, Cardiovascular Risks, and Lipoproteins #Cardiovascular and exercise physiology #Medicine #Diabetes mellitus #Type 2 diabetes #Internal medicine #Population #Metabolic equivalent #Prospective cohort study #Cohort study #Relative risk #Incidence (geometry) #Meta-analysis #Endocrinology #Confidence interval #Physical therapy #Physical activity #Environmental health #Mathematics
paper · pdf · doi:10.1007/s00125-016-4079-0
openalex publication_date 2016/10/15 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
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.