Staying active could help keep the onset of type 2 diabetes at bay, even if someone has a genetic risk of developing the disease. Researchers say this highlights the importance of exercise in preventing chronic diseases.
Accelerometer-Measured Intensity-Specific Physical Activity, Genetic Risk, and Incident Type 2 Diabetes: A Prospective Cohort Study
Summary Aim Although 30 min/day of moderate-intensity physical activity is suggested to prevent type 2 diabetes (T2D), current recommendations are based exclusively on self-report and rarely consider genetic risk. We examined prospective dose-response relationships between total/intensity-specific physical activity and incidence of T2D that were accounted for and stratified by different levels of genetic risk. Methods This prospective cohort study was based on 59,325 participants in the UK Biobank (mean age = 61.1 years in 2013-2015). Total/intensity-specific physical activity was collected using accelerometers and linked to national records through September 30, 2021. We examined the shape of the dose-response association between physical activity and T2D incidence using restricted cubic splines fitted and stratified by a polygenic risk score (based on 424 selected single nucleotide polymorphisms) using Cox proportional hazards models. Results Over a median follow-up of 6.8 years , there was a strong linear dose-response association between moderate-to-vigorous intensity physical activity (MVPA) and incident T2D, even after adjusting for genetic risk. Compared to less active participants, the HRs (95% CI) for higher levels of MVPA were: 0.63 (0.53 to 0.75) for 5.3 to 25.9 min/day, 0.63 (0.53 to 0.75) for 5.3 to 25.9 min/day, 41 (0.34 to 0.51) for 26.0 to 68.4 min/day and 0.26 (0.18 to 0.38) for >68.4 min/day. While no significant multiplicative interaction was found between physical activity measures and genetic risk, we found a significant additive interaction between MVPA and genetic risk score, suggesting greater absolute risk differences by MVPA levels among those with higher genetic risk. Conclusion Participation in physical activity, particularly in MVPA, should be promoted, especially in those at high genetic risk for T2D. There may be no minimum or maximum threshold for benefits. This finding may inform the development of future guidelines and interventions to prevent T2D. |
Joint association between total and specific intensity physical activity measured by accelerometer and polygenic risk score in incident T2D. All analyzes were based on multivariable Cox proportional hazards models adjusted for age such as underlying time scale, gender, day of total use, seasonality, ethnicity, educational level, household income, Townsend deprivation index, employment status, centers evaluation, smoking, alcohol consumption. , healthy diet score, T2D diagnosis sources, hypertension, dyslipidemia, depression, genotyping matrix, first 10 principal components of ancestry, and LPA or MVPA (MVPA and LPA adjusted for each other, but not for total volume of physical activity ). A polygenic risk score was constructed with 424 selected genome-wide SNPs significantly associated with T2D, and classified into low, intermediate, and high genetic risk groups by tertile. *The y-axis is plotted on a logarithmic scale. LPA, light intensity physical activity; mg, milligravity; MVPA, moderate to vigorous intensity physical activity; P, percentiles; PA, physical activity; SNP, single nucleotide polymorphisms; T2D, type 2 diabetes.
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New research has revealed that being active could reduce the risk of type 2 diabetes, even in people with a high genetic risk of developing the medical condition.
The University of Sydney-led study found that higher levels of total physical activity, especially moderate to vigorous intensity physical activity, had a strong association with a lower risk of developing type 2 diabetes.
The findings were published in the British Journal of Sports Medicine .
Researchers say the study demonstrates that higher levels of physical activity should be promoted as an important strategy for the prevention of type 2 diabetes, which affects millions of Australians.
The study involved 59,325 adults from the UK Biobank, who wore accelerometers (wrist-worn activity trackers) at the start of the study and were then followed for up to seven years to track health outcomes. The UK Biobank is a large-scale biomedical database and research resource containing anonymised genetic, lifestyle and health information from half a million UK participants.
This included genetic markers associated with an increased risk of developing type 2 diabetes. People with a high genetic risk score had a 2.4 times greater risk of developing type 2 diabetes compared to those with a low genetic risk score.
The study showed that more than an hour of moderate to vigorous intensity physical activity per day was associated with a 74 percent lower risk of developing type 2 diabetes compared to participants who did less than 5 minutes of physical activity. This was even when other factors, including genetic risk, were taken into account.
Another compelling finding was that participants with a high genetic risk, but who were in the most physically active category, actually had a lower risk of developing type 2 diabetes compared to those with a low genetic risk but in the least active category. .
Lead author, Associate Professor Melody Ding of the Charles Perkins Center and Faculty of Medicine and Health, says that although the role of genetics and physical activity in the onset of type 2 diabetes is well established, until now most Data were self-reported and there was little evidence whether genetic risk could be counteracted by physical activity.
"We cannot control our genetic risk and family history, but this finding provides promising and positive news that through an active lifestyle, one can ’fight’ much of the excess risk of type 2 diabetes."
Associate Professor Ding says moderate-intensity physical activity describes movements that make you sweaty and a little breathless, such as brisk walking and general gardening.
Examples of vigorous-intensity physical activity include running, aerobic dancing, bicycling uphill or at a fast pace, and heavy yard work, such as digging, all activities that leave you breathless or make you breathe hard.
Study to help inform public health guidelines
Diabetes is a global public health problem. In 2021, there were 537 million adults living with diabetes worldwide. Almost 1.2 million Australians were recorded living with type 2 diabetes in 2020.
The findings also have strong personal meaning for Associate Professor Ding, whose father was recently diagnosed with type 2 diabetes in his sixties.
"My father’s side of the family has a history of type 2 diabetes, so the result of the study is extremely encouraging for my family and I. Since I am already an active person, I now have additional motivation to maintain this style of active life," says Associate. Professor Ding.
"Our hope is that this study will inform clinical and public health guidelines so that it can assist in chronic disease prevention for healthcare professionals, organizations and the public."
"I am delighted to share the results of our research with a wide audience so that people know that physical activity improves health, especially for people at high genetic risk. If you have a family history of type 2 diabetes, or even if you don’t’ t, today is the day to start being physically active," says doctoral candidate Mengyun (Susan) Luo, who led the study.
What is already known about the topic?
The WHO recommends at least 30 min of moderate-intensity physical activity per day for the prevention of type 2 diabetes (T2D). However, such recommendations are based almost exclusively on studies using self-reported measures of physical activity, which are subject to bias. The dose-response association between device-measured physical activity, particularly low-intensity physical activity, and T2D is rarely explored. Furthermore, while genetics play an important role in the onset of T2D, the interaction between genetic risk and physical activity in T2D is less known.
What does the study provide?
First, there was a strong linear inverse dose-response association between accelerometer-measured physical activity and type 2 diabetes, even when adjusting for genetic risk. The magnitude of the association appeared greater than in studies that used self-reported physical activity.
Second, this association was strongest for moderate-to-vigorous-intensity physical activity (MVPA), while the association with light-intensity physical activity was weak and inconsistent.
Third, we did not find a multiplicative interaction between physical activity and genetic risk, but a significant additive interaction with MVPA. The association between total physical activity/MVPA and T2D was similar across genetic risk strata, but the absolute risk reduction for MVPA was greater for those at high genetic risk.
How it can affect clinical practice and health policy
In contrast to existing evidence based primarily on self-reported physical activity, our findings imply that there may be no threshold for the “optimal amount” of physical activity for T2D prevention and that the association may be stronger than previously estimated. . These findings may inform the development of future guidelines and interventions to prevent T2D. Physical activity, specifically MVPA, is beneficial, especially in those at high genetic risk, and should be promoted as a priority strategy for the prevention of T2D.
