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


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.

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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.

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Correspondence to Dagfinn Aune.

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Aune, D., Norat, T., Leitzmann, M. et al. Physical activity and the risk of type 2 diabetes: a systematic review and dose–response meta-analysis. Eur J Epidemiol 30, 529–542 (2015).

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