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IJE Advance Access originally published online on September 19, 2006
International Journal of Epidemiology 2006 35(6):1553-1562; doi:10.1093/ije/dyl209
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2006; all rights reserved.

Article

Physical activity and the incidence of type 2 diabetes in the Shanghai women's health study

Raquel Villegas1, Xiao-Ou Shu1,*, Honglan Li2, Gong Yang1, Charles E Matthews1, Michael Leitzmann3, Qi Li2, Hui Cai1, Yu-Tang Gao2 and Wei Zheng1

1 Department of Medicine, Vanderbilt Epidemiology Center Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
2 Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China.
3 Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA.

* Corresponding author. Center for Health Services Research, 6009 Medical Center East, Vanderbilt University, Nashville TN 37232-8300, USA. E-mail: xiao-ou.shu{at}vanderbilt.edu


  Abstract

Background Leisure-time physical activity (LPA) has been associated with a reduced risk of type 2 diabetes. However, the potential effect of other types of physical activity on type 2 diabetes is still uncertain. The aim of this study was to examine the effect of occupational, commuting, daily living, and LPA on the incidence of type 2 diabetes in a cohort of middle-aged women.

Methods We prospectively followed 70 658 women who had no prior history of diabetes at study recruitment for 4.6 years. Participants completed in-person interviews at baseline that collected information on diabetes risk factors including physical activity habits. Anthropometric measurements were taken by trained interviewers. Multivariate-adjusted hazard ratios were estimated by levels of occupational, commuting, daily living, and LPA.

Results We documented 1973 incident cases of diabetes during 326 625 person-years of follow-up. LPA and daily living physical activity (DPA) were associated with a moderately reduced risk of type 2 diabetes. The relative risk for type 2 diabetes associated with LPA and DPA categories were 1.00, 0.89, 1.05, and 0.83, (P trend = 0.12) and 1.00, 0.98, 0.95, and 0.88, (P trend = 0.06) respectively. LPA was associated with lower risk of type 2 diabetes in employed participants (P trend = 0.09) while DPA was mainly associated with a reduction in risk in non-employed participants (P trend <0.01). While occupational physical activity was not associated with type 2 diabetes risk in this population, commuting to work was associated with a reduction in risk. A combination of DPA and LPA was associated with a reduced risk of type 2 diabetes.

Conclusions This study suggests that physical activity, either from leisure-time exercise or daily activity reduces the risk of type 2 diabetes in women, supporting the current health promotion efforts encouraging both exercise and non-exercise activity levels.

Keywords occupational, daily living leisure, commuting physical activity, type 2 diabetes

Accepted 23 August 2006


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