TY - JOUR
T1 - 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
AU - Cloostermans, Laura
AU - Wendel-Vos, Wanda
AU - Doornbos, Gerda
AU - Howard, Bethany
AU - Craig, Cora Lynn
AU - Kivimäki, Mika
AU - Tabak, Adam G.
AU - Jefferis, Barbara J.
AU - Ronkainen, Kimmo
AU - Brown, Wendy J.
AU - Picavet, Susan H.S.J.
AU - Ben-Shlomo, Yoav
AU - Laukkanen, Jari Antero
AU - Kauhanen, Jussi
AU - Bemelmans, Wanda J.E.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84952864900&partnerID=8YFLogxK
U2 - 10.1186/s12966-015-0304-3
DO - 10.1186/s12966-015-0304-3
M3 - Article
C2 - 26619831
AN - SCOPUS:84952864900
SN - 1479-5868
VL - 12
JO - International Journal of Behavioral Nutrition and Physical Activity
JF - International Journal of Behavioral Nutrition and Physical Activity
IS - 1
M1 - 147
ER -
