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Int J Behav Nutr Phys Act. 2015 Dec 1;12:147. doi: 10.1186/s12966-015-0304-3.

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.

Author information

1
National Institute for Public Health and the Environment, Bilthoven, The Netherlands. Laura.Cloostermans@rivm.nl.
2
National Institute for Public Health and the Environment, Bilthoven, The Netherlands. Wanda.Vos@rivm.nl.
3
National Institute for Public Health and the Environment, Bilthoven, The Netherlands. Gerda.Doornbos@rivm.nl.
4
Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia. Bethany.Howard@bakeridi.edu.au.
5
Canadian Fitness and Lifestyle Research Institute, Ottawa, Canada. ccraig@cflri.ca.
6
Department of Epidemiology and Public Health, University College London, London, UK. m.kivimaki@ucl.ac.uk.
7
Department of Epidemiology and Public Health, University College London, London, UK. a.tabak@ucl.ac.uk.
8
Department of Primary Care and Population Health, University College London, London, United Kingdom. b.jefferis@ucl.ac.uk.
9
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. kimmo.ronkainen@uef.fi.
10
School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia. wbrown@hms.uq.edu.au.
11
National Institute for Public Health and the Environment, Bilthoven, The Netherlands. Susan.piavet@rivm.nl.
12
Department of Clinical Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK. Y.Ben-Shlomo@bristol.ac.uk.
13
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. Jari.laukkanen@uef.fi.
14
Department of Internal Medicine, Lapland Central Hospital, Rovaniemi, Finland. Jari.laukkanen@uef.fi.
15
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland. Jussi.kauhanen@uef.fi.
16
National Institute for Public Health and the Environment, Bilthoven, The Netherlands. Wanda.bemelmans@rivm.nl.

Abstract

BACKGROUND:

The 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.

METHODS:

Our 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.

RESULTS:

Mean 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.

CONCLUSIONS:

This harmonized meta-analysis shows the importance of maintaining a healthy weight and being physically active in diabetes prevention.

PMID:
26619831
PMCID:
PMC4666059
DOI:
10.1186/s12966-015-0304-3
[Indexed for MEDLINE]
Free PMC Article

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