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European Journal of Epidemiology

, Volume 30, Issue 7, pp 529–542 | Cite as

Physical activity and the risk of type 2 diabetes: a systematic review and dose–response meta-analysis

  • Dagfinn Aune
  • Teresa Norat
  • Michael Leitzmann
  • Serena Tonstad
  • Lars Johan Vatten
META-ANALYSIS

Abstract

We investigated the association between specific types of physical activity and the risk of type 2 diabetes in a systematic review and meta-analysis of published studies. PubMed, Embase and Ovid databases were searched for prospective studies and randomized trials up to 2nd of March 2015. Summary relative risks (RRs) were calculated using a random effects model. Eighty-one studies were included. The summary RRs for high versus low activity were 0.65 (95 % CI 0.59–0.71, I2 = 18 %, n = 14) for total physical activity, 0.74 (95 % CI 0.70–0.79, I2 = 84 %, n = 55) for leisure-time activity, 0.61 (95 % CI 0.51–0.74, I2 = 73 %, n = 8) for vigorous activity, 0.68 (95 % CI 0.52–0.90, I2 = 93 %, n = 5) for moderate activity, 0.66 (95 % CI 0.47–0.94, I2 = 47 %, n = 4) for low intensity activity, and 0.85 (95 % CI 0.79–0.91, I2 = 0 %, n = 7) for walking. Inverse associations were also observed for increasing activity over time, resistance exercise, occupational activity and for cardiorespiratory fitness. Nonlinear relations were observed for leisure-time activity, vigorous activity, walking and resistance exercise (p nonlinearity < 0.0001 for all), with steeper reductions in type 2 diabetes risk at low activity levels than high activity levels. This meta-analysis provides strong evidence for an inverse association between physical activity and risk of type 2 diabetes, which may partly be mediated by reduced adiposity. All subtypes of physical activity appear to be beneficial. Reductions in risk are observed up to 5–7 h of leisure-time, vigorous or low intensity physical activity per week, but further reductions cannot be excluded beyond this range.

Keywords

Physical activity Sports Exercise Walking Type 2 diabetes Systematic review Meta-analysis 

Notes

Acknowledgments

This project was funded by the Liaison Committee between the Central Norway Regional Health Authority (RHA) and the Norwegian University of Science and Technology (NTNU). The funding source had no role in the planning of the project, conduct of the analyses, interpretation of the results, or decision to submit the manuscript for publication.

Conflict of interest

The authors declare that there is no duality of interest associated with this manuscript.

Supplementary material

10654_2015_56_MOESM1_ESM.pdf (1.2 mb)
Supplementary material 1 (PDF 1.16 MB)

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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Dagfinn Aune
    • 1
    • 2
  • Teresa Norat
    • 2
  • Michael Leitzmann
    • 3
  • Serena Tonstad
    • 4
  • Lars Johan Vatten
    • 1
  1. 1.Department of Public Health and General Practice, Faculty of MedicineNorwegian University of Science and TechnologyTrondheimNorway
  2. 2.Department of Epidemiology and Biostatistics, School of Public HealthImperial College LondonLondonEngland, UK
  3. 3.Department of Epidemiology and Preventive MedicineRegensburg University Medical CenterRegensburgGermany
  4. 4.Department of Endocrinology, Morbid Obesity and Preventive MedicineOslo University HospitalOsloNorway

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