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Physical Activity and Reduced Occurrence of Non-InsulinDependent Diabetes Mellitus

Susan P. Helmrich, Ph.D., David R. Ragland, Ph.D., M.P.H., Rita W. Leung, A.B., and Ralph S. Paffenbarger, Jr., M.D., Dr.P.H. N Engl J Med 1991; 325:147-152July 18, 1991DOI: 10.1056/NEJM199107183250302

Total expenditure of energy during leisure time had a protective effect against the development of NIDDM in middle-aged men. This effect was independent of obesity, age, history of hypertension, and parental history of diabetes. The occurrence of NIDDM was reduced by 6 percent for every increment of 500 kcal per week in leisure-time physical activity. For the average (75-kg) man, this energy expenditure can be achieved by engaging in regular, sustained body movement jogging at approximately 5 miles per hour, bicycling at 10 miles per hour, swimming laps with light-to-moderate effort, or the like for approximately one hour.21 Vigorous sports activity was most effective in decreasing the risk of NIDDM, but moderate sports activity was also effective. Physical activity may protect against the development of NIDDM by helping to maintain a proper lean-to-fat balance with respect to body mass. Alternatively, physical activity may influence glucose metabolism. Among patients with diabetes, short periods of exercise can lower plasma glucose levels by enhancing the effect of insulin, 23 , 24and more extended exercise training may improve the action of insulin and glucose tolerance.25 In healthy subjects, studies of the effects of exercise on insulin sensitivity and glucose tolerance have been limited to short periods of followup.23 , 24 However, long-distance runners and physically trained middle-aged men have lower plasma insulin levels than healthy sedentary men,26 and an increase in sensitivity to insulin is characteristic of well-trained athletes.27 , 28 The protective effect of physical activity was particularly apparent in the subjects at high risk for NIDDM. This protective effect was especially strong among the heaviest persons, a finding consistent with the improvement in glucose tolerance in obese subjects after physical training.29 ,30 In addition, glucose intolerance that is related to obesity diminishes with exercise, whether or not there are changes in body weight

Physical Activity and Television Viewing in Relation to Risk of Undiagnosed Abnormal Glucose Metabolism in Adults
1. 2. 3. 4. 5. 6. David W. Dunstan, PHD1, Jo Salmon, PHD2, Neville Owen, PHD3, Timothy Armstrong, PHD4, Paul Z. Zimmet, MD1, Timothy A. Welborn, PHD5,

7. Adrian J. Cameron, MPH1, 8. Terence Dwyer, PHD6, 9. Damien Jolley, MSC2, 10. Jonathan E. Shaw, MD1and 11. on behalf of the AusDiab Steering Committee

CONCLUSIONSThese findings suggest a protective effect of physical activity and a deleterious effect of TV time on the risk of abnormal glucose metabolism in adults. Population strategies to reduce risk of abnormal glucose metabolism should focus on reducing sedentary behaviors such as TV time, as well as increasing physical activity.

Alcohol Drinking Patterns and Risk of Type 2 Diabetes Mellitus Among Younger Women FREE
S. Goya Wannamethee, PhD; Carlos A. Camargo, MD, DrPH; JoAnn E. Manson, MD, DrPH; Walter C. Willett, MD, DrPH; Eric B. Rimm, ScD [+] Author Affiliations Arch Intern Med. 2003;163(11):1329-1336. doi:10.1001/archinte.163.11.1329.

Conclusion Light to moderate alcoholic beverage consumption may be associated with a lower risk of

type 2 diabetes mellitus among women aged 25 to 42 years, although this benefit may not persist at higher levels. PROSPECTIVE STUDIES of alcohol intake and risk of type 2 diabetes mellitus have produced conflicting results. Some,1- 5 but not all,6- 7 studies have implicated heavy drinking as a risk factor for type 2 diabetes mellitus.1- 4 Conversely, several recent prospective studies,8- 13 mainly conducted in men, have suggested that light to moderate drinking may be inversely associated with the development of type 2 diabetes mellitus. This is consistent with the observations that low to moderate amounts of alcohol intake may increase insulin sensitivity and slow glucose uptake from a meal.14- 17 Few prospective studies have examined the relationship between alcohol intake and diabetes mellitus in women. In an early study of women aged 34 to 59 years from the original Nurses' Health Study, low to moderate alcohol consumption was associated with a lower risk of diabetes mellitus,18 which was confirmed in a later analysis from the same cohort.13 In the Rancho Bernardo cohort1 and in the San Antonio Heart Study,4 alcohol consumption was positively associated with risk of diabetes mellitus in men, but not in women. In the latter study,4 alcohol consumption was inversely associated with type 2 diabetes mellitus in women. The influence of patterns of drinking or type of drink on the risk of diabetes mellitus has been less studied, but the inverse relationship seems to depend on frequency and pattern of drinking.12 This study aims to examine the relationship between alcohol consumption and type 2 diabetes mellitus among women aged 25 to 42 years who participated in the Nurses' Health Study II, with focus on (1) the role of lifestyle factors that may confound or modify the main association, (2) the influence of beverage choice, and (3) the impact of frequency of alcohol consumption.