Prevention of type 2 diabetes by physical activity: What has history taught us?

Abstract

The relationship between physical activity and prevention of T2D is described in ground-breaking epidemiological studies by Helmrich and Manson and in the excellent epidemiological overview by Kriska and Bennett. The ideas proposed have led to a new era of intervention studies of randomized control trials which have paved the way for proof that prevention of this disease is indeed feasible. These historical papers, though only observational research or reviews, can be considered important milestones in prevention research, because all pointed towards how to achieve scientific rigor: prospective epidemiological studies on large numbers, selection of individuals with impaired glucose tolerance, with proper data quantification and with correct evaluation of patient compliance in both genders. Prior epidemiological studies, suggested that societies that change lifestyle and become more sedentary, have a greater increase in T2D. Their data supported the idea that persons with T2D are less active and more sedentary than non-diabetic people and hypothesized that there may be a relationship between obesity, fat distribution, physical inactivity and glucose tolerance. Hence physical activity as a means to prevent or delay the onset of T2D was indeed possible but meaningful answers could only be found in large-scale intervention trials which should be well-designed and use appropriate tools that objectively evaluate physical activity, as seen in intervention trials carried out in the following years. The present paper attempts to indicate the most salient studies that conform to the suggestions made in this trailblazing study for preventing or delaying T2D, and suggest future research This article is protected by copyright. All rights reserved.