Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 24;21(1):191.
doi: 10.1186/s12916-023-02851-5.

Dose-response relationship between device-measured physical activity and incident type 2 diabetes: findings from the UK Biobank prospective cohort study

Jirapitcha Boonpor  1   2 , Solange Parra-Soto  1   3 , Fanny Petermann-Rocha  1   4 , Nathan Lynskey  1 , Verónica Cabanas-Sánchez  1   5 , Naveed Sattar  1 , Jason M R Gill  1 , Paul Welsh  1 , Jill P Pell  6 , Stuart R Gray #  1 , Frederick K Ho #  6 , Carlos Celis-Morales #  7   8
Affiliations

Dose-response relationship between device-measured physical activity and incident type 2 diabetes: findings from the UK Biobank prospective cohort study

Jirapitcha Boonpor et al. BMC Med. .

Abstract

Background: Most studies investigating the association between physical activity (PA) and the risk of type 2 diabetes are derived from self-reported questionnaires, with limited evidence using device-based measurements. Therefore, this study aimed to investigate the dose-response relationship between device-measured PA and incident type 2 diabetes.

Methods: This prospective cohort study included 40,431 participants of the UK Biobank. Wrist-worn accelerometers were used to estimate total, light, moderate, vigorous and moderate-to-vigorous PA. The associations between PA and incident type 2 diabetes were analysed using Cox-proportional hazard models. The mediating role of body mass index (BMI) was tested under a causal counterfactual framework.

Results: The median follow-up period was 6.3 years (IQR: 5.7-6.8), with 591 participants developing type 2 diabetes. Compared to those achieving < 150 min/week of moderate PA, people achieving 150-300, 300-600 and > 600 min/week were at 49% (95% CI 62-32%), 62% (95% CI 71-50%) and 71% (95% CI 80-59%) lower risk of type 2 diabetes, respectively. For vigorous PA, compared to those achieving < 25 min/week, individuals achieving 25-50, 50-75 and > 75 min/week were at 38% (95% CI 48-33%), 48% (95% CI 64-23%) and 64% (95% CI 78-42%) lower type 2 diabetes risk, respectively. Twelve per cent and 20% of the associations between vigorous and moderate PA and type 2 diabetes were mediated by lower BMI, respectively.

Conclusions: PA has clear dose-response relationship with a lower risk of type 2 diabetes. Our findings support the current aerobic PA recommendations but suggest that additional PA beyond the recommendations is associated with even greater risk reduction.

Trial registration: The UK Biobank study was approved by the North West Multi-Centre Research Ethics Committee (Ref 11/NW/0382 on June 17, 2011).

Keywords: Accelerometer; Obesity; Physical activity; Type 2 diabetes mellitus.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Non-penalised cubic splines for the association between physical activity domains and incident type 2 diabetes. Data are presented as hazard ratios (HR) and their 95% CI. The top row of the panel was adjusted for age, sex, deprivation, education, ethnicity, alcohol intake and smoking status. The second row was additionally adjusted for BMI. The bottom row was adjusted for the same covariates as the middle row but include a 2-year landmark analysis. Vertical dotted lines represent the current PA recommendations for moderate and vigorous PA. LPA, light physical activity; MPA, moderate physical activity; MVPA, moderate-vigorous physical activity; PA, physical activity; T2D, type 2 diabetes; VPA, vigorous physical activity. MVPA is the sum of time spent on MPA and VPA × 2
Fig. 2
Fig. 2
Risk matrix for the joint association of MPA and VPA with incident type 2 diabetes. Estimated in Cox regression adjusted for age, sex, deprivation, education, ethnicity, alcohol intake and smoking status. The numbers presented are the associated reduction in hazard (%) compared with the least active group, based on the hazard ratios (HRs) shown in Table 2. MPA, moderate physical activity; VPA, vigorous physical activity
See this image and copyright information in PMC

References

    1. International Diabetes Federation. IDF Diabetes atlas ninth edition. Available from https://diabetesatlas.org/atlas/ninth-edition/. Access Oct 2021.
    1. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, Colagiuri S, Guariguata L, Motala AA, Ogurtsova K, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019;157:107843. doi: 10.1016/j.diabres.2019.107843. - DOI - PubMed
    1. Lean MEJ, Leslie WS, Barnes AC, Brosnahan N, Thom G, McCombie L, Peters C, Zhyzhneuskaya S, Al-Mrabeh A, Hollingsworth KG, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018;391(10120):541–551. doi: 10.1016/S0140-6736(17)33102-1. - DOI - PubMed
    1. Tarp J, Stole AP, Blond K, Grontved A. Cardiorespiratory fitness, muscular strength and risk of type 2 diabetes: a systematic review and meta-analysis. Diabetologia. 2019;62(7):1129–1142. doi: 10.1007/s00125-019-4867-4. - DOI - PMC - PubMed
    1. Al-Ozairi E, Alsaeed D, Alroudhan D, Voase N, Hasan A, Gill JMR, Sattar N, Welsh P, Gray CM, Boonpor J, et al. Skeletal muscle and metabolic health: how do we increase muscle mass and function in people with type 2 diabetes? J Clin Endocrinol Metab. 2021;106(2):309–17. doi: 10.1210/clinem/dgaa835. - DOI - PubMed

Publication types