Quantifying the Association Between Physical Activity and Cardiovascular Disease and Diabetes: A Systematic Review and Meta‐Analysis

Abstract

BackgroundThe relationships between physical activity (PA) and both cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) have predominantly been estimated using categorical measures of PA, masking the shape of the dose‐response relationship. In this systematic review and meta‐analysis, for the very first time we are able to derive a single continuous PA metric to compare the association between PA and CVD/T2DM, both before and after adjustment for a measure of body weight.Methods and ResultsThe search was applied to MEDLINE and EMBASE electronic databases for all studies published from January 1981 to March 2014. A total of 36 studies (3 439 874 participants and 179 393 events, during an average follow‐up period of 12.3 years) were included in the analysis (33 pertaining to CVD and 3 to T2DM). An increase from being inactive to achieving recommended PA levels (150 minutes of moderate‐intensity aerobic activity per week) was associated with lower risk of CVD mortality by 23%, CVD incidence by 17%, and T2DM incidence by 26% (relative risk [RR], 0.77 [0.71–0.84]), (RR, 0.83 [0.77–0.89]), and (RR, 0.74 [0.72–0.77]), respectively, after adjustment for body weight.ConclusionsBy using a single continuous metric for PA levels, we were able to make a comparison of the effect of PA on CVD incidence and mortality including myocardial infarct (MI), stroke, and heart failure, as well as T2DM. Effect sizes were generally similar for CVD and T2DM, and suggested that the greatest gain in health is associated with moving from inactivity to small amounts of PA.

Physical Activity, Sedentary Time, and Cardiovascular Disease Biomarkers at Age 60 to 64 Years

“…Moreover, higher adiposity, which is an established CVD risk factor,22 has also been related to an adverse biomarker profile,23 and might help explain associations between PA and CVD biomarkers24; however, to what extent adiposity mediates these associations is unclear, especially as PA and adiposity associations are still widely debated 25, 26. Additionally, among older adults, women tend to have a higher fat mass for a given body mass index than men,27 meaning it is important to study the mediating role of more direct measures of adiposity.…”

Physical inactivity and cardiovascular disease at the time of coronavirus disease 2019 (COVID-19)

“…11 A recent meta-analysis of prospective studies, totalling 36 investigations and over three million subjects followed up for a median period of 12 years, concluded that achieving the WHO recommended physical activity levels was associated with 17% lower risk of cardiovascular events (relative risk (RR), 0.83; 95% confidence interval (CI), 0.77-0.89), 23% lower risk of cardiovascular mortality (RR, 0.77; 95% CI, 0.71-0.84) and 26% lower incidence of type 2 diabetes (RR, 0.74; 95% CI, 0.72-0.77). 12 These findings were more recently confirmed by Kivim€ aki and colleagues, 13 who pooled data from 19 prospective observational cohort studies, totalling 404,840 subjects. Overall, physical inactivity was associated with 24% higher risk of coronary heart disease (hazard ratio, 1.24; 95% CI, 1.13-1.36), 16% enhanced risk of stroke (hazard ratio, 1.16; 95% CI, 1.05-1.27) and 42% higher risk of diabetes (hazard ratio, 1.42; 95% CI, 1.25-1.61).…”

The joint impact of habitual exercise and glycemic control on the incidence of chronic kidney disease (CKD) in middle-aged and older males

“…Adherence to habitual exercise is well known to be related to a decreased incidence of cardiovascular morbidity and mortality [29–32]. Additionally, it is also well known that poor glycemic control is an important independent risk factor for the development of CVD [33].…”