A Prospective Study of Weight Training and Risk of Type 2 Diabetes Mellitus in Men

Archives of internal medicine (Impact Factor: 17.33). 08/2012; 172(17):1-7. DOI: 10.1001/archinternmed.2012.3138
Source: PubMed


BACKGROUND The role of weight training in the primary prevention of type 2 diabetes mellitus (T2DM) is largely unknown. METHODS To examine the association of weight training with risk of T2DM in US men and to assess the influence of combining weight training and aerobic exercise, we performed a prospective cohort study of 32 002 men from the Health Professionals Follow-up Study observed from 1990 to 2008. Weekly time spent on weight training and aerobic exercise (including brisk walking, jogging, running, bicycling, swimming, tennis, squash, and calisthenics/rowing) was obtained from questionnaires at baseline and biennially during follow-up. RESULTS During 508 332 person-years of follow-up (18 years), we documented 2278 new cases of T2DM. In multivariable-adjusted models, we observed a dose-response relationship between an increasing amount of time spent on weight training or aerobic exercise and lower risk of T2DM (P < .001 for trend). Engaging in weight training or aerobic exercise for at least 150 minutes per week was independently associated with a lower risk of T2DM of 34% (95% CI, 7%-54%) and 52% (95% CI, 45%-58%), respectively. Men who engaged in aerobic exercise and weight training for at least 150 minutes per week had the greatest reduction in T2DM risk (59%; 95% CI, 39%-73%). CONCLUSIONS Weight training was associated with a significantly lower risk of T2DM, independent of aerobic exercise. Combined weight training and aerobic exercise conferred a greater benefit.

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Available from: Lars Bo Andersen, Oct 30, 2014
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    • "Current guidelines for T2DM prevention and management [3,19] recommend at least 150 min per week of moderate-vigorous aerobic activity and an additional two (ideally three) RT sessions per week (at least 60 min). Studies have reported that the combination of aerobic plus RT has additive benefits on glucose control [16,20,21] and can achieve greater reductions in T2DM incidence [22,23] than the use of a single exercise modality. However, multi-component (diet + aerobic exercise + RT) lifestyle interventions have the potential to become excessively burdensome, which could compromise program adherence. "
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    ABSTRACT: Current recommendations for the prevention of type 2 diabetes advise modification of diet and exercise behaviors including both aerobic and resistance training. However, the efficacy of multi-component interventions involving a combination of these three components has not been established. The aims of this review were to systematically review and meta-analyze the evidence on multi-component (diet + aerobic exercise + resistance training) lifestyle interventions for type 2 diabetes prevention. Eight electronic databases (Medline, Embase, SportDiscus, Web of Science, CINAHL, Informit health collection, Cochrane library and Scopus) were searched up to June 2013. Eligible studies 1) recruited prediabetic adults or individuals at risk of type 2 diabetes; 2) conducted diet and exercise [including both physical activity/aerobic and resistance training] programs; and 3) reported weight and plasma glucose outcomes. In total, 23 articles from eight studies were eligible including five randomized controlled trials, one quasi-experimental, one two-group comparison and one single-group pre-post study. Four studies had a low risk of bias (score >= 6/10). Median intervention length was 12 months (range 4-48 months) with a follow-up of 18 months (range 6.5 - 48 months). The diet and exercise interventions varied slightly in terms of their specific prescriptions. Meta-analysis favored interventions over controls for weight loss (-3.79 kg [-6.13, -1.46; 95% CI], Z = 3.19, P = 0.001) and fasting plasma glucose (-0.13 mmol.L-1 [-0.24, -0.02; 95% CI], Z = 2.42, P = 0.02). Diabetes incidence was only reported in two studies, with reductions of 58% and 56% versus control groups. In summary, multi-component lifestyle type 2 diabetes prevention interventions that include diet and both aerobic and resistance exercise training are modestly effective in inducing weight loss and improving impaired fasting glucose, glucose tolerance, dietary and exercise outcomes in at risk and prediabetic adult populations. These results support the current exercise guidelines for the inclusion of resistance training in type 2 diabetes prevention, however there remains a need for more rigorous studies, with long-term follow-up evaluating program efficacy, muscular fitness outcomes, diabetes incidence and risk reduction.
    International Journal of Behavioral Nutrition and Physical Activity 01/2014; 11(1):2. DOI:10.1186/1479-5868-11-2 · 4.11 Impact Factor
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    • "Evidence from randomized controlled trials has shown that RT improves glycemic control in patients with T2D, increases glucose disposal, and even improves the lipid and cardiovascular disease risk profile of patients with T2D [7] [8]. Furthermore, the Health Professionals Follow-up Study examined the association of RT in the primary prevention of T2D and found a 34% lower risk of T2D in men, independent of aerobic exercise [9]. However, there is limited mechanistic insight into how these adaptations occur. "
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    ABSTRACT: Type 2 diabetes mellitus (T2D) is characterized by insulin resistance, impaired glycogen synthesis, lipid accumulation, and impaired mitochondrial function. Exercise training has received increasing recognition as a cornerstone in the prevention and treatment of T2D. Emerging research suggests that resistance training (RT) has the power to combat metabolic dysfunction in patients with T2D and seems to be an effective measure to improve overall metabolic health and reduce metabolic risk factors in diabetic patients. However, there is limited mechanistic insight into how these adaptations occur. This review provides an overview of the intervention data on the impact of RT on glucose metabolism. In addition, the molecular mechanisms that lead to adaptation in skeletal muscle in response to RT and that are associated with possible beneficial metabolic responses are discussed. Some of the beneficial adaptations exerted by RT include increased GLUT4 translocation in skeletal muscle, increased insulin sensitivity and hence restored metabolic flexibility. Increased energy expenditure and excess postexercise oxygen consumption in response to RT may be other beneficial effects. RT is increasingly establishing itself as an effective measure to improve overall metabolic health and reduce metabolic risk factors in diabetic patients.
    12/2013; 2013(4):805217. DOI:10.1155/2013/805217
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    • "The comparable effects of these two exercise regimes are also supported by a recent experimental study reporting that a single session of either aerobic or resistance exercise provided similar effects on 24-h postexercise glycemic control in insulin-resistant individuals with and without type 2 diabetes (32). Finally, in a prospective study of men from the Health Professionals Follow-up study, engagement in weight training and aerobic MVPA were both independently associated with reduced risk of incident type 2 diabetes with fairly comparable risk reduction sizes (33). "
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    ABSTRACT: OBJECTIVE To examine the independent and combined association of isometric muscle strength of the abdomen and back and cardiorespiratory fitness (CRF) in youth with indices of glucose metabolism in young adulthood among boys and girls from the European Youth Heart Study.RESEARCH DESIGN AND METHODS We used data from a population-based prospective cohort study among youth followed-up for up to 12 years (n = 317). In youth, maximal voluntary contractions during isometric back extension and abdominal flexion were determined using a strain-gauge dynamometer and CRF was obtained from a maximal cycle ergometer test. Insulin resistance (homeostasis model assessment of insulin resistance [HOMA-IR]) and β-cell function (homeostasis model assessment of β-cell function [HOMA-B]) were estimated from fasting serum insulin and glucose that were obtained in youth and at follow-up in young adulthood.RESULTSFor each 1-SD difference in isometric muscle strength (0.16 N/kg) in youth, fasting insulin, HOMA-IR, and HOMA-B in young adulthood changed with -11.3% (95% CI, -17.0 to -5.2), -12.2% (-18.2 to -5.7), and -8.9% (-14.4 to -3.0), respectively, in young adulthood after adjustment for CRF and personal lifestyle and demographic factors. Results for CRF were very similar in magnitude, and the magnitude of associations for both exposures was unchanged with additional adjustment for general or abdominal adiposity in youth. Combined associations of muscle strength and CRF with fasting insulin, HOMA-IR, and HOMA-B were additive, and adolescents in the highest sex-specific tertile for both isometric muscle strength and CRF had the lowest levels of these glucose metabolism outcomes.CONCLUSIONS Increasing muscle strength and CRF should be targets in youth primordial prevention strategies of insulin resistance and β-cell dysfunction.
    Diabetes care 04/2013; 36(9). DOI:10.2337/dc12-2252 · 8.42 Impact Factor
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