A prospective study of cardiorespiratory fitness and risk of type 2 diabetes in women
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OBJECTIVE—The purpose of this study was to determine the independent and joint associations of cardiorespiratory fitness (CRF) and BMI with the incidence of type 2 diabetes in women. RESEARCH DESIGN AND METHODS—An observational cohort of 6,249 women aged 20–79 years was free of baseline cardiovascular disease, cancer, and diabetes. CRF was measured using a maximal treadmill exercise test. BMI was computed from measured height and weight. The incidence of type 2 diabetes was identified primarily by 1997 American Diabetes Association criteria. RESULTS—During a 17-year follow-up, 143 cases of type 2 diabetes occurred. Compared with the least fit third, the multivariate (including BMI)-adjusted hazard ratio (HR) (95% CI) was 0.86 (0.59–1.25) for the middle third and 0.61 (0.38–0.96) for the upper third of CRF. For BMI, the multivariate (including CRF)-adjusted HR (95% CI) was 2.34 (1.55–3.54) for overweight individuals and 3.70 (2.12–6.44) for obese individuals, compared with normal-weight patients. In the combined analyses, overweight/obese unfit (the lowest one-third of CRF) women had significantly higher risks compared with normal-weight fit (the upper two-thirds of CRF) women. CONCLUSIONS—Low CRF and higher BMI were independently associated with incident type 2 diabetes. The protective effect of CRF was observed in individuals who were overweight or obese, but CRF did not eliminate the increased risk in these groups. These findings underscore the critical importance of promoting regular physical activity and maintaining normal weight for diabetes prevention.
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Observational studies have reported that greater fitness is associated with a reduced risk of developing type 2 diabetes, even if only moderate-intensity exercise is undertaken.
“Observational studies have reported that greater fitness is associated with a reduced risk of developing type 2 diabetes ( 251 , 273 ), even if only moderate-intensity exercise is undertaken.”
From Exercise and Type 2 Diabetes (2010) · cites this paper as [251]
The Results report that women in the middle and higher fitness thirds had lower risks of type 2 diabetes than women in the lowest third. The Discussion also says moderate-intensity walking can improve fitness, but this observational study did not establish that the lower diabetes risk held specifically for women undertaking only moderate-intensity exercise. (LLM, conf=0.85)
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References 37 · Cited by 185
- Authors
- Sui, X., Hooker, S. P., Lee, I.-M., Church, T. S., Colabianchi, N., Lee, C.-D., & Blair, S. N.
- Affiliations
- University of South Carolina (US)
- Harvard University (US)
- Pennington Biomedical Research Center (US)
- Arizona State University (US)
- University of North Texas (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2008-03-01
- Volume
- 31
- Issue
- 3
- Pages
- 550-555
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3410433
- OpenAlex
- W2132076378
- Cited by
- 185
- References
- 37
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 24 · 2022: 10 · 2021: 7 · 2020: 9 · 2019: 10 · 2018: 4 · 2017: 13 · 2016: 15 · 2015: 14 · 2014: 15 · 2013: 9 · 2012: 9
- FWCI
- 9.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (AG06945)
- National Institute on Aging (R37AG006945, AG06945, R01AG006945)
- National Heart, Lung, and Blood Institute (HL62508, R01HL062508)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- cardiorespiratory fitness, type 2 diabetes, women, body mass index, obesity, overweight, diabetes incidence, physical activity, diabetes prevention, treadmill exercise testing
- MeSH terms
- Adult, Aged, Cardiovascular Physiological Phenomena, Diabetes Mellitus, Type 2, Female, Humans, Middle Aged, Physical Fitness, Prospective Studies, Respiratory Physiological Phenomena, Risk Factors, Texas, Cohort Studies, Body Mass Index, Incidence, Multivariate Analysis
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