Physical activity and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis
Abstract
We investigated the association between specific types of physical activity and the risk of type 2 diabetes in a systematic review and meta-analysis of published studies. PubMed, Embase and Ovid databases were searched for prospective studies and randomized trials up to 2nd of March 2015. Summary relative risks (RRs) were calculated using a random effects model. Eighty-one studies were included. The summary RRs for high versus low activity were 0.65 (95 % CI 0.59-0.71, I(2) = 18 %, n = 14) for total physical activity, 0.74 (95 % CI 0.70-0.79, I(2) = 84 %, n = 55) for leisure-time activity, 0.61 (95 % CI 0.51-0.74, I(2) = 73 %, n = 8) for vigorous activity, 0.68 (95 % CI 0.52-0.90, I(2) = 93 %, n = 5) for moderate activity, 0.66 (95 % CI 0.47-0.94, I(2) = 47 %, n = 4) for low intensity activity, and 0.85 (95 % CI 0.79-0.91, I(2) = 0 %, n = 7) for walking. Inverse associations were also observed for increasing activity over time, resistance exercise, occupational activity and for cardiorespiratory fitness. Nonlinear relations were observed for leisure-time activity, vigorous activity, walking and resistance exercise (p nonlinearity < 0.0001 for all), with steeper reductions in type 2 diabetes risk at low activity levels than high activity levels. This meta-analysis provides strong evidence for an inverse association between physical activity and risk of type 2 diabetes, which may partly be mediated by reduced adiposity. All subtypes of physical activity appear to be beneficial. Reductions in risk are observed up to 5-7 h of leisure-time, vigorous or low intensity physical activity per week, but further reductions cannot be excluded beyond this range.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The meta-analysis included 20 articles (22 independent studies), comprising 40,485 pregnant women and 4402 gestational diabetes mellitus participants.
“The initial search yielded 4368 relevant articles in the database. Following the elimination of 4348 ineligible articles, 20 articles were ultimately included (a total of 22 independent studies), which included 40,485 pregnant women and 4402 GDM participants [10, 14, 16–18, 28–42].”
From Physical activity during pregnancy and the risk of gestational diabetes mellitus: a systematic review and dose–response meta-analysis (2024) · cites this paper as [14]
Risk factors for type 2 diabetes include overweight and obesity, physical inactivity, age, family history, race and ethnicity, history of gestational diabetes, and presence of other conditions (eg, hypertension, dyslipidemia, cardiovascular disease).
“Risk factors for type 2 diabetes include overweight and obesity, physical inactivity, age, family history, race and ethnicity, history of gestational diabetes, and presence of other conditions (eg, hypertension, dyslipidemia, cardiovascular disease).9–14”
From Diagnosis and Treatment of Type 2 Diabetes in Adults (2025) · cites this paper as [9]
Physical activity is an effective regimen to lower the risk of developing diabetes by improving β-cell function.
“Several studies have demonstrated that physical activity is an effective regimen to lower the risk of developing diabetes by improving the β-cell function (172).”
From Diabetes and Sarcopenic Obesity: Pathogenesis, Diagnosis, and Treatments (2020) · cites this paper as [172]
Lack of physical activity is a risk factor for ASCVD such as CAD and cerebrovascular disease.
“It is also a risk factor for ASCVD such as CAD and cerebrovascular disease577–587).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [577]
Lack of physical activity is associated with increased body fat (obesity), dyslipidemia, metabolic syndrome, hypertension, diabetes/impaired glucose tolerance, vascular endothelial dysfunction, and decreased physical fitness.
“Lack of physical activity is associated with increased body fat (obesity), dyslipidemia, metabolic syndrome, hypertension, diabetes/impaired glucose tolerance, vascular endothelial dysfunction, and decreased physical fitness.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [577]
Six of the 8 reports of systematic review and meta-analysis reported a significant increase in HDL-C levels.
“Six reported a significant increase in HDL-C levels, which was the most frequently observed effect of exercise on serum lipids577, 607–613).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [577]
Among 8 reports of systematic review and meta-analysis of RCTs comparing exercise and non-exercise control, significant decreases in LDL-C and TG levels were reported in two articles, respectively.
“Among 8 reports of systematic review and metaanalysis of RCTs with comparison of exercise and non-exercise control including Japanese participants and were published after 2,000, significant decreases in LDL-C and TG levels were reported in two articles, respectively.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [577]
Evidence suggests that low-intensity physical activity may be similarly as effective as moderate to intense physical activity in preventing type 2 diabetes mellitus.
“Moreover, evidence suggests that low-intensity physical activity may be similarly as effective as moderate to intense physical activity in preventing type 2 diabetes mellitus,360 which is a concern in nondiabetic adults with RH.”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [360]
Cites
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722 · see citing works
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552 · see citing works
Quantifying heterogeneity in a meta‐analysis
Higgins, J. P. T., & Thompson, S. G. (2002) · Statistics in Medicine · doi:10.1002/sim.1186 · Cited by 36,763 · see citing works
Dermyshi, E., Wang, Y., Yan, C., Hong, W., Qiu, G., Gong, X., & Zhang, T. (2017) · Neonatology · doi:10.1159/000454668 · Cited by 24,577 · see citing works
Stroup, D. F. (2000) · JAMA · doi:10.1001/jama.283.15.2008 · Cited by 20,623 · see citing works
(2014) · Medical Entomology and Zoology · Cited by 17,633 · see citing works
IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040
Ogurtsova, K., Fernandes, J. D. D. R., Huang, Y., Linnenkamp, U., Guariguata, L., Cho, N. H., Cavan, D. A., Shaw, J. E., & Makaroff, L. (2017) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2017.03.024 · Cited by 6,977 · see citing works
2011 Compendium of Physical Activities: A Second Update of Codes and MET Values
AINSWORTH, B. E., HASKELL, W. L., HERRMANN, S. D., MECKES, N., BASSETT, D. R., TUDOR-LOCKE, C., GREER, J. L., VEZINA, J., WHITT-GLOVER, M. C., & LEON, A. S. (2011) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31821ece12 · Cited by 6,317 · see citing works
Pan, X.-R., Li, G.-W., Hu, Y.-H., Wang, J.-X., Yang, W.-Y., An, Z.-X., Hu, Z.-X., Juan-Lin, Xiao, J.-Z., Cao, H.-B., et al. (1997) · Diabetes Care · doi:10.2337/diacare.20.4.537 · Cited by 4,320 · see citing works
IDF Diabetes Atlas: Global estimates of the prevalence of diabetes for 2011 and 2030
Whiting, D. R., Guariguata, L., Weil, C., & Shaw, J. E. (2011) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2011.10.029 · Cited by 3,994 · see citing works
Diet, lifestyle, and the risk of type 2 diabetes mellitus in women.
Hu, F. B., Manson, J. E., Stampfer, M. J., Colditz, G., Liu, S., Solomon, C. G., & Willett, W. C. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa010492 · Cited by 2,901 · see citing works
Changes in diet and lifestyle and long-term weight gain in women and men
Mozaffarian, D., Hao, T., Rimm, E. B., Willett, W. C., & Hu, F. B. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1014296 · Cited by 2,527 · see citing works
Methods for Trend Estimation from Summarized Dose-Response Data, with Applications to Meta-Analysis
Greenland, S., & Longnecker, M. P. (1992) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116237 · Cited by 2,353 · see citing works
Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, B. J., Rubin, R. R., Chasan-Taber, L., Albright, A. L., & Braun, B. (2010) · Diabetes Care · doi:10.2337/dc10-9990 · Cited by 1,955 · see citing works
Boulé, N. G., Haddad, E., Kenny, G. P., Wells, G. A., & Sigal, R. J. (2001) · JAMA · doi:10.1001/jama.286.10.1218 · Cited by 1,889 · see citing works
Lindström, J., Ilanne-Parikka, P., Peltonen, M., Aunola, S., Eriksson, J. G., Hemiö, K., Hämäläinen, H., Härkönen, P., Keinänen-Kiukaanniemi, S., Laakso, M., et al. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69701-8 · Cited by 1,799 · see citing works
Physical activity and reduced occurrence of non–insulin-dependent diabetes mellitus
Helmrich, S. P., Ragland, D. R., Leung, R. W., & Paffenbarger, R. S. (1991) · New England Journal of Medicine · doi:10.1056/nejm199107183250302 · Cited by 1,634 · see citing works
Li, G., Zhang, P., Wang, J., Gregg, E. W., Yang, W., Gong, Q., Li, H., Li, H., Jiang, Y., An, Y., et al. (2008) · The Lancet · doi:10.1016/s0140-6736(08)60766-7 · Cited by 1,600 · see citing works
Orsini, N., Li, R., Wolk, A., Khudyakov, P., & Spiegelman, D. L. (2011) · American Journal of Epidemiology · doi:10.1093/aje/kwr265 · Cited by 1,276 · see citing works
Physical activity and incidence of non-insulin-dependent diabetes mellitus in women
Manson, J. E., Stampfer, M. J., Colditz, G. A., Willett, W. C., Rosner, B., Hennekens, C. H., Speizer, F. E., Rimm, E. B., & Krolewski, A. S. (1991) · The Lancet · doi:10.1016/0140-6736(91)90664-b · Cited by 1,164 · see citing works
Hu, F. B., Sigal, R. J., Rich-Edwards, J. W., Colditz, G. A., Solomon, C. G., Willett, W. C., Speizer, F. E., & Manson, J. E. (1999) · JAMA · doi:10.1001/jama.282.15.1433 · Cited by 914 · see citing works
Physical Activity and Television Watching in Relation to Risk for Type 2 Diabetes Mellitus in Men
Hu, F. B., Leitzmann, M. F., Stampfer, M. J., Colditz, G. A., Willett, W. C., & Rimm, E. B. (2001) · Archives of Internal Medicine · doi:10.1001/archinte.161.12.1542 · Cited by 828 · see citing works
Self-citationNilssen, O., Førde, O. H., & Brenn, T. (1990) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115661 · Cited by 816 · see citing works
Physical Activity of Moderate Intensity and Risk of Type 2 Diabetes
Jeon, C. Y., Lokken, R. P., Hu, F. B., & van Dam, R. M. (2007) · Diabetes Care · doi:10.2337/dc06-1842 · Cited by 758 · see citing works
Perseghin, G., Price, T. B., Petersen, K. F., Roden, M., Cline, G. W., Gerow, K., Rothman, D. L., & Shulman, G. I. (1996) · New England Journal of Medicine · doi:10.1056/nejm199610313351804 · Cited by 699 · see citing works
[The Da Qing IGT and Diabetes study].
Ayame, H. (2005) · PubMed · Cited by 658 · see citing works
Hamling, J., Lee, P. N., Weitkunat, R., & Ambühl, M. (2007) · Statistics in Medicine · doi:10.1002/sim.3013 · Cited by 649 · see citing works
Physical Activity in the Prevention of Type 2 Diabetes
Laaksonen, D. E., Lindström, J., Lakka, T. A., Eriksson, J. G., Niskanen, L., Wikström, K., Aunola, S., Keinänen-Kiukaanniemi, S., Laakso, M., Valle, T. T., et al. (2005) · Diabetes · doi:10.2337/diabetes.54.1.158 · Cited by 614 · see citing works
Intensity and Amount of Physical Activity in Relation to Insulin Sensitivity
Mayer-Davis, E. J. (1998) · JAMA · doi:10.1001/jama.279.9.669 · Cited by 598 · see citing works
Extending DerSimonian and Laird's methodology to perform multivariate random effects meta‐analyses
Jackson, D., White, I. R., & Thompson, S. G. (2009) · Statistics in Medicine · doi:10.1002/sim.3602 · Cited by 591 · see citing works
Vegetarian diets and incidence of diabetes in the Adventist Health Study-2
Tonstad, S., Stewart, K., Oda, K., Batech, M., Herring, R. P., & Fraser, G. E. (2013) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2011.07.004 · Cited by 442 · see citing works
Relationship of Physical Activity vs Body Mass Index With Type 2 Diabetes in Women
Weinstein, A. R. (2004) · JAMA · doi:10.1001/jama.292.10.1188 · Cited by 420 · see citing works
Hu, G., Qiao, Q., Silventoinen, K., Eriksson, J. G., Jousilahti, P., Lindström, J., Valle, T. T., Nissinen, A. M., & Tuomilehto, J. O. (2003) · Diabetologia · doi:10.1007/s00125-003-1031-x · Cited by 380 · see citing works
Meena Kumari, B., Head, J. A., & Marmot, M. G. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.17.1873 · Cited by 378 · see citing works
Schulze, M. B., Hoffmann, K., Boeing, H., Linseisen, J., Rohrmann, S., Möhlig, M., Pfeiffer, A. F. H., Spranger, J., Thamer, C., Häring, H., et al. (2007) · Diabetes Care · doi:10.2337/dc06-2089 · Cited by 374 · see citing works
Mozaffarian, D., Kamineni, A., Carnethon, M., Djoussé, L., Mukamal, K. J., & Siscovick, D. (2009) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.21 · Cited by 358 · see citing works
Lynch, J. (1996) · Archives of Internal Medicine · doi:10.1001/archinte.1996.00440110073010 · Cited by 354 · see citing works
Montgomery, M. P., Kamel, F., Saldana, T. M., Alavanja, M. C. R., & Sandler, D. P. (2008) · American Journal of Epidemiology · doi:10.1093/aje/kwn028 · Cited by 325 · see citing works
Incidence of Diabetes in Middle-Aged Men Is Related to Sleep Disturbances
Nilsson, P. M., Rööst, M., Engström, G., Hedblad, B., & Berglund, G. (2004) · Diabetes Care · doi:10.2337/diacare.27.10.2464 · Cited by 322 · see citing works
Haapanen, N., Miilunpalo, S. I., VUORI, I. M., Oja, P., & Pasanen, M. E. (1997) · International Journal of Epidemiology · doi:10.1093/ije/26.4.739 · Cited by 311 · see citing works
Population-Based Incidence Rates and Risk Factors for Type 2 Diabetes in White Individuals
Bonora, E., Kiechl, S. J., Willeit, J., Oberhollenzer, F., Egger, G., Meigs, J. B., Bonadonna, R. C., & Muggeo, M. (2004) · Diabetes · doi:10.2337/diabetes.53.7.1782 · Cited by 270 · see citing works
Physical Activity, Obesity, and the Incidence of Type 2 Diabetes in a High-Risk Population
Kriska, A. M. (2003) · American Journal of Epidemiology · doi:10.1093/aje/kwg191 · Cited by 259 · see citing works
Physical Activity and the Risk of Preeclampsia: A Systematic Review and Meta-Analysis
Aune, D., Saugstad, O. D., Henriksen, T., & Tonstad, S. (2014) · Epidemiology · doi:10.1097/ede.0000000000000036 · Cited by 244 · see citing works
Self-citationRisk due to inactivity in physically capable older adults.
Simonsick, E. M., Lafferty, M. E., Phillips, C. L., Mendes de Leon, C. F., Kasl, S. V., Seeman, T. E., Fillenbaum, G., Hebert, P., & Lemke, J. H. (1993) · American Journal of Public Health · doi:10.2105/ajph.83.10.1443 · Cited by 242 · see citing works
Wannamethee, S. G., Shaper, A. G., & Alberti, K. G. M. M. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.14.2108 · Cited by 239 · see citing works
A strategy for modelling the effect of a continuous covariate in medicine and epidemiology.
Royston, P. (2000) · Statistics in Medicine · doi:10.1002/1097-0258(20000730)19:14 · Cited by 234 · see citing works
Signaling mechanisms in skeletal muscle: acute responses and chronic adaptations to exercise
Röckl, K. S. C., Witczak, C. A., & Goodyear, L. J. (2008) · IUBMB Life · doi:10.1002/iub.21 · Cited by 222 · see citing works
Glucose Indices, Health Behaviors, and Incidence of Diabetes in Australia
Magliano, D. J., Barr, E., Zimmet, P., Cameron, A. J., Dunstan, D. W., Colagiuri, S., Jolley, D., Owen, N. G., Phillips, P., Tapp, R. J., et al. (2008) · Diabetes Care · doi:10.2337/dc07-0912 · Cited by 210 · see citing works
Meisinger, C., L�wel, H., Thorand, B., & D�ring, A. (2005) · Diabetologia · doi:10.1007/s00125-004-1604-3 · Cited by 209 · see citing works
Adiposity Compared With Physical Inactivity and Risk of Type 2 Diabetes in Women
Rana, J. S., Li, T. Y., Manson, J. E., & Hu, F. B. (2006) · Diabetes Care · doi:10.2337/dc06-1456 · Cited by 201 · see citing works
Physical Activity and Incidence of Diabetes: The Honolulu Heart Program
Burchfiel, C. M., Sharp, D. S., Curb, J. D., Rodríguez, B. L., Hwang, L.-J., Marcus, E. B., & Yano, K. (1995) · American Journal of Epidemiology · doi:10.1093/aje/141.4.360 · Cited by 197 · see citing works
Elwood, P., Galante, J., Pickering, J. E., Palmer, S., Bayer, A. J., Ben‐Shlomo, Y., Longley, M. J., & Gallacher, J. (2013) · PLoS ONE · doi:10.1371/journal.pone.0081877 · Cited by 196 · see citing works
A Prospective Study of Weight Training and Risk of Type 2 Diabetes Mellitus in Men
Grøntved, A., Rimm, E. B., Willett, W. C., Andersen, L. B., & Hu, F. B. (2012) · Archives of Internal Medicine · doi:10.1001/archinternmed.2012.3138 · Cited by 192 · see citing works
A prospective study of cardiorespiratory fitness and risk of type 2 diabetes in women
Sui, X., Hooker, S. P., Lee, I.-M., Church, T. S., Colabianchi, N., Lee, C.-D., & Blair, S. N. (2008) · Diabetes Care · doi:10.2337/dc07-1870 · Cited by 185 · see citing works
Rathmann, W., Straßburger, K., Heier, M., Holle, R., Thorand, B., Giani, G., & Meisinger, C. (2009) · Diabetic Medicine · doi:10.1111/j.1464-5491.2009.02863.x · Cited by 181 · see citing works
Waki, K., Noda, M., Sasaki, S., Matsumura, Y., Takahashi, Y., Isogawa, A., Ohashi, Y., Kadowaki, T., Tsugane, S., & for the JPHC Study Group (2005) · Diabetic Medicine · doi:10.1111/j.1464-5491.2004.01403.x · Cited by 170 · see citing works
Stringhini, S., Tabák, Á. G., Akbaraly, T. N., Sabia, S., Shipley, M. J., Marmot, M. G., Brunner, E. J., Batty, G. D., Bovet, P., & Mika Kivimaki, B. (2012) · BMJ · doi:10.1136/bmj.e5452 · Cited by 163 · see citing works
Demakakos, P., Hamer, M., Stamatakis, E. A., & Steptoe, A. (2010) · Diabetologia · doi:10.1007/s00125-010-1785-x · Cited by 160 · see citing works
Physical activity and incident diabetes mellitus in postmenopausal women
Folsom, A. R., Kushi, L. H., & Hong, C. P. (2000) · American Journal of Public Health · doi:10.2105/ajph.90.1.134 · Cited by 155 · see citing works
Grøntved, A., Pan, A., Mekary, R. A., Stampfer, M. J., Willett, W. C., Manson, J. E., & Hu, F. B. (2014) · PLoS Medicine · doi:10.1371/journal.pmed.1001587 · Cited by 150 · see citing works
Krishnan, S., Rosenberg, L., & Palmer, J. R. (2008) · American Journal of Epidemiology · doi:10.1093/aje/kwn344 · Cited by 149 · see citing works
Walking Versus Running for Hypertension, Cholesterol, and Diabetes Mellitus Risk Reduction
Williams, P. T., & Thompson, P. D. (2013) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.112.300878 · Cited by 146 · see citing works
lstad, I. N., Amesen, E., & Lund‐Larsen, P. G. (1998) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009366 · Cited by 146 · see citing works
Shi, L., Shu, X., Li, H., Cai, H., Liu, Q., Zheng, W., Xiang, Y., & Villegas, R. (2013) · PLoS ONE · doi:10.1371/journal.pone.0077919 · Cited by 139 · see citing works
Lifestyle Factors and Risk for New-Onset Diabetes
Reis, J. P., Loria, C. M., Sorlie, P. D., Park, Y., Hollenbeck, A. R., & Schatzkin, A. G. (2011) · Annals of Internal Medicine · doi:10.7326/0003-4819-155-5-201109060-00006 · Cited by 126 · see citing works
Physical Activity and Life Expectancy With and Without Diabetes
Jonker, J. T., Laet, C. E. D. H. D., Franco, O. H., Peeters, A., Mackenbach, J. P., & Nusselder, W. J. (2006) · Diabetes Care · doi:10.2337/diacare.29.01.06.dc05-0985 · Cited by 124 · see citing works
Adiposity, physical fitness and incident diabetes: the physical activity longitudinal study
Katzmarzyk, P. T., Craig, C. L., & Gauvin, L. I. (2007) · Diabetologia · doi:10.1007/s00125-006-0554-3 · Cited by 123 · see citing works
Sieverdes, J. C., Sui, X., Lee, D.-C., Church, T. S., McClain, A. C., Hand, G. A., & Blair, S. N. (2009) · British Journal of Sports Medicine · doi:10.1136/bjsm.2009.062117 · Cited by 118 · see citing works
Nilsen, T. I. L., Romundstad, P., & VATTEN, L. J. (2006) · International Journal of Cancer · doi:10.1002/ijc.22184 · Cited by 116 · see citing works
Self-citationDotevall, A., Johansson, S., Wilhelmsen, L., & Rosengren, A. (2004) · Diabetic Medicine · doi:10.1111/j.1464-5491.2004.01189.x · Cited by 115 · see citing works
Smoking and Risk for Diabetes Incidence and Mortality in Korean Men and Women
Jee, S. H., Foong, A. W. P., Hur, N. W., & Samet, J. M. (2010) · Diabetes Care · doi:10.2337/dc10-0261 · Cited by 113 · see citing works
Kawakami, N., Takatsuka, N., Shimizu, H., & Ishibashi, H. (1997) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009080 · Cited by 110 · see citing works
Patja, K., Jousilahti, P., Hu, G., Valle, T. T., Qiao, Q., & Tuomilehto, J. O. (2005) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2005.01545.x · Cited by 103 · see citing works
Okada, K., Hayashi, T., Tsumura, K., Suematsu, C., Endo, G., & Fujii, S. (2000) · Diabetic Medicine · doi:10.1046/j.1464-5491.2000.00229.x · Cited by 102 · see citing works
Laaksonen, M. A., Knekt, P., Rissanen, H. A., Härkänen, T., Virtala, E. T., Marniemi, J., Aromaa, A., Heliövaara, M., & Reunanen, A. (2009) · European Journal of Epidemiology · doi:10.1007/s10654-009-9405-0 · Cited by 93 · see citing works
The InterAct Consortium (614230) (2012) · Diabetologia · doi:10.1007/s00125-012-2532-2 · Cited by 91 · see citing works
Carlsson, S., Midthjell, K., Tesfamarian, M. Y., & Grill, V. (2006) · Diabetologia · doi:10.1007/s00125-006-0518-7 · Cited by 91 · see citing works
Physical activity and diabetes risk in postmenopausal women
Hsia, J. A., Wu, L., Allen, C. I., Oberman, A., Lawson, W. E., Torréns, J. I., Safford, M. M., Limacher, M. C., & Howard, B. V. (2004) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2004.09.012 · Cited by 91 · see citing works
Sex Difference in Lifestyle Factors Predictive of Diabetes in Mexican-Americans
Monterrosa, A., Haffner, S. M., D, M. P. S. M., & Hazuda, H. P. (1995) · Diabetes Care · doi:10.2337/diacare.18.4.448 · Cited by 75 · see citing works
Physical activity and the incidence of type 2 diabetes in the Shanghai women's health study
Villegas, R., Shu, X.-O., Li, H., Yang, G., Matthews, C. E., Leitzmann, M., Li, Q., Cai, H., Gao, Y.-T., & Zheng, W. (2006) · International Journal of Epidemiology · doi:10.1093/ije/dyl209 · Cited by 72 · see citing works
Self-citationHolme, I., Tonstad, S., Søgaard, A. J., Larsen, P. G. L., & Håheim, L. L. (2007) · BMC Public Health · doi:10.1186/1471-2458-7-154 · Cited by 72 · see citing works
Self-citationLong-Term Trends in Cardiorespiratory Fitness and the Incidence of Type 2 Diabetes
Sawada, S. S., Lee, I.-M. M., Naıto, H., Noguchi, J., Tsukamoto, K., Muto, T., Higaki, Y., Tanaka, H., & Blair, S. N. (2010) · Diabetes Care · doi:10.2337/dc09-1654 · Cited by 69 · see citing works
Sun, F., Tao, Q., & Zhan, S. (2009) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2009.05.005 · Cited by 67 · see citing works
Physical Activity and Incident Diabetes in American Indians: The Strong Heart Study
Fretts, A. M., Howard, B. V., Kriska, A. M., Smith, N., Lumley, T., Lee, E. T., Russell, M., & Siscovick, D. S. (2009) · American Journal of Epidemiology · doi:10.1093/aje/kwp181 · Cited by 66 · see citing works
Walking to Work Is an Independent Predictor of Incidence of Type 2 Diabetes in Japanese Men
Satō, K., Hayashi, T., Kambe, H., Nakamura, Y., Harita, N., Endo, G., & Yoneda, T. (2007) · Diabetes Care · doi:10.2337/dc07-0090 · Cited by 64 · see citing works
Two risk score models for predicting incident Type 2 diabetes in Japan
Doi, Y., Ninomiya, T., Hata, J., Hirakawa, Y., Mukai, N., Iwase, M., & Kiyohara, Y. (2011) · Diabetic Medicine · doi:10.1111/j.1464-5491.2011.03376.x · Cited by 60 · see citing works
Leisure-time physical activity and type 2 diabetes during a 28 year follow-up in twins
Waller, K. L., Kaprio, J. A., Lehtovirta, M., Silventoinen, K., Koskenvuo, M., & Kujala, U. M. (2010) · Diabetologia · doi:10.1007/s00125-010-1875-9 · Cited by 58 · see citing works
Incidence of and risk factors for type-2 diabetes in a general population: The Tromsø Study
Joseph, J., Svartberg, J. B., Njølstad, I., & Schirmer, H. (2010) · Scandinavian Journal of Public Health · doi:10.1177/1403494810380299 · Cited by 57 · see citing works
Longo‐Mbenza, B., On'kin, J. B. K. L., Okwe, A. N., Kabangu, N. K., & Fuele, S. M. (2009) · Diabetes and Vascular Disease Research · doi:10.1177/1479164109346362 · Cited by 56 · see citing works
Jefferis, B. J. M. H., Whincup, P. H., LENNON, L. T., & Wannamethee, S. G. (2012) · Diabetes Care · doi:10.2337/dc11-2280 · Cited by 55 · see citing works
Mehlig, K., Skoog, I. G., Wærn, M., Jonasson, J. M., Lapidus, L., Björkelund, C., Östling, S., & Lissner, L. (2014) · Neuroepidemiology · doi:10.1159/000362201 · Cited by 52 · see citing works
Pronk, N. P., Lowry, M., Kottke, T. E., Austin, E. E., Gallagher, J. M., & Katz, A. S. (2010) · Population Health Management · doi:10.1089/pop.2009.0075 · Cited by 51 · see citing works
Physical Activity, Body Mass Index, and Diabetes Risk in Men: A Prospective Study
Siegel, L. C., Sesso, H. D., Bowman, T. S., Lee, I.-M. M., Manson, J. E., & Gaziano, J. M. (2009) · The American Journal of Medicine · doi:10.1016/j.amjmed.2009.02.008 · Cited by 50 · see citing works
Nakanishi, N., Takatorige, T., & Suzuki, K. (2004) · Diabetologia · doi:10.1007/s00125-004-1528-y · Cited by 44 · see citing works
Lee, D.-C., Park, I., Jun, T.-W., Nam, B., Cho, S., Blair, S. N., & Kim, Y. S. (2012) · American Journal of Epidemiology · doi:10.1093/aje/kwr471 · Cited by 44 · see citing works
Fossum, E., Gleim, G. W., Kjeldsen, S. E., Kizer, J. R., Julius, S., Devereux, R. B., Brady, W. E., Hille, D. A., Lyle, P. A., & Dahlöf, B. (2007) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2007.01808.x · Cited by 42 · see citing works
10-year Incidence of Diabetes and Associated Risk Factors in Greece: the ATTICA study (2002-2012)
Koloverou, E., Panagiotakos, D. B., Pitsavos, C. E., Chrysohoou, C. A., Georgousopoulou, E. N., Pitaraki, E., Metaxa, V., & Stefanadis, C. (2014) · The Review of Diabetic Studies · doi:10.1900/rds.2014.11.181 · Cited by 38 · see citing works
Shirom, A., Toker, S., Jacobson, O., & Balicer, R. D. (2010) · Psychosomatic Medicine · doi:10.1097/psy.0b013e3181eeb643 · Cited by 37 · see citing works
Engberg, S., Glümer, C., Witte, D. R., Jørgensen, T., & Borch‐Johnsen, K. (2009) · Diabetologia · doi:10.1007/s00125-009-1587-1 · Cited by 35 · see citing works
Physical Activity Level and Incident Type 2 Diabetes among Chinese Adults
Fan, S., Chen, J., Huang, J., Li, Y., Zhao, L., Liu, X., Li, J., Cao, J., Yu, L., Deng, Y., et al. (2014) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000471 · Cited by 33 · see citing works
Lucke, J. C., Waters, B., Hockey, R., et al. (2007) · Women s Health · doi:10.2217/17455057.3.4.423 · Cited by 32 · see citing works
Steinbrecher, A., Erber, E., Grandinetti, A., Nigg, C. R., Kolonel, L. N., & Maskarinec, G. (2012) · Journal of Physical Activity and Health · doi:10.1123/jpah.9.5.634 · Cited by 31 · see citing works
Sports activity and risk of type 2 diabetes in Chinese.
Chien, K., Chen, M.-F., Hsu, H., Su, T., & Lee, Y.-T. (2009) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2009.03.006 · Cited by 31 · see citing works
Burke, V., Zhao, Y., Lee, A. H., Hunter, E. M., Spargo, R. M., Gracey, M. S., Smith, R. M., Beilin, L. J., & Puddey, I. B. (2007) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2007.04.007 · Cited by 30 · see citing works
Association of Cardiorespiratory Fitness and Overweight with Risk of Type 2 Diabetes in Japanese Men
Kuwahara, K., Uehara, A., Kurotani, K., Pham, N. M., Nanri, A., Yamamoto, M., & Mizoue, T. (2014) · PLoS ONE · doi:10.1371/journal.pone.0098508 · Cited by 26 · see citing works
Five-year predictive factors of type 2 diabetes in men with impaired fasting glucose.
Lecomte, P., Vol, S., Cacès, E., Born, C., Chabrolle, C., Lasfargues, G., Halimi, J., & Tichet, J. (2007) · Diabetes & Metabolism · doi:10.1016/j.diabet.2006.11.009 · Cited by 25 · see citing works
Someya, Y., Kawai, S., Kohmura, Y., Aoki, K., & Daida, H. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-493 · Cited by 24 · see citing works
Jacobsen, B. K., Bønaa, K. H., & Njølstad, I. (2002) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(02)00404-3 · Cited by 23 · see citing works
Determinants of new-onset diabetes in older adults–Results of a national cohort study
Tsai, A. C.-H., & Lee, S.-H. (2014) · Clinical Nutrition · doi:10.1016/j.clnu.2014.09.021 · Cited by 23 · see citing works
Xu, F., Wang, Y., Ware, R. S., Tse, L. A., Dunstan, D. W., Liang, Y., Wang, Z., Hong, X., & Owen, N. G. (2011) · Diabetic Medicine · doi:10.1111/j.1464-5491.2011.03495.x · Cited by 19 · see citing works
Health Risk Factor Modification Predicts Incidence of Diabetes in an Employee Population
Rolando, L. A., Byrne, D. W., McGown, P. W., Goetzel, R. Z., Elasy, T. A., & Yarbrough, M. I. (2013) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e31827cbaec · Cited by 19 · see citing works
Effect of fitness on incident diabetes from statin use in primary prevention
Radford, N. B., DeFina, L. F., Barlow, C. E., Kerr, A., Chakravorty, R., Khera, A., & Levine, B. D. (2014) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2014.12.051 · Cited by 13 · see citing works
Brouwer, B. G., van der Graaf, Y., Soedamah‐Muthu, S. S., Wassink, A. M. J., & Visseren, F. L. J. (2010) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2009.12.001 · Cited by 12 · see citing works
Prospective evidence for physical activity protecting Turkish adults from metabolic disorders
Onat, A., Hergenç, G., Küçükdurmaz, Z., et al. (2007) · DSpace - Düzce (Duzce University) · Cited by 4 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Health benefits of physical activity: a systematic review of current systematic reviews
Warburton, D. E. R., & Bredin, S. S. D. (2017) · Current Opinion in Cardiology · doi:10.1097/hco.0000000000000437 · Cited by 2,410 · see citing works
Kyu, H. H., Bachman, V. F., Alexander, L. T., Mumford, J. E., Afshin, A., Estep, K., Veerman, J. L., Delwiche, K., Iannarone, M. L., Moyer, M. L., et al. (2016) · BMJ · doi:10.1136/bmj.i3857 · Cited by 1,272 · see citing works
Carey, R. M., Calhoun, D. A., Bakris, G. L., Brook, R. D., Daugherty, S. L., Dennison-Himmelfarb, C. R., Egan, B. M., Flack, J. M., Gidding, S. S., Judd, E., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000084 · Cited by 1,153 · see citing works
The Generation R Study: design and cohort update 2010
Jaddoe, V. W. V., van Duijn, C. M., van der Heijden, A. J., Mackenbach, J. P., Moll, H. A., Steegers, E. A. P., Tiemeier, H., Uitterlinden, A. G., Verhulst, F. C., & Hofman, A. (2010) · European Journal of Epidemiology · doi:10.1007/s10654-010-9516-7 · Cited by 1,027 · see citing works
Kinoshita, M., Yokote, K., Arai, H., Iida, M., Ishigaki, Y., Ishibashi, S., Umemoto, S., Egusa, G., Ohmura, H., Okamura, T., et al. (2018) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.gl2017 · Cited by 813 · see citing works
Role of Inactivity in Chronic Diseases: Evolutionary Insight and Pathophysiological Mechanisms
Booth, F. W., Roberts, C. K., Thyfault, J. P., Ruegsegger, G. N., & Toedebusch, R. G. (2017) · Physiological Reviews · doi:10.1152/physrev.00019.2016 · Cited by 696 · see citing works
Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses
Bellou, V., Belbasis, L., Tzoulaki, I., & Evangelou, E. (2018) · PLOS ONE · doi:10.1371/journal.pone.0194127 · Cited by 713 · see citing works
Japanese clinical practice guideline for diabetes 2019
Araki, E., Goto, A., Kondo, T., Noda, M., Noto, H., Origasa, H., Osawa, H., Taguchi, A., Tanizawa, Y., Tobe, K., et al. (2020) · Diabetology International · doi:10.1007/s13340-020-00439-5 · Cited by 545 · see citing works
Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis
Sampath Kumar, A., Maiya, A. G., Shastry, B. A., Vaishali, K., Ravishankar, N., Hazari, A., Gundmi, S., & Jadhav, R. (2019) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2018.11.001 · Cited by 469 · see citing works
Smith, A. D., Crippa, A., Woodcock, J., & Brage, S. (2016) · Diabetologia · doi:10.1007/s00125-016-4079-0 · Cited by 430 · see citing works
Coenen, P., Huysmans, M. A., Holtermann, A., Krause, N., van Mechelen, W., Straker, L. M., & van der Beek, A. J. (2018) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-098540 · Cited by 360 · see citing works
Diabetes and Sarcopenic Obesity: Pathogenesis, Diagnosis, and Treatments
Wang, M., Tan, Y., Shi, Y., Wang, X., Liao, Z., & Wei, P. (2020) · Frontiers in Endocrinology · doi:10.3389/fendo.2020.00568 · Cited by 231 · see citing works
The 2017 Dutch Physical Activity Guidelines
Committee Dutch Physical Activity Guidelines 2017, Weggemans, R. M., Backx, F. J. G., Borghouts, L., Chinapaw, M., Hopman, M. T. E., Koster, A., Kremers, S., van Loon, L. J. C., May, A., et al. (2018) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-018-0661-9 · Cited by 227 · see citing works
Bennie, J. A., De Cocker, K., Teychenne, M. J., Brown, W. J., & Biddle, S. J. H. (2019) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-019-0797-2 · Cited by 224 · see citing works
De Nardi, A. T., Tolves, T., Lenzi, T. L., Signori, L. U., & Silva, A. M. V. D. (2018) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2017.12.017 · Cited by 191 · see citing works
Tarp, J., Støle, A. P., Blond, K., & Grøntved, A. (2019) · Diabetologia · doi:10.1007/s00125-019-4867-4 · Cited by 173 · see citing works
Aune, D., Sen, A., Henriksen, T., Saugstad, O. D., & Tonstad, S. (2016) · European Journal of Epidemiology · doi:10.1007/s10654-016-0176-0 · Cited by 170 · see citing works
Self-citationThe impact of physical activity and sedentary behaviors on frailty levels
Kehler, D. S., & Theou, O. (2019) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2019.03.004 · Cited by 166 · see citing works
Diagnosis and Treatment of Type 2 Diabetes in Adults
Kalyani, R. R., Neumiller, J. J., Maruthur, N. M., & Wexler, D. J. (2025) · JAMA · doi:10.1001/jama.2025.5956 · Cited by 145 · see citing works
Gao, Y., Gan, T., Jiang, L., Yu, L., Tang, D., Wang, Y., Li, X., & Ding, G. (2020) · Chronobiology International · doi:10.1080/07420528.2019.1683570 · Cited by 134 · see citing works
Dysregulation of a long noncoding RNA reduces leptin leading to a leptin-responsive form of obesity
Dallner, O. S., Marinis, J. M., Lu, Y.-H., Birsoy, K., Werner, E., Fayzikhodjaeva, G., Dill, B. D., Molina, H., Moscati, A., Kutalik, Z., et al. (2019) · Nature Medicine · doi:10.1038/s41591-019-0370-1 · Cited by 106 · see citing works
Six-Year Changes in Physical Activity and the Risk of Incident Heart Failure: ARIC Study
Florido, R., Kwak, L., Lazo, M., Nambi, V., Ahmed, H. M., Hegde, S. M., Gerstenblith, G., Blumenthal, R. S., Ballantyne, C. M., Selvin, E., et al. (2018) · Circulation · doi:10.1161/circulationaha.117.030226 · Cited by 56 · see citing works
Ballin, M., Nordström, P., Niklasson, J., Alamäki, A., Condell, J., Tedesco, S., & Nordström, A. (2020) · BMC Public Health · doi:10.1186/s12889-020-09929-2 · Cited by 47 · see citing works
Objective Measures of Physical Activity and Cardiometabolic and Endocrine Biomarkers
ALESSA, H. B., CHOMISTEK, A. K., HANKINSON, S. E., BARNETT, J. B., ROOD, J., MATTHEWS, C. E., RIMM, E. B., WILLETT, W. C., HU, F. B., & TOBIAS, D. K. (2017) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000001287 · Cited by 42 · see citing works
Albergoni, A., Hettinga, F. J., La Torre, A., Bonato, M., & Sartor, F. (2019) · Sports Medicine - Open · doi:10.1186/s40798-019-0214-z · Cited by 39 · see citing works
Xie, W., Zhang, L., Cheng, J., Wang, Y., Kang, H., & Gao, Y. (2024) · BMC Public Health · doi:10.1186/s12889-024-18131-7 · Cited by 41 · see citing works
“As this did not meet the requirement of dose–response analysis, this analysis ultimately included 16 studies [10, 14, 16–18, 28, 30, 32–35, 38, 41, 42].”
BackgroundMethodInfluentialYamaoka, K., Nemoto, A., & Tango, T. (2019) · Nutrients · doi:10.3390/nu11061373 · Cited by 32 · see citing works
Boonpor, J., Parra-Soto, S., Petermann-Rocha, F., Lynskey, N., Cabanas-Sánchez, V., Sattar, N., Gill, J. M. R., Welsh, P., Pell, J. P., Gray, S. R., et al. (2023) · BMC Medicine · doi:10.1186/s12916-023-02851-5 · Cited by 31 · see citing works
Verbrugge, S. A. J., Alhusen, J. A., Kempin, S., Pillon, N. J., Rozman, J., Wackerhage, H., & Kleinert, M. (2022) · Journal of Cellular Biochemistry · doi:10.1002/jcb.30179 · Cited by 21 · see citing works
Yang, J., Zhang, Y. L., Ye, J., Guo, Q., Sun, Y. N., & Zeng, Q. (2018) · Public Health · doi:10.1016/j.puhe.2018.07.010 · Cited by 9 · see citing works
- Authors
- Aune, D., Norat, T., Leitzmann, M., Tonstad, S., & Vatten, L. J.
- Affiliations
- Norwegian University of Science and Technology (NO)
- Imperial College London (GB)
- University Hospital Regensburg (DE)
- Oslo University Hospital (NO)
- Corresponding author
- Aune, Dagfinn
- Venue
- European Journal of Epidemiology
- Published
- 2015-06-20
- Volume
- 30
- Issue
- 7
- Pages
- 529-542
- ISSN
- 0393-2990 (ISSN-L)
- 1573-7284
- OpenAlex
- W581981666
- Cited by
- 880
- References
- 114
- Citations by year
- 2026: 69 · 2025: 95 · 2024: 90 · 2023: 83 · 2022: 109 · 2021: 103 · 2020: 83 · 2019: 87 · 2018: 78 · 2017: 44 · 2016: 31 · 2015: 6
- FWCI
- 6.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- University of Regensburg Publication Server (University of Regensburg) (submittedVersion)
- Funders
- Norges Teknisk-Naturvitenskapelige Universitet
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
- Keywords
- physical activity, type 2 diabetes, diabetes risk, dose-response relationship, leisure-time physical activity, high-intensity exercise, moderate physical activity, walking, resistance training, cardiorespiratory fitness, occupational physical activity, adiposity, nonlinear dose-response relationship
- MeSH terms
- Diabetes Mellitus, Type 2, Humans, Leisure Activities, Motor Activity, Physical Fitness, Prospective Studies, Sports, Exercise, Walking
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
