Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study
Open accessAbstract
PURPOSE: The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity (PA) with the risk of incident type 2 diabetes in a population-based prospective cohort study. METHODS: Altogether, 88,000 participants (mean age = 62.2 ± 7.9 years, mean ± SD) were included from the UK Biobank. Sleep duration (short: <6 h/day; normal: 6-8 h/day; long: >8 h/day) and PA of different intensities were measured using a wrist-worn accelerometer over a 7-day period between 2013 and 2015. PA was classified according to the median or World Health Organization-recommendation: total volume of PA (high, low), moderate-to-vigorous PA (MVPA) (recommended, not recommended), and light-intensity PA (high, low). Incidence of type 2 diabetes was ascertained using hospital records or death registries. RESULTS: During a median follow-up of 7.0 years, 1615 incident type 2 diabetes cases were documented. Compared with normal sleep duration, short (hazard ratio (HR) = 1.21, 95% confidence interval (95%CI): 1.03-1.41) but not long sleep duration (HR = 1.01, 95%CI: 0.89-1.15) was associated with excessive type 2 diabetes risk. This increased risk among short sleepers seems to be protected against by PA. Compared with normal sleepers with high or recommended PA, short sleepers with low volume of PA (HR = 1.81, 95%CI: 1.46-2.25), not recommended (below the World Health Organization-recommended level of) MVPA (HR = 1.92, 95%CI: 1.55-2.36), or low light-intensity PA (HR = 1.49, 95%CI: 1.13-1.90) had a higher risk of type 2 diabetes, while short sleepers with a high volume of PA (HR = 1.14, 95%CI: 0.88-1.49), recommended MVPA (HR = 1.02, 95%CI: 0.71-1.48), or high light-intensity PA (HR = 1.14, 95%CI: 0.92-1.41) did not. CONCLUSION: Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes. A higher level of PA, regardless of intensity, potentially ameliorates this excessive risk.
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Undertaking accelerometer-measured light-intensity physical activity at intensity levels lower than 3.0 metabolic equivalents could be an easier choice than moderate-to-vigorous intensity physical activity for enhancing health.
“Instead, undertaking accelerometer-measured light-intensity PA (LPA) at intensity levels lower than 3.0 metabolite equivalents (METs) could be an easier choice than MVPA for enhancing health.10, 11, 12”
From Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes (2025) · cites this paper as [12]
The Discussion (Joint association of accelerometer-measured sleep duration and PA with incident type 2 diabetes; page unavailable) describes LPA as an alternative for people who have difficulty performing MVPA and reports an association with lower type 2 diabetes risk. However, the Exposures section defines accelerometer-measured LPA as 30–100 mg, not as activity below 3.0 METs; the paper also addresses diabetes risk rather than health generally. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe study repeated the analyses excluding events that occurred within the first 2 years to exclude participants potentially at the preclinical stage of any diabetic vascular event and to help address reverse causality.
“To exclude participants who were potentially at the preclinical stage of any diabetic vascular event, and to help address reverse causality, we also repeated the analyses excluding events that occurred within the first 2 years.12,37”
From Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes (2025) · cites this paper as [12]
The Statistical analyses section says the study repeated analyses after excluding type 2 diabetes events in the first two years of follow-up, and the Discussion reports that the findings remained robust. Our copy does not state that this exclusion was intended to address reverse causality or preclinical diabetic vascular events; its outcome was incident type 2 diabetes. (LLM, conf=0.86)
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- Authors
- Jin, X., Chen, Y., Feng, H., Zhou, M., Chan, J. W. Y., Liu, Y., Kong, A. P. S., Tan, X., Wing, Y.-K., Liang, Y. Y., & Zhang, J.
- Affiliations
- Guangdong Academy of Medical Sciences (CN)
- Chinese University of Hong Kong (HK)
- Uppsala University (SE)
- Corresponding author
- Liang, Yannis Yan
- Zhang, Jihui
- ORCID
- Venue
- Journal of Sport and Health Science
- Publisher
- Elsevier BV
- Published
- 2024-03
- Volume
- 13
- Issue
- 2
- Pages
- 222-232
- ISSN
- 2213-2961 (ISSN-L)
- 2095-2546
- PMC
- PMC10980868
- OpenAlex
- W4323044041
- Cited by
- 42
- References
- 47
- Citations by year
- 2026: 5 · 2025: 22 · 2024: 13 · 2023: 2
- FWCI
- 7.42
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- Locations
- Journal of sport and health science/Journal of Sport and Health Science (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Uppsala University Publications (Uppsala University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Key Research and Development Program of China (2021YFC2501500)
- National Natural Science Foundation of China (82171476)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, sleep duration, short sleep duration, long sleep, physical activity, moderate-to-vigorous physical activity, light physical activity, physical activity volume, accelerometer-measured activity, incident diabetes risk, UK Biobank, older adults, lifestyle intervention, WHO physical activity guidelines
- MeSH terms
- Sleep Duration, Aged, Diabetes Mellitus, Type 2, Humans, Middle Aged, Prospective Studies, Cohort Studies, Exercise, Accelerometry
About these checks
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