Increasing overall physical activity and aerobic fitness is associated with improvements in metabolic risk: cohort analysis of the ProActive trial

Diabetologia. 2008 May;51(5):787-94. doi: 10.1007/s00125-008-0949-4. Epub 2008 Mar 4.


Aims/hypothesis: Our aim was to examine the association between change in physical activity energy expenditure (PAEE), total body movement (counts per day) and aerobic fitness (maximum oxygen consumption [VO2max] over 1 year and metabolic risk among individuals with a family history of diabetes.

Methods: Three hundred and sixty-five offspring of people with type 2 diabetes underwent measurement of energy expenditure (PAEE measured using the flex heart rate method), total body movement (daily activity counts from accelerometry data), [VO2max] predicted from a submaximal graded treadmill exercise test and anthropometric and metabolic status at baseline and 1 year (n = 321) in the ProActive trial. Clustered metabolic risk was calculated by summing standardised values for waist circumference, fasting triacylglycerol, insulin and glucose, blood pressure and the inverse of HDL-cholesterol. Linear regression was used to quantify the association between changes in PAEE, total body movement and fitness and clustered metabolic risk at follow-up.

Results: Participants increased their activity by 0.01 units PAEE kJ kg(-1) day(-1) over 1 year. Total body movement increased by an average of 9,848 counts per day. Change in total body movement (beta = -0.066, p = 0.004) and fitness (beta = -0.056, p = 0.003) was associated with clustered metabolic risk at follow-up, independently of age, sex, smoking status, socioeconomic status and baseline metabolic score.

Conclusions/interpretation: Small increases in activity and fitness were associated with a reduction in clustered metabolic risk in this cohort of carefully characterised at-risk individuals. Further research to quantify the reduction in risk of type 2 diabetes associated with feasible changes in these variables should inform preventive interventions.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aerobiosis
  • Body Mass Index
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / genetics*
  • Diabetes Mellitus, Type 2 / prevention & control
  • Energy Metabolism
  • Evidence-Based Medicine
  • Exercise Test
  • Exercise*
  • Female
  • Heart Rate
  • Humans
  • Male
  • Metabolic Syndrome / epidemiology
  • Middle Aged
  • Motor Activity
  • Oxygen Consumption
  • Physical Fitness*

Associated data

  • ISRCTN/ISRCTN61323766