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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.

Cloostermans L, Wendel-Vos W, Doornbos G, Howard B, Craig CL, Kivimäki M, Tabak AG, Jefferis BJ, Ronkainen K, Brown WJ, Picavet SH, Ben-Shlomo Y, Laukkanen JA, Kauhanen J, Bemelmans WJ - Int J Behav Nutr Phys Act (2015)

Bottom Line: Hazard ratios from individual studies were combined in a random-effects meta-analysis.Mean follow-up time was 9.1 years.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.

View Article: PubMed Central - PubMed

Affiliation: National Institute for Public Health and the Environment, Bilthoven, The Netherlands. Laura.Cloostermans@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.

No MeSH data available.


Related in: MedlinePlus

Meta-analysis of combined classes of baseline physical activity and body mass index on T2D development. Model 1: T2D = combined physical activity level and BMI categories. Model 2: Model 1 + age + gender + educational level + smoking
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Fig2: Meta-analysis of combined classes of baseline physical activity and body mass index on T2D development. Model 1: T2D = combined physical activity level and BMI categories. Model 2: Model 1 + age + gender + educational level + smoking

Mentions: The combined effect of physical activity and body mass index levels on T2D was assessed by creating separate indicators for combinations of PA and BMI. Results are in Table 6 and graphically shown in Fig. 2.Table 6


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.

Cloostermans L, Wendel-Vos W, Doornbos G, Howard B, Craig CL, Kivimäki M, Tabak AG, Jefferis BJ, Ronkainen K, Brown WJ, Picavet SH, Ben-Shlomo Y, Laukkanen JA, Kauhanen J, Bemelmans WJ - Int J Behav Nutr Phys Act (2015)

Meta-analysis of combined classes of baseline physical activity and body mass index on T2D development. Model 1: T2D = combined physical activity level and BMI categories. Model 2: Model 1 + age + gender + educational level + smoking
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4666059&req=5

Fig2: Meta-analysis of combined classes of baseline physical activity and body mass index on T2D development. Model 1: T2D = combined physical activity level and BMI categories. Model 2: Model 1 + age + gender + educational level + smoking
Mentions: The combined effect of physical activity and body mass index levels on T2D was assessed by creating separate indicators for combinations of PA and BMI. Results are in Table 6 and graphically shown in Fig. 2.Table 6

Bottom Line: Hazard ratios from individual studies were combined in a random-effects meta-analysis.Mean follow-up time was 9.1 years.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.

View Article: PubMed Central - PubMed

Affiliation: National Institute for Public Health and the Environment, Bilthoven, The Netherlands. Laura.Cloostermans@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.

No MeSH data available.


Related in: MedlinePlus