Lack of Physical Fitness in Youth Linked With 3-Fold Risk of Developing Diabetes in Adulthood
Aerobic exercise ==> outdoors more ==> vitamin D ==> less diabetes
- Prediabetes reduced by monthly 60,000 IU of vitamin D – RCT May 2015
Note: can easkily get 60,000 IU vitamin D monthly from outdoor exercise - Prediabetics 60 percent less likely to become diabetic if given some vitamin D – Jan 2014
- Type 2 diabetes 1.5X more likely if low vs high vitamin D – meta-analysis Feb 2013
- Diabetes 3.5X less likely if more than 25 ng Vitamin D – Sept 2012
- Outdoor distance runners had great Vitamin D levels (50 ng) – Dec 2015
- Dr. Holick video on vitamin D - March 2013
Higher latitude ==> less sun (Unless outdoors more) ==> more diabetes
Results: 34 008 men were diagnosed with type 2 DM in 39.4 million person-years of follow-up. Low aerobic capacity and muscle strength were independently associated with increased risk for type 2 DM. The absolute difference in cumulative incidence of type 2 DM between the lowest and highest tertiles of both aerobic capacity and strength was 0.22% at 20 years of follow-up (95% CI, 0.20% to 0.25%), 0.76% at 30 years (CI, 0.71% to 0.81%), and 3.97% at 40 years (CI, 3.87% to 4.06%).
Overall, the combination of low aerobic capacity and muscle strength was associated with a 3-fold risk for type 2 DM (adjusted hazard ratio, 3.07 [CI, 2.88 to 3.27]; P < 0.001), with a positive additive interaction (P < 0.001).
These associations were seen even among men with normal body mass index.
Limitation: This cohort did not include women and did not measure physical fitness at older ages.
Conclusion: In this large cohort of Swedish male military conscripts, low aerobic capacity and muscle strength at age 18 years were associated with increased long-term risk for type 2 DM, even among those with normal body mass index.
The combination of low aerobic capacity and low muscle strength at age 18 is associated with a 3 times greater risk of developing type 2 diabetes in adulthood, according to a study published in the Annals of Internal Medicine.
The study also found that poor physical fitness was a long-term risk factor even among individuals with a normal body mass index (BMI).
Researchers examined fitness and health records from more than 1.5 million male military conscripts in Sweden from 1969 to 1997. As a result of Sweden’s national healthcare system, researchers were able to track the cohort’s data over several decades (to a maximum age of 62 years) and obtain follow-up information to see if and when the conscripts were diagnosed with type 2 diabetes.
Most studies of physical fitness have examined aerobic but not muscular fitness, and have focused on adults but lacked data at younger ages with sufficient follow-up to examine the long-term risk of type 2 diabetes.
“This is the first study to examine early-life physical fitness in relation to the long-term risk for type 2 diabetes in adulthood, independent of BMI, family history or socioeconomic factors,” said Casey Crump, MD, Icahn School of Medicine at Mount Sinai, New York, New York. “Our findings suggest that prevention should start early in life and should include both aerobic and muscular conditioning. We hope our research will help inform more effective lifestyle interventions among children and youth to promote better population health in the United States and other countries.”
“This research has enormous implications for the work we have been doing in our department, promoting adequate physical education programs in schools and the need for safe play spaces for children and teens in our communities,” said co-author Neil Calman, MD, Mount Sinai Health System. “Addressing these problems has now been proven to be of critical importance in preventing adult diabetes.”
“Our research group is also studying the effects of aerobic fitness, muscular strength and BMI on other health outcomes, including ischemic heart disease and cancer,” said Dr. Crump. “We need more longitudinal measurements of physical fitness over individuals’ life course to determine age windows of greatest susceptibility to its effects on type 2 diabetes.”
SOURCE: Mount Sinai Health System