American Diabetes Association
Supplementary_Sedentary_T2D_R3.pdf (339.67 kB)

Replacement of Sedentary Behavior by Various Daily-Life Physical Activities and Structured Exercises: Genetic Risk and Incident Type 2 Diabetes

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posted on 2021-06-28, 14:58 authored by Xiang Li, Tao Zhou, Hao Ma, Zhaoxia Liang, Vivian A Fonseca, Lu Qi
Objective: To prospectively analyze the association of sedentary behavior time with T2D risk and perform the iso-temporal substitution analyses to estimate the effect of substituting sedentary behaviors by equal time of different types of daily-life physical activities and structured exercise. We also examined modifications by the genetic predisposition to T2D.

Research Design and Methods: We included 475,502 participants free of T2D in the UK Biobank. Sedentary time was quantified by summing up the time spent on television watching, computer using, and driving.

Results: During a median follow-up of 11 years, we documented 18,169 incident T2D. Comparing the extreme categories (≥6 vs. <2 hours/day), the hazard ratio (HR) for T2D was 1.58 (95% CI, 1.47-1.71), after adjustment for age, race, sex, lifestyle factors, and other covariates. Replacing 30 minutes of sedentary behavior per day with an equal time of different types of daily-life activities and structured exercise were significantly associated with a 6-31% risk reduction of T2D, with strenuous sports showing the strongest (31%, 95% CI, 24%-37%) benefit. Moreover, we found a significant interaction between sedentary behavior and genetic predisposition on the risk of T2D (p-interaction=0.0008). The association was more profound among participants with a lower genetic risk of T2D.

Conclusions: Our study indicates that sedentary behavior time is associated with an increased risk of T2D; replacing sedentary behavior with a short-duration (30 minutes/day) daily-life physical activities or structured exercise is related to a significant reduction in T2D risk. Furthermore, such association was stronger among those with a lower genetic risk of T2D.


The study was supported by grants from the National Heart, Lung, and Blood Institute (HL071981, HL034594, HL126024), the National Institute of Diabetes and Digestive and Kidney Diseases (DK115679, DK091718, DK100383), the Fogarty International Center (TW010790), and Tulane Research Centers of Excellence Awards. Xiang Li was the recipient of the American Heart Association Predoctoral Fellowship Award (19PRE34380036).


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