The wide benefits of being regularly engaged in physical activity to prevent or delay cardiometabolic diseases have been known for decades. However, accurately measuring physical activity in epidemiological research has been challenging as it primarily relied on self-report questionnaires, the limitations of which have been documented in several studies. Indeed, self-report questionnaires often lead to an overestimation of physical activity level when compared with data obtained by accelerometers. In this regard, the UK Biobank is a rich database containing a lot of variables obtained using simple to sophisticated methods, allowing to explore a plethora of research questions. For instance, as an impressive number of participants from the UK Biobank wore an accelerometer, this offered the opportunity to study the relationship between the level of physical activity assessed with this device and incident type 2 diabetes. Two studies have recently reported findings relevant to this question.
In one of the studies published in the May issue of BMC Medicine, the authors have examined the relationship between intensity-specific physical activity and incident type 2 diabetes in a sample of 40,431 UK Biobank participants. They found that irrespective of intensity level, a greater amount of physical activity was associated with a lower risk of developing type 2 diabetes over a 6.3-year follow-up period. Moreover, compared to participants who did not meet the recommendations of at least 150 minutes of moderate-to-vigorous physical activity per week, those who met the recommendations (≥150 minutes/week) delayed their risk of developing type 2 diabetes by 13.5 years and those engaged in ≥600 minutes/week by 37.6 years. Thus, results of this study clearly confirm the benefits of physical activity on reducing/delaying the risk of developing type 2 diabetes even at low dose (≈22 minutes/day), with no plateau observed regarding the dose.
In the second study published in the June issue of Diabetes Care, the association between physical activity energy expenditure and incident type 2 diabetes was investigated in a sample of 90,096 individuals from the UK Biobank followed over a period of 6 years. The investigators observed a 19% lower risk of developing type 2 diabetes per 5 kJ/kg/day increase in physical activity related energy expenditure, this difference being equivalent to an additional 20 minutes of brisk walking every day. Similar findings were obtained in several subgroups. Moreover, the association between physical activity energy expenditure and incident type 2 diabetes was linear.
In conclusion, these two publications shed light on the crucial role played by physical activity as a lifestyle modality to prevent or delay type 2 diabetes. One key message is that there is no evidence of a plateau: the more you move, the lower is your risk to develop type 2 diabetes. These results should support campaigns promoting the key role of physical activity in the prevention of diabetes at the population level.