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Diabetes 54:158-165, 2005
© 2005 by the American Diabetes Association, Inc.

Physical Activity in the Prevention of Type 2 Diabetes

The Finnish Diabetes Prevention Study

David E. Laaksonen1,2, Jaana Lindström3, Timo A. Lakka2,4,5, Johan G. Eriksson3, Leo Niskanen1, Katja Wikström3, Sirkka Aunola6,7, Sirkka Keinänen-Kiukaanniemi8,9, Mauri Laakso8, Timo T. Valle3, Pirjo Ilanne-Parikka10,11, Anne Louheranta12, Helena Hämäläinen7, Merja Rastas3,7, Virpi Salminen13, Zygimantas Cepaitis3, Martti Hakumäki2,12, Hannu Kaikkonen8,9, Pirjo Härkönen8,9, Jouko Sundvall14, Jaakko Tuomilehto3,15, and Matti Uusitupa12 for the Finnish Diabetes Prevention Study Group

1 Department of Medicine, Kuopio University Hospital, Kuopio, Finland
2 Department of Physiology, University of Kuopio, Kuopio, Finland
3 Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, Helsinki, Finland
4 Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
5 Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
6 Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland
7 Research Department, Social Insurance Institution, Turku, Finland
8 Department of Public Health Science and General Practice, Unit of General Practice, Oulu University Hospital, Oulu, Finland
9 Department of Sports Medicine, Oulu Deaconess Institute, Oulu, Finland
10 Finnish Diabetes Association, Tampere, Finland
11 Tampere University Hospital Research Unit, Tampere, Finland
12 Department of Clinical Nutrition and Food and Health Research Center, University of Kuopio, Kuopio, Finland
13 Institute of Nursing and Health Care, Tampere, Finland
14 Laboratory of Analytical Biochemistry, National Public Health Institute, Helsinki, Finland
15 Department of Public Health, University of Helsinki, Helsinki, Finland

Clinical trials have demonstrated that lifestyle changes can prevent type 2 diabetes, but the importance of leisure-time physical activity (LTPA) is still unclear. We carried out post hoc analyses on the role of LTPA in preventing type 2 diabetes in 487 men and women with impaired glucose tolerance who had completed 12-month LTPA questionnaires. The subjects were participants in the Finnish Diabetes Prevention Study, a randomized controlled trial of lifestyle changes including diet, weight loss, and LTPA. There were 107 new cases of diabetes during the 4.1-year follow-up period. Individuals who increased moderate-to-vigorous LTPA or strenuous, structured LTPA the most were 63–65% less likely to develop diabetes. Adjustment for changes in diet and body weight during the study attenuated the association somewhat (upper versus lower third: moderate-to-vigorous LTPA, relative risk 0.51, 95% CI 0.26–0.97; strenuous, structured LTPA, 0.63, 0.35–1.13). Low-intensity and lifestyle LTPA and walking also conferred benefits, consistent with the finding that the change in total LTPA (upper versus lower third: 0.34, 0.19–0.62) was the most strongly associated with incident diabetes. Thus increasing physical activity may substantially reduce the incidence of type 2 diabetes in high-risk individuals.

Address correspondence and reprint requests to Prof. Matti Uusitupa, MD, PhD, Department of Clinical Nutrition and Food and Health Research Center, University of Kuopio, P.O. Box 1627, Kuopio, Finland. E-mail: matti.uusitupa{at}uku.fi


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Copyright © 2005 by the American Diabetes Association.