Leisure time physical activity and the risk of type 2 diabetes in men and women from the general population

Aims/hypothesis: The aim of this study was to examine sex- specific associations between leisure time physical activity and incident type 2 diabetes in a representative population sample in Germany. Methods: The study was based on 4,069 men and 4,034 women ( aged 25 to 74 years) who participated in one of the three MONICA Augsburg surveys between 1984 and 1995. Subjects were free of diabetes at baseline. Incident cases of type 2 diabetes were assessed in 1998 using a follow- up questionnaire. Sex-specific hazard ratios (HRs) were estimated from Cox proportional hazard models. Results: A total of 145 cases of incident type 2 diabetes among men and 82 among women were registered during the mean follow- up period of 7.4 years. In both sexes, a high leisure time physical activity level was associated with a reduced risk of incident type 2 diabetes. After adjustment for confounding factors, the HR in highly active men ( more than 2 h physical activity per week in summer and winter) was 0.83 ( 95% CI: 0.50 - 1.36). In contrast, highly active women had the lowest risk of type 2 diabetes even after multivariable adjustment ( HR 0.24; 95% CI: 0.06 - 0.98). In subgroup analyses, after multivariable adjustment, the protective effect of moderate to high physical activity was significant in women with a BMI below 30 kg/ m2 ( HR 0.24; 95% CI: 0.09 - 0.65) but not in women with a BMI of 30 kg/ m2 or higher ( HR 0.97; 95% CI: 0.44 - 2.11). Conclusions/ interpretation: Leisure time physical activity is effective in preventing type 2 diabetes, especially in nonobese women, in the general population.