BACKGROUND: Early-life physical fitness has rarely been examined in relation to type 2 diabetes mellitus (DM) in adulthood because of the lengthy follow-up required. Elucidation of modifiable risk factors at young ages may help facilitate earlier and more effective interventions. OBJECTIVE: To examine aerobic capacity and muscle strength at age 18 years in relation to risk for type 2 DM in adulthood. DESIGN: National cohort study. SETTING: Sweden. PARTICIPANTS: 1 534 425 military conscripts from 1969 to 1997 (97% to 98% of all men aged 18 years nationwide) without prior type 2 DM. MEASUREMENTS: Aerobic capacity and muscle strength (measured in watts and newtons per kilogram of body weight, respectively) were examined in relation to type 2 DM identified from outpatient and inpatient diagnoses from 1987 to 2012 (maximum age, 62 years). 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. PRIMARY FUNDING SOURCE: National Institutes of Health.
BACKGROUND: Early-life physical fitness has rarely been examined in relation to type 2 diabetes mellitus (DM) in adulthood because of the lengthy follow-up required. Elucidation of modifiable risk factors at young ages may help facilitate earlier and more effective interventions. OBJECTIVE: To examine aerobic capacity and muscle strength at age 18 years in relation to risk for type 2 DM in adulthood. DESIGN: National cohort study. SETTING: Sweden. PARTICIPANTS: 1 534 425 military conscripts from 1969 to 1997 (97% to 98% of all men aged 18 years nationwide) without prior type 2 DM. MEASUREMENTS: Aerobic capacity and muscle strength (measured in watts and newtons per kilogram of body weight, respectively) were examined in relation to type 2 DM identified from outpatient and inpatient diagnoses from 1987 to 2012 (maximum age, 62 years). 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. PRIMARY FUNDING SOURCE: National Institutes of Health.
Authors: Radim Jurca; Michael J Lamonte; Carolyn E Barlow; James B Kampert; Timothy S Church; Steven N Blair Journal: Med Sci Sports Exerc Date: 2005-11 Impact factor: 5.411
Authors: Nicholas R Lamoureux; John S Fitzgerald; Kevin I Norton; Todd Sabato; Mark S Tremblay; Grant R Tomkinson Journal: Sports Med Date: 2019-01 Impact factor: 11.136
Authors: Pontus Henriksson; Hanna Henriksson; Per Tynelius; Daniel Berglind; Marie Löf; I-Min Lee; Eric J Shiroma; Francisco B Ortega Journal: Ann Intern Med Date: 2019-02-12 Impact factor: 25.391
Authors: Esmée A Bakker; Duck-Chul Lee; Xuemei Sui; Enrique G Artero; Jonatan R Ruiz; Thijs M H Eijsvogels; Carl J Lavie; Steven N Blair Journal: Mayo Clin Proc Date: 2017-06-13 Impact factor: 7.616
Authors: Carmen L Wilson; Carrie R Howell; Robyn E Partin; Lu Lu; Sue C Kaste; Daniel A Mulrooney; Ching-Hon Pui; Jennifer Q Lanctot; Deo Kumar Srivastava; Leslie L Robison; Melissa M Hudson; Kirsten K Ness Journal: Pediatr Blood Cancer Date: 2018-07-29 Impact factor: 3.167