Modest Levels of Physical Activity Are Associated With a Lower Incidence of Diabetes in a Population With a High Rate of Obesity

The Strong Heart Family Study

  1. David S. Siscovick, MD6
  1. 1Department of Epidemiology, University of Washington, Seattle, Washington
  2. 2MedStar Health Research Institute, Washington, District of Columbia
  3. 3Georgetown and Howard Universities Center for Translational Science, Washington, District of Columbia
  4. 4Department of Biostatistics, University of Washington, Seattle, Washington
  5. 5Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania
  6. 6Departments of Medicine and Epidemiology, Cardiovascular Health Research Unit, University of Washington, Seattle, Washington
  1. Corresponding author: Amanda M. Fretts, amfretts{at}


OBJECTIVE To examine the association of objectively measured participation in low levels of physical activity with incident type 2 diabetes.

RESEARCH DESIGN AND METHODS The study population included participants free of diabetes and cardiovascular disease at baseline (n = 1,826) who participated in a follow-up examination. Generalized estimating equations were used to examine the association of steps per day with incident diabetes.

RESULTS During 5 years of follow-up, 243 incident cases of diabetes were identified. When compared with participants in the lowest quartile of steps per day (<3,500 steps), participants in the upper three quartiles of steps per day had lower odds for diabetes, consistent with a threshold effect. Contrasting the three upper quartiles with the lowest quartile, the odds ratio of diabetes was 0.71 (95% CI 0.51–0.98).

CONCLUSIONS Modest levels of physical activity are associated with a lower risk of incident diabetes, compared with lower levels of activity.

  • Received November 30, 2011.
  • Accepted April 1, 2012.

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