Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease.

Epidemiological studies suggest that physically active individuals have a 30-50% lower risk of developing type 2 diabetes than do sedentary persons and that physical activity confers a similar risk reduction for coronary heart disease. Risk reductions are observed with as little as 30 min of moderate-intensity activity per day. Protective mechanisms of physical activity include the regulation of body weight; the reduction of insulin resistance, hypertension, atherogenic dyslipidemia, and inflammation; and the enhancement of insulin sensitivity, glycemic control, and fibrinolytic and endothelial function. Public health initiatives promoting moderate increases in physical activity may offer the best balance between efficacy and feasibility to improve metabolic and cardiovascular health in largely sedentary populations.

[1]  Meena Kumari,et al.  Prospective study of social and other risk factors for incidence of type 2 diabetes in the Whitehall II study. , 2004, Archives of internal medicine.

[2]  K. Khaw,et al.  Family history of diabetes identifies a group at increased risk for the metabolic consequences of obesity and physical inactivity in EPIC-Norfolk: a population-based study , 2000, International Journal of Obesity.

[3]  K. Patrick,et al.  Physical Activity and Public Health: A Recommendation From the Centers for Disease Control and Prevention and the American College of Sports Medicine , 1995 .

[4]  T. Valle,et al.  Occupational, commuting, and leisure-time physical activity in relation to risk for Type 2 diabetes in middle-aged Finnish men and women , 2003, Diabetologia.

[5]  R. Paffenbarger,et al.  Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. , 1991, The New England journal of medicine.

[6]  Neil Skolnik,et al.  Dietary Guidelines for Americans 2005 , 2005 .

[7]  P. Thompson,et al.  The effect of physical activity on endothelial function in man. , 2004, Acta physiologica Scandinavica.

[8]  J. Manson,et al.  Physical activity and coronary heart disease in women: is "no pain, no gain" passé? , 2001, JAMA.

[9]  B. Ainsworth,et al.  Cardiorespiratory Fitness and C-Reactive Protein Among a Tri-Ethnic Sample of Women , 2002, Circulation.

[10]  Karen C Johnson,et al.  Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. , 2003, Controlled clinical trials.

[11]  P. Barnes,et al.  Leisure-Time Physical Activity Among Adults: United States, 1997-98 , 2002 .

[12]  N. Vaziri,et al.  Effect of Diet and Exercise Intervention on Blood Pressure, Insulin, Oxidative Stress, and Nitric Oxide Availability , 2002, Circulation.

[13]  Stuart Biddle,et al.  Accumulating brisk walking for fitness, cardiovascular risk, and psychological health. , 2002, Medicine and science in sports and exercise.

[14]  W. Kraus,et al.  Effects of the amount and intensity of exercise on plasma lipoproteins. , 2002, The New England journal of medicine.

[15]  Daniel L. McGee,et al.  Determinants of incident non-insulin-dependent diabetes mellitus among blacks and whites in a national sample. The NHANES I Epidemiologic Follow-up Study. , 1993, American journal of epidemiology.

[16]  P. Ridker,et al.  High-sensitivity C-reactive protein: clinical importance. , 2004, Current problems in cardiology.

[17]  Godfrey Fowler,et al.  THE STRATEGY OF PREVENTIVE MEDICINE , 1992 .

[18]  D. Williamson,et al.  Weight change and diabetes incidence: findings from a national cohort of US adults. , 1997, American journal of epidemiology.

[19]  David R Bassett,et al.  Increasing daily walking improves glucose tolerance in overweight women. , 2003, Preventive medicine.

[20]  W. Kraus,et al.  Effect of the volume and intensity of exercise training on insulin sensitivity. , 2004, Journal of applied physiology.

[21]  G. Schuler,et al.  Effect of Exercise on Coronary Endothelial Function in Patients With Coronary Artery Disease , 2000 .

[22]  A. Kriska,et al.  Handbook of Exercise in Diabetes , 2004 .

[23]  Tomoshige Hayashi,et al.  Walking to Work and the Risk for Hypertension in Men: The Osaka Health Survey , 1999, Annals of Internal Medicine.

[24]  A. Leon,et al.  Response of blood lipids to exercise training alone or combined with dietary intervention. , 2001, Medicine and science in sports and exercise.

[25]  K. Eriksson,et al.  Prevention of Type 2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise The 6-year Malmö feasibility study , 1991, Diabetologia.

[26]  J. Manson,et al.  A Prospective Study of Walking as Compared with Vigorous Exercise in the Prevention of Coronary Heart Disease in Women , 2000 .

[27]  A. Manley.  Physical Activity And Health: A Report Of The Surgeon General , 2004 .

[28]  R. Marfella,et al.  Effect of weight loss on cardiac synchronization and proinflammatory cytokines in premenopausal obese women. , 2004, Diabetes care.

[29]  W C Willett,et al.  A prospective study of exercise and incidence of diabetes among US male physicians. , 1992, JAMA.

[30]  A. Folsom,et al.  Physical activity and incident diabetes mellitus in postmenopausal women. , 2000, American journal of public health.

[31]  P. Whincup,et al.  Physical Activity and Hemostatic and Inflammatory Variables in Elderly Men , 2002, Circulation.

[32]  I-Min Lee,et al.  Physical Activity and Coronary Heart Disease in Women: Is No Pain, No Gain Passé? , 2001 .

[33]  C. Lambert,et al.  Effects of endurance training and resistance training on plasma lipoprotein profiles in elderly women. , 2002, The journals of gerontology. Series A, Biological sciences and medical sciences.

[34]  Usdhhs.  Physical Activity and Health: A Report of the Surgeon General , 1996 .

[35]  G. Watts,et al.  Effects of exercise training on conduit and resistance vessel function in treated and untreated hypercholesterolaemic subjects. , 2003, European heart journal.

[36]  G. Schuler,et al.  Regular Physical Activity Improves Endothelial Function in Patients With Coronary Artery Disease by Increasing Phosphorylation of Endothelial Nitric Oxide Synthase , 2003, Circulation.

[37]  J M Jakicic,et al.  Prescribing exercise in multiple short bouts versus one continuous bout: effects on adherence, cardiorespiratory fitness, and weight loss in overweight women. , 1995, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[38]  R. Paffenbarger,et al.  Physical activity and cardiovascular disease risk in middle-aged and older women. , 1999, American journal of epidemiology.

[39]  Plamen Nikolov,et al.  Economic Costs of Diabetes in the U.S. in 2002 , 2003, Diabetes care.

[40]  J. Manson,et al.  Physical activity and incidence of non-insulin-dependent diabetes mellitus in women , 1991, The Lancet.

[41]  P. Williams,et al.  Physical activity and public health. , 1995, JAMA.

[42]  Hideo Ayame,et al.  [The Da Qing IGT and Diabetes study]. , 2005, Nihon rinsho. Japanese journal of clinical medicine.

[43]  T. Valle,et al.  Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. , 2001, The New England journal of medicine.

[44]  J. Tuomilehto,et al.  Occupational, Commuting, and Leisure-Time Physical Activity in Relation to Total and Cardiovascular Mortality Among Finnish Subjects With Type 2 Diabetes , 2004, Circulation.

[45]  G. Davey Smith,et al.  Physical activity and cause‐specific mortality in men with Type 2 diabetes/impaired glucose tolerance: evidence from the Whitehall study , 2002, Diabetic medicine : a journal of the British Diabetic Association.

[46]  L Murray,et al.  What level of physical activity protects against premature cardiovascular death? The Caerphilly study , 2003, Heart.

[47]  B. Ainsworth,et al.  Moderate-intensity physical activity and fasting insulin levels in women: the Cross-Cultural Activity Participation Study. , 2000, Diabetes care.

[48]  D A Schoeller,et al.  How much physical activity is needed to minimize weight gain in previously obese women? , 1997, The American journal of clinical nutrition.

[49]  Gregory Y H Lip,et al.  Effects of lifestyle on hemostasis, fibrinolysis, and platelet reactivity: a systematic review. , 2003, Archives of internal medicine.

[50]  John D Potter,et al.  Effect of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial. , 2003, JAMA.

[51]  James O. Hill,et al.  Obesity and the Environment: Where Do We Go from Here? , 2003, Science.

[52]  D Kromhout,et al.  Physical activity and 10-year mortality from cardiovascular diseases and all causes: The Zutphen Elderly Study. , 1998, Archives of internal medicine.

[53]  J. Manson,et al.  Physical Activity and Risk for Cardiovascular Events in Diabetic Women , 2001, Annals of Internal Medicine.

[54]  S. Fowler,et al.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. , 2002 .

[55]  Jiang He,et al.  Effect of Aerobic Exercise on Blood Pressure , 2002, Annals of Internal Medicine.

[56]  Oluf Pedersen,et al.  Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. , 2003, The New England journal of medicine.

[57]  Gösta Samuelson,et al.  Global strategy on diet, physical activity and health , 2004 .

[58]  Carl J Caspersen,et al.  Relationship of walking to mortality among US adults with diabetes. , 2003, Archives of internal medicine.

[59]  T. Lakka,et al.  Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non-insulin-dependent diabetes mellitus in middle-aged men. , 1996, Archives of internal medicine.

[60]  S. Blair,et al.  Physical fitness and incidence of hypertension in healthy normotensive men and women. , 1984, JAMA.

[61]  V. Vaccarino,et al.  Relationship between physical activity and inflammation among apparently healthy middle-aged and older US adults. , 2002, Archives of internal medicine.

[62]  K. Yano,et al.  Effects of walking on coronary heart disease in elderly men: the Honolulu Heart Program. , 1999, Circulation.

[63]  G. Colditz,et al.  Weight Gain as a Risk Factor for Clinical Diabetes Mellitus in Women , 1995, Annals of Internal Medicine.

[64]  Walter C Willett,et al.  Exercise type and intensity in relation to coronary heart disease in men. , 2002, JAMA.

[65]  G A Colditz,et al.  Physical activity and television watching in relation to risk for type 2 diabetes mellitus in men. , 2001, Archives of internal medicine.

[66]  K. Kelley,et al.  Aerobic exercise and resting blood pressure: a meta-analytic review of randomized, controlled trials. , 2001, Preventive cardiology.

[67]  Robert M. Anderson,et al.  5. Prevention or Delay of Type 2 Diabetes , 2016, Diabetes Care.

[68]  Greta L. Hoetzer,et al.  Effects of ageing and regular aerobic exercise on endothelial fibrinolytic capacity in humans , 2003, The Journal of physiology.

[69]  J. Manson,et al.  Walking compared with vigorous exercise for the prevention of cardiovascular events in women. , 2002, The New England journal of medicine.

[70]  C. Meisinger,et al.  Sex differences in risk factors for incident type 2 diabetes mellitus: the MONICA Augsburg cohort study. , 2002, Archives of internal medicine.

[71]  G A Colditz,et al.  Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. , 1999, JAMA.

[72]  T. Valle,et al.  Physical activity, body mass index, and risk of type 2 diabetes in patients with normal or impaired glucose regulation. , 2004, Archives of internal medicine.

[73]  K. Flegal,et al.  Prevalence and trends in obesity among US adults, 1999-2000. , 2002, JAMA.

[74]  R. Holman,et al.  Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study , 2000, BMJ : British Medical Journal.

[75]  J. Kampert,et al.  The Association between Cardiorespiratory Fitness and Impaired Fasting Glucose and Type 2 Diabetes Mellitus in Men , 1999, Annals of Internal Medicine.

[76]  E. Rimm,et al.  Physical Activity in Relation to Cardiovascular Disease and Total Mortality Among Men With Type 2 Diabetes , 2003, Circulation.

[77]  S. Blair,et al.  Cardiorespiratory fitness and the incidence of type 2 diabetes: prospective study of Japanese men. , 2003, Diabetes care.

[78]  Dang Qing,et al.  Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance The , 2022 .

[79]  K. Alberti,et al.  Physical activity, metabolic factors, and the incidence of coronary heart disease and type 2 diabetes. , 2000, Archives of internal medicine.

[80]  R. Rauramaa,et al.  Dose-response and coagulation and hemostatic factors. , 2001, Medicine and science in sports and exercise.

[81]  J. Manson,et al.  Weight, weight change, and coronary heart disease in women. Risk within the 'normal' weight range. , 1995, JAMA.

[82]  Mark A Pereira,et al.  Physical activity and incident hypertension in black and white adults: the Atherosclerosis Risk in Communities Study. , 1999, Preventive medicine.

[83]  R N Bergman,et al.  Intensity and amount of physical activity in relation to insulin sensitivity: the Insulin Resistance Atherosclerosis Study. , 1998, JAMA.

[84]  C. Ulrich,et al.  Effect of Exercise on Total and Intraabdominal Body Fat in Postmenopausal Women: A Randomized, Controlled Trial , 2003 .

[85]  Trends in intake of energy and macronutrients--United States, 1971-2000. , 2004, MMWR. Morbidity and mortality weekly report.

[86]  B. Howard,et al.  Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance: The Da Qing IGT and Diabetes Study , 1997, Diabetes Care.

[87]  I. Vuori,et al.  Association of leisure time physical activity with the risk of coronary heart disease, hypertension and diabetes in middle-aged men and women. , 1997, International journal of epidemiology.

[88]  R S Paffenbarger,et al.  Physical activity and incidence of hypertension in college alumni. , 1983, American journal of epidemiology.

[89]  Susan L. Johnson,et al.  Effects of a 16-month randomized controlled exercise trial on body weight and composition in young, overweight men and women: the Midwest Exercise Trial. , 2003, Archives of internal medicine.

[90]  J. McGavock,et al.  Low cardiorespiratory fitness is associated with elevated C-reactive protein levels in women with type 2 diabetes. , 2004, Diabetes care.

[91]  R R Wing,et al.  Physical activity in the treatment of the adulthood overweight and obesity: current evidence and research issues. , 1999, Medicine and science in sports and exercise.

[92]  Richard Kahn,et al.  Preventing Cancer, Cardiovascular Disease, and Diabetes: A Common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association , 2004, Stroke.

[93]  A. Kriska,et al.  Physical activity, obesity, and the incidence of type 2 diabetes in a high-risk population. , 2003, American journal of epidemiology.

[94]  J. Polak,et al.  Association between physical activity and markers of inflammation in a healthy elderly population. , 2001, American journal of epidemiology.

[95]  Gregory P. Samsa,et al.  Effects of the Amount of Exercise on Body Weight, Body Composition, and Measures of Central Obesity STRRIDE—A Randomized Controlled Study , 2004 .

[96]  G. Kelley,et al.  Progressive resistance exercise and resting blood pressure : A meta-analysis of randomized controlled trials. , 2000, Hypertension.

[97]  J. Tuomilehto,et al.  Long-term improvement in insulin sensitivity by changing lifestyles of people with impaired glucose tolerance: 4-year results from the Finnish Diabetes Prevention Study. , 2003, Diabetes.

[98]  J. Kampert,et al.  Associations Between Cardiorespiratory Fitness and C-Reactive Protein in Men , 2002, Arteriosclerosis, thrombosis, and vascular biology.

[99]  J. Manson.  Prevention of myocardial infarction , 1996 .

[100]  Z. Tran,et al.  Walking and resting blood pressure in adults: a meta-analysis. , 2001, Preventive medicine.

[101]  K. Eriksson,et al.  No excess 12-year mortality in men with impaired glucose tolerance who participated in the Malmö Preventive Trial with diet and exercise , 1998, Diabetologia.

[102]  Tamara B. Harris,et al.  The Associations Between Physical Activity and Inflammatory Markers in High‐Functioning Older Persons: MacArthur Studies of Successful Aging , 2003, Journal of the American Geriatrics Society.

[103]  I. Lee.  No pain, no gain? Thoughts on the Caerphilly study , 2004, British Journal of Sports Medicine.

[104]  K. Tsumura,et al.  Leisure‐time physical activity at weekends and the risk of Type 2 diabetes mellitus in Japanese men: the Osaka Health Survey , 2000, Diabetic medicine : a journal of the British Diabetic Association.

[105]  Theodore R. Sizer,et al.  No Pain, No Gain. , 1991 .

[106]  R. Sigal,et al.  Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta‐analysis of controlled clinical trials , 2002, JAMA.

[107]  I. Sartori.  Weight, Weight Change, and Coronary Heart Disease in Women: Risk Within the 'Normal' Weight Range , 1996 .

[108]  E. Ford.  Does Exercise Reduce Inflammation? Physical Activity and C-Reactive Protein Among U.S. Adults , 2002, Epidemiology.

[109]  K. Asplund,et al.  Regular leisure time physical activity predicts high activity of tissue plasminogen activator: The Northern Sweden MONICA Study. , 1996, International journal of epidemiology.

[110]  M. Carroll,et al.  Overweight and obesity in the United States: prevalence and trends, 1960–1994 , 1998, International Journal of Obesity.

[111]  R R Wing,et al.  A descriptive study of individuals successful at long-term maintenance of substantial weight loss. , 1997, The American journal of clinical nutrition.

[112]  Anson,et al.  DIET , LIFESTYLE , AND THE RISK OF TYPE 2 DIABETES MELLITUS IN WOMEN , 2001 .

[113]  K. Yano,et al.  Physical activity and incidence of diabetes: the Honolulu Heart Program. , 1995, American journal of epidemiology.

[114]  Edward J Boyko,et al.  Diet and exercise among adults with type 2 diabetes: findings from the third national health and nutrition examination survey (NHANES III). , 2002, Diabetes care.

[115]  J. Tuomilehto,et al.  Relationship of Physical Activity and Body Mass Index to the Risk of Hypertension: A Prospective Study in Finland , 2004, Hypertension.