Physical activity reduces the risk of incident type 2 diabetes in general and in abdominally lean and obese men and women: the EPIC–InterAct Study

• Published in: Diabetologia 2012-07, Vol.55 (7), p.1944-1952
• Main Author: INTERACT CONSORTIUM, The
• Format: Article
• Language: English
• Subjects: 10 european countries; Abdominal obesity; accelerometry; adiposity; Biological and medical sciences; Body Mass Index; Cancer; Case-cohort study; Clinical Medicine; Cohort Studies; Consortia; Diabetes; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - genetics; Diabetes Mellitus, Type 2 - prevention & control; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinology and Diabetes; Endocrinopathies; Endokrinologi och diabetes; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Europe - epidemiology; Exercise; fat distribution; Female; Follow-Up Studies; Genetic Predisposition to Disease; heart-rate; Human Physiology; Humans; improves; Incidence; Incident diabetes; insulin sensitivity; Internal Medicine; Klinisk medicin; Life Style; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; mellitus; Metabolic Diseases; Middle Aged; Motor Activity; Obesity; Obesity - epidemiology; Obesity - genetics; Obesity - prevention & control; Physical activity; Risk Factors; Surveys and Questionnaires; Waist Circumference - genetics; Women
• ISSN: 0012-186X; 1432-0428; 1432-0428
• DOI: 10.1007/s00125-012-2532-2

Aims/hypothesis We examined the independent and combined associations of physical activity and obesity with incident type 2 diabetes in men and women. Methods The InterAct case–cohort study consists of 12,403 incident type 2 diabetes cases and a randomly selected subcohort of 16,154 individuals, drawn from a total cohort of 340,234 participants with 3.99 million person-years of follow-up. Physical activity was assessed by a four-category index. Obesity was measured by BMI and waist circumference (WC). Associations between physical activity, obesity and case-ascertained incident type 2 diabetes were analysed by Cox regression after adjusting for educational level, smoking status, alcohol consumption and energy intake. In combined analyses, individuals were stratified according to physical activity level, BMI and WC. Results A one-category difference in physical activity (equivalent to approximately 460 and 365 kJ/day in men and women, respectively) was independently associated with a 13% (HR 0.87, 95% CI 0.80, 0.94) and 7% (HR 0.93, 95% CI 0.89, 0.98) relative reduction in the risk of type 2 diabetes in men and women, respectively. Lower levels of physical activity were associated with an increased risk of diabetes across all strata of BMI. Comparing inactive with active individuals, the HRs were 1.44 (95% CI 1.11, 1.87) and 1.38 (95% CI 1.17, 1.62) in abdominally lean and obese inactive men, respectively, and 1.57 (95% CI 1.19, 2.07) and 1.19 (95% CI 1.01, 1.39) in abdominally lean and obese inactive women, respectively. Conclusions/interpretation Physical activity is associated with a reduction in the risk of developing type 2 diabetes across BMI categories in men and women, as well as in abdominally lean and obese men and women.