Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease

Abstract

Epidemiological studies suggest that physically active individuals have a 30–50% lower risk of developing type 2 diabetes than do sedentary persons and that physical activity confers a similar risk reduction for coronary heart disease. Risk reductions are observed with as little as 30 min of moderate-intensity activity per day. Protective mechanisms of physical activity include the regulation of body weight; the reduction of insulin resistance, hypertension, atherogenic dyslipidemia, and inflammation; and the enhancement of insulin sensitivity, glycemic control, and fibrinolytic and endothelial function. Public health initiatives promoting moderate increases in physical activity may offer the best balance between efficacy and feasibility to improve metabolic and cardiovascular health in largely sedentary populations. the incidence of diabetes in the United States is increasing sharply, with ∼1.3 million new cases occurring annually in recent years (17). Type 2 diabetes affects more than 16 million Americans, or almost 8% of US adults. In addition, an estimated 34% of the population have impaired fasting glucose levels, 15% have impaired glucose tolerance (IGT), and 40% have one or both of these conditions (9). A major cause of cardiovascular morbidity and mortality, diabetes increases the risk of developing coronary heart disease (CHD) by three- to sevenfold in women and by two- to threefold in men (67). The economic costs of diabetes and cardiovascular disease (CVD) in this country have been estimated at $132.0 billion (34) and $351.8 billion (73) per year, respectively. These amounts include both direct health care costs and indirect costs from lost productivity due to illness or death.