Physical Activity in the Prevention of Type 2 Diabetes

The Finnish Diabetes Prevention Study

  1. David E. Laaksonen12,
  2. Jaana Lindström3,
  3. Timo A. Lakka245,
  4. Johan G. Eriksson3,
  5. Leo Niskanen1,
  6. Katja Wikström3,
  7. Sirkka Aunola67,
  8. Sirkka Keinänen-Kiukaanniemi89,
  9. Mauri Laakso8,
  10. Timo T. Valle3,
  11. Pirjo Ilanne-Parikka1011,
  12. Anne Louheranta12,
  13. Helena Hämäläinen7,
  14. Merja Rastas37,
  15. Virpi Salminen13,
  16. Zygimantas Cepaitis3,
  17. Martti Hakumäki212,
  18. Hannu Kaikkonen89,
  19. Pirjo Härkönen89,
  20. Jouko Sundvall14,
  21. Jaakko Tuomilehto315,
  22. Matti Uusitupa12 and
  23. for the Finnish Diabetes Prevention Study Group
  1. 1Department of Medicine, Kuopio University Hospital, Kuopio, Finland
  2. 2Department of Physiology, University of Kuopio, Kuopio, Finland
  3. 3Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, Helsinki, Finland
  4. 4Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
  5. 5Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
  6. 6Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland
  7. 7Research Department, Social Insurance Institution, Turku, Finland
  8. 8Department of Public Health Science and General Practice, Unit of General Practice, Oulu University Hospital, Oulu, Finland
  9. 9Department of Sports Medicine, Oulu Deaconess Institute, Oulu, Finland
  10. 10Finnish Diabetes Association, Tampere, Finland
  11. 11Tampere University Hospital Research Unit, Tampere, Finland
  12. 12Department of Clinical Nutrition and Food and Health Research Center, University of Kuopio, Kuopio, Finland
  13. 13Institute of Nursing and Health Care, Tampere, Finland
  14. 14Laboratory of Analytical Biochemistry, National Public Health Institute, Helsinki, Finland
  15. 15Department of Public Health, University of Helsinki, Helsinki, Finland
  1. 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

Abstract

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.

Footnotes

    • Accepted September 15, 2004.
    • Received June 22, 2004.
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  1. doi: 10.2337/diabetes.54.1.158 Diabetes January 2005 vol. 54 no. 1 158-165
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