Physical Activity In Relation Research Articles

A Prospective Study of Physical Activity and Incident and Fatal Prostate Cancer

Whether physical activity has benefits against prostate cancer incidence or progression is unclear. Therefore, we assessed physical activity in relation to prostate cancer incidence, mortality, and Gleason histologic grade. We used data from the Health Professionals Follow-up Study, a prospective cohort study, to determine the number of cases of incident, advanced (seminal vesicle invasion, metastasis, or fatal), fatal, and high-grade prostate cancer in a cohort of 47,620 US male health professionals, followed up from February 1, 1986, to January 31, 2000. During 14 years of follow-up, we documented 2892 new cases of prostate cancer, including 482 advanced cases (280 of which were fatal). For total prostate cancer, no association was observed for total, vigorous, and nonvigorous physical activity. In men 65 years or older, we observed a lower risk in the highest category of vigorous activity for advanced (multivariable relative risk, 0.33; 95% confidence interval, 0.17-0.62, for more than 29 vs 0 metabolic equivalent hours) and for fatal (relative risk, 0.26; 95% confidence interval, 0.11-0.66) prostate cancer. No associations were observed in younger men. Differential screening by prostate-specific antigen or a reduction in physical activity due to undiagnosed prostate cancer did not appear to account for the results. Among cases, men with high levels of physical activity were less likely to be diagnosed with poorly differentiated cancers (Gleason grade > or = 7). Although the mechanisms are not yet understood, these findings suggest that regular vigorous activity could slow the progression of prostate cancer and might be recommended to reduce mortality from prostate cancer, particularly given the many other documented benefits of exercise.

A Prospective Cohort Study Of Physical Activity In Relation To Disease-free Survival Of Breast Cancer In Women Diagnosed With Breast Cancer

Purpose To examine the associations of physical activity with disease-free survival of breast cancer in women diagnosed with Stage 0 – IIIA breast cancer and enrolled in the Health, Eating, Activity, and Lifestyle (HEAL) Study. Methods At baseline (6 +/-2 months post-diagnosis), 800 women completed interview-administered questionnaires which included information on year before diagnosis physical activity levels, physical activity levels at baseline, and health history. Body weight and height were measured at the baseline visit. During the two year follow-up, 732 (91.5%) women experienced a disease-free survival, 35 (4.4%) women were diagnosed with a recurrence of breast cancer or new breast primary, and 41 (5.1%) women died of breast cancer. Results In multivariate analyses that accounted for potential confounders including age, BMI, disease stage, adjuvant treatment, tamoxifen use, ethnicity, menopausal status, family history, smoking status, and education, the RRs (95% CI) for the combined end point (breast cancer death, recurrence, or new breast primary) for <1.75, 1.76 – 13.1, and >13.2 METhr/week of sports/recreational physical activity reported for the year before diagnosis were 1.00 (referent), 0.62 (0.31–1.27), and 0.77 (0.53 – 1.11), respectively (p trend = .16). The RRs (95% CI) for 0, 0.1 – 10.4, and >10.4 METhr/week of physical activity at baseline were 1.00 (referent), 0.77 (0.37- 1.61), and 0.85 (0.58 – 1.25), respectively (p trend = .49). Conclusions These results are suggestive of an association between higher levels of physical activity reported for the year before breast cancer diagnosis or within the first year after diagnosis and disease-free survival of breast cancer. With additional 5-year follow-up data on breast cancer recurrence and mortality (available in January 2005), these results should become definitive. Supported by NCI contracts N01-CN-75036-20, NO1-CN-05228, NO1-PC-67010, and training grant T32 CA09661. A portion of this work was conducted through the Clinical Research Center at the University of Washington and supported by the National Institutes of Health, Grant M01-RR-00037, and the University of New Mexico, NCRR M01-RR-0997.

Physical Activity In Relation To Family Income In Finnish Adolescents Aged 15 To 16 Years

Physical Activity In Relation To Family Income In Finnish Adolescents Aged 15 To 16 Years

A Prospective Cohort Study Of Physical Activity In Relation To Disease-free Survival Of Breast Cancer In Women Diagnosed With Breast Cancer

A Prospective Cohort Study Of Physical Activity In Relation To Disease-free Survival Of Breast Cancer In Women Diagnosed With Breast Cancer

Physical Activity In Relation To Family Income In Finnish Adolescents Aged 15 To 16 Years

PURPOSE This study evaluated how family income is associated with the level and the types of physical activity in adolescents. METHODS Study population consisted of the Northern Finland birth cohort 1986 including 7182 boys and girls aged 15 to 16 years and their parents. They responded to mailed questions on physical activity and social background. Adolescents were classified into quartile groups (I to IV) according to family income reported by their parents. Logistic regression analyses was used to evaluate the association between family income and physical activity. RESULTS The proportion of active adolescents was 45 % in the high-income group I and 32 % in the low-income group IV. Odds ratio for being active was 1.65 (CI 1.31–2.08) for the group I compared to the group IV after adjustment for family type (single vs two parent family), mother's level of education and place of residence (urban vs rural residence). Participation in different types of physical activity varied only modestly between different family income groups. However, participation in indoor bandy, slalom, tennis and golf in boys, and in roller-skating or skateboarding in both sexes, was more common in the high-income group I (p <0.05). CONCLUSIONS Family income was positively associated with the level of physical activity in adolescents. Participation in some sports that require relatively expensive equipments or participation fees was more common in the highest family income groups.

Levels of Physical Activity for Colon Cancer Prevention Compared with Generic Public Health Recommendations: Population Prevalence and Sociodemographic Correlates

The proportion of Australian adults achieving physical activity levels believed to be sufficient for colon cancer prevention was estimated, and sociodemographic correlates (age, gender, educational attainment, occupation, marital status, and children in household) of meeting these levels of activity were analyzed. Data from the 2000 National Physical Activity Survey were used to estimate the prevalence of participation in physical activity in relation to three criteria: generic public health recommendations, weekly amount of at least moderate-intensity physical activity currently believed to reduce risk of colon cancer, and weekly amount of vigorous-intensity physical activity believed to reduce risk of colon cancer. Overall, 46% of adults met the generic public health criterion, 26% met the colon cancer criterion based on participation in at least moderate-intensity physical activity, and 10% met the colon cancer criterion based on vigorous-intensity physical activity. Women were less likely than men to meet the colon cancer criteria. Younger and more educated persons were more likely to meet all three criteria. The most pronounced differences between gender, age, and educational attainment groups were found for meeting the amount of vigorous-intensity physical activity believed to reduce risk of colon cancer. The population prevalence for meeting proposed physical activity criteria for colon cancer prevention is low and much lower than that related to the more generic public health recommendations. If further epidemiologic studies confirm that high volumes and intensities of activity are required, the public health challenges for colon cancer will be significant.

Physical activity in relation to cognitive decline in elderly men

Physical activity may be associated with better cognition. To investigate whether change in duration and intensity of physical activity is associated with 10-year cognitive decline in elderly men. Data of 295 healthy survivors, born between 1900 and 1920, from the Finland, Italy, and the Netherlands Elderly (FINE) Study were used. From 1990 onward, physical activity was measured with a validated questionnaire for retired men and cognitive functioning with the Mini-Mental State Examination (maximum score 30 points). The rates of cognitive decline did not differ among men with a high or low duration of activity at baseline. However, a decrease in activity duration of >60 min/day over 10 years resulted in a decline of 1.7 points (p < 0.0001). This decline was 2.6 times stronger than the decline of men who maintained their activity duration (p = 0.06). Men in the lowest intensity quartile at baseline had a 1.8 (p = 0.07) to 3.5 (p = 0.004) times stronger 10-year cognitive decline than those in the other quartiles. A decrease in intensity of physical activity of at least half a standard deviation was associated with a 3.6 times stronger decline than maintaining the level of intensity (p = 0.003). Even in old age, participation in activities with at least a medium-low intensity may postpone cognitive decline. Moreover, a decrease in duration or intensity of physical activity results in a stronger cognitive decline than maintaining duration or intensity.

Physical Activity in Relation to All-Site and Lung Cancer Incidence and Mortality in Current and Former Smokers

Abstract Increased physical activity has been associated with a reduction in the incidence and mortality from all-site cancer and some site-specific cancers in samples of primarily nonsmoking individuals; however, little is known about whether physical activity is associated with similar risk reductions among smokers and ex-smokers. This study examined physical activity in relation to all-site cancer and lung cancer incidence and mortality in a sample of current and former smokers (n = 7,045; 59% male; 95% Caucasian; mean age, 63 years) drawn from the β-Carotene and Retinol Efficacy Trial, a lung cancer chemoprevention trial. Hazard rate ratios and 95% confidence intervals associated with a 1 SD increase in physical activity were 0.86 (0.80-0.94) for all-site cancer only among men, 0.84 (0.69-1.03) for lung cancer only for younger participants, 0.75 (0.59-0.94) for cancer mortality among younger participants and 0.68 (0.53-0.89) among women, and 0.69 (0.53-0.90) for lung cancer mortality only among women. These results suggest that incidence may be more attenuated by physical activity for men and mortality more attenuated for women. Effects may be more pronounced for younger people and may differ inconsistently by pack-years of smoking. Physical activity may play a role in reducing cancer risk and mortality among those with significant tobacco exposure. Prospective studies using more sophisticated measures of physical activity assessed at multiple time points during follow-up are needed to corroborate these associations.

Amount, Type, and Timing of Recreational Physical Activity in Relation to Colon and Rectal Cancer in Older Adults: the Cancer Prevention Study II Nutrition Cohort

AbstractPhysical activity has consistently been associated with lower risk of colon cancer, but information is limited on the amount, type, and timing of activities. The relationship between physical activity and rectal cancer is unclear. We examined characteristics of recreational physical activity in relation to colon and rectal cancer in the Cancer Prevention Study II Nutrition Cohort of 70,403 men and 80,771 women (median age, 63 years); 940 colon and 390 rectal cancers were identified from enrollment in 1992 to 1993 through August 1999. The multivariate-adjusted rate ratios (95% confidence intervals) associated with any recreational physical activity compared with none were 0.87 (0.71-1.06) for colon cancer and 0.70 (0.53-0.93) for rectal cancer. Colon cancer risk decreased significantly with increasing total hours (P for trend without reference group = 0.007) and metabolic equivalent hours (P for trend = 0.006) per week of activities. No clear decrease in rectal cancer risk was seen with increasing hours per week of physical activity. Rate ratios (95% confidence intervals) were 0.72 (0.52-0.98) for &amp;lt;2 hours, 0.68 (0.47-0.97) for 2 to 3 hours, 0.59 (0.41-0.83) for 4 to 6 hours, and 0.83 (0.59-1.16) for ≥7 hours per week of physical activity compared with none. Past exercise, as reported in 1982, was not associated with risk of either colon or rectal cancer. We conclude that increasing amounts of time spent at recreational physical activity are associated with substantially lower risk of colon cancer and that recreational physical activity is associated with lower risk of rectal cancer in older men and women.

Interactions between physical activity and variants of the genes encoding uncoupling proteins −2 and −3 in relation to body weight changes during a 10-y follow-up

To examine interactions between physical activity and possibly functional variants of the genes encoding uncoupling proteins -2 and -3 in relation to body weight change. We hypothesize that physical inactivity acts synergistically with a 45 bp insertion variant in the 3'untranslated region (3'UTR) of the UCP2-gene and with a t-allele of codon -55 in the promoter of the UCP3-gene in relation to subsequent weight change. Population-based longitudinal study of cohorts of juvenile obese and nonobese men, who were identified at the mandatory draft board examination in Copenhagen and adjacent regions at a median age of 19 y in 1943-77 and later examined at general health surveys in 1981-83 and 1991-93. The juvenile obese cohort included 568 men who at the draft board had a BMI > or =31 kg/m2 and the cohort of controls included 717 randomly selected draftees. Height and weight were measured, and information about physical activity was collected from a self-administered questionnaire. The genotyping of the polymorphisms was performed using RFLP techniques. The main outcome measure was change in BMI during the 10-y follow-up period. Additional outcome measures were obesity, waist circumference and body fat mass index measured at follow-up. Physical activity, the 3'UTR insertion polymorphism and the -55 c/t polymorphism were not consistently associated with changes in BMI, and there were no evidence for interactions between the UCP-variants and physical activity in relation to changes in BMI. No evidence for interaction between the UCP-variants and physical activity was found in relation to the additional obesity measures. This study does not support that interactions between physical activity and variants in the UCP2- or UCP3-gene are major determinants of subsequent weight changes in Danish Caucasian men.

Occupational, commuting, and leisure-time physical activity in relation to total and cardiovascular mortality among finnish subjects with type 2 diabetes

Occupational, commuting, and leisure-time physical activity in relation to total and cardiovascular mortality among finnish subjects with type 2 diabetes

Some life-style factors and the risk of invasive epithelial ovarian cancer in Swedish women

The objective of this nationwide case-control study was to examine body mass index (BMI), alcohol use, coffee consumption, cigarette smoking, and leisure-time physical activity in relation to epithelial ovarian cancer (EOC) risk. Subjects were 655 newly diagnosed EOC cases and 3899 population controls, all 50-74 years of age at recruitment between 1993 and 1995. Data were collected through mailed questionnaires. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. Women with a BMI > or = 30 kg/m2 compared with those with a BMI < 22 kg/m2 appeared to have an elevated EOC risk (OR = 1.37, 95% CI: 1.01-1.85), particularly of mucinous (OR = 2.76, 95% CI: 1.15-6.61) and clear-cell histologies (OR = 2.68, 95% CI: 0.96-7.48). The OR for EOC among coffee users reporting > or = 6 daily cups compared with non-users was 0.68 (95% CI: 0.42-1.10). Alcohol consumption was unrelated to EOC risk. Compared to non-smokers the ORs of EOC among current smokers were 0.70 (95% CI: 0.52-0.94) for those who smoked 1-10 cigarettes/day and 0.74 (95% CI: 0.53-1.02) for heavier smokers, while former smokers were at an unaltered risk (OR = 0.83, 95% CI: 0.66-1.04). Reduced EOC risks were observed among women in the highest compared with the lowest physical activity levels both at age 18-30 years (OR = 0.67, 95% CI: 0.52-0.87) and during the last years preceding study enrollment (OR = 0.68, 95% CI: 0.53-0.87). We conclude that women may avoid an excess risk of EOC through maintaining a normal BMI and reduce their risk by participation in leisure-time physical activity. The use of coffee, alcohol, or cigarette smoking does not appear to increase the risk of EOC.

Occupational, commuting, and leisure-time physical activity in relation to total and cardiovascular mortality among Finnish subjects with type 2 diabetes.

Some previous studies have assessed the association between leisure-time physical activity and mortality among patients with diabetes, but the potential effect of occupational and commuting physical activity remains uncertain. We prospectively followed up 3316 Finnish participants 25 to 74 years of age with type 2 diabetes. The association of different types of physical activity with mortality was examined with Cox proportional-hazard models. During a mean follow-up of 18.4 years, 1410 deaths were recorded, 903 of which were due to cardiovascular disease (CVD). The multivariate-adjusted (age, sex, study year, body mass index, systolic blood pressure, cholesterol, smoking, and the 2 other types of physical activity) hazard ratios associated with light, moderate, and active work were 1.00, 0.86, and 0.60 (P(trend)<0.001) for total mortality and 1.00, 0.91, and 0.60 (P(trend)<0.001) for CVD mortality, respectively. The multivariate-adjusted hazard ratios associated with low, moderate, and high leisure-time physical activity were 1.00, 0.82, and 0.71 (P(trend)<0.001) for total mortality and 1.00, 0.83, and 0.67 (P(trend)=0.005) for CVD mortality, respectively. Active commuting had significant inverse associations with total and CVD mortality, but these relations were no longer significant after additional adjustment for occupational and leisure-time physical activity. Moderate or high levels of physical activity reduce total and CVD mortality among patients with type 2 diabetes. Not only leisure-time physical activity but also occupational and commuting physical activities are important components of a healthy lifestyle among patients with diabetes.

Leisure and occupational physical activity in relation to body mass index in men and women

Background: When studying physical activity in relation to health it is important to use valid methods. Objective : To test the relative validity of a short physical activity questionnaire against 3 day physical activity records, and to describe leisure and occupational physical activity in men and women by body mass index(BMI).Design: The validation study included 133 men and 139 women, and the cross-sectional study 1380 men and 2281 women. All subjects were aged 37-60 years, with a BMI of 17.6-59.2 kg m-2. Results: Mean estimated physical activity level (PAL) from the 3 day activity records differed by reported grade of occupational physical activity from the short activity questionnaire (p

Leisure and occupational physical activity in relation to body mass index in men and women

Background: When studying physical activity in relation to health it is important to use valid methods. Objective : To test the relative validity of a short physical activity questionnaire against 3 day physical activity records, and to describe leisure and occupational physical activity in men and women by body mass index(BMI).Design: The validation study included 133 men and 139 women, and the cross-sectional study 1380 men and 2281 women. All subjects were aged 37-60 years, with a BMI of 17.6-59.2 kg m-2. Results: Mean estimated physical activity level (PAL) from the 3 day activity records differed by reported grade of occupational physical activity from the short activity questionnaire (p

Relationship of physical activity and body mass index to the risk of hypertension: a prospective study in Finland.

Prospective studies on physical activity in relation to the risk for hypertension are scant, particularly in women. This study aimed at finding out whether regular physical activity can reduce the risk of hypertension in both men and women, and in subjects with and without overweight. We prospectively followed 8302 Finnish men and 9139 women aged 25 to 64 years without a history of antihypertensive drug use, coronary heart disease, stroke, and heart failure at baseline. Both single and joint associations of physical activity and body mass index with the risk of hypertension were examined using Cox proportional hazard models. During a mean followup of 11 years, there were 1600 incident cases of drug-treated hypertension. Multivariate-adjusted hazards ratios of hypertension associated with light, moderate, and high physical activity were 1.00, 0.63, and 0.59 in men (Ptrend<0.001), and 1.00, 0.82, and 0.71 in women (Ptrend=0.005), respectively. This association persisted both in subjects who were overweight and in those who were not. Multivariate-adjusted hazards ratios of hypertension based at different levels of body mass index (<25, 25 to 29.9, and > or =30) were 1.00, 1.18, and 1.66 for men (Ptrend<0.001), and 1.00, 1.24, and 1.32 for women (Ptrend=0.007), respectively. Further adjustment for baseline systolic blood pressure did not affect the protective effect associated with physical activity, but it weakened markedly the association between body mass index and hypertension. The present study indicates that regular physical activity and weight control can reduce the risk of hypertension. The protective effect of physical activity was observed in both sexes regardless of the level of obesity.

Physical activity in relation to development and maintenance of obesity in men with and without juvenile onset obesity.

To examine long-term effects of leisure time physical activity (ltpa) and occupational physical activity (opa) on later obesity, and to examine the effect of body weight on later physical inactivity in men with and without juvenile onset obesity. Population-based longitudinal study of obese and nonobese men, who were identified as draftees of median age of 19 y in 1943-77 and later examined at general health surveys in 1982-84, and in 1991-93. Copenhagen and adjacent regions, Denmark. In all, 1143 juvenile obese men with a BMI > or =31 kg/m2 (corresponding to 35% overweight by an originally used national standard) at draft board examination, and, as a nonobese control group, 1278 men selected as a 0.5% random sample of the approximately 255,600 men examined at the draft board and thus representing the study population. Obesity, defined as BMI > or =30 kg/m2, and physical inactivity at the last survey. In the cross-sectional analyses, there were strong concurrent inverse associations between ltpa and prevalence of obesity in both groups, whereas there was no relation to opa. In logistic regression analyses of obesity at the last survey, including both ltpa and opa as well as age, BMI at draft board examination, BMI at first follow-up, length of education, smoking and drinking habits, there were no significant effects of ltpa and opa on the risk of development of obesity in the nonobese group or maintenance of obesity in the obese group. Similar analyses of physical inactivity at the last follow-up as outcome showed a significant direct effect of BMI at first follow-up, with a significant trend in the nonobese group, but not in the obese group and no effects on opa. There is no long-term influence of physical activity on development and maintenance of obesity in men, whereas greater body weight increases risk of later physical inactivity during leisure time.

Predictors of Postmenopausal Body Mass Index and Waist Hip Ratio in the Oklahoma Postmenopausal Health Disparities Study

Objective: The goal of the current study has been to examine systematically the respective roles of nutrition, exercise, menopausal weight gain, moderate drinking and smoking as determinants of body mass index (BMI) and waist hip ratio (WHR) in a setting in which the role of race or ethnic group could be simultaneously or individually evaluated as predictors of BMI and WHR. Because the use of estrogen replacement has been reported to affect estimates of body fat mass in postmenopausal women, endocrine factors have also been evaluated.Methods: The design is cross-sectional with historical prospective elements. The study has a biomedical focus and is not an epidemiologic study. Data are from 649 women recruited into The Postmenopausal Health Disparities Study in Oklahoma. The study population was composed of 649 postmenopausal women: American Indian: 226 (34.9%), Asian: 21 (3.2%), Black: 78 (12.0%), Hispanics: 54 (8.3%) and Whites: 270 (41.6%). Recruitment occurred between 1994 and late 1999 in Oklahoma.Results: In this multi-racial, multi-ethnic study population, there was statistical heterogeneity in all nutrition/dietary and exercise variables as well as in other potential determinants of BMI and WHR. In contrast to the literature available for postmenopausal women in which postmenopausal status, estrogen replacement and race have rarely been taken into account, the results of multi-linear regression revealed the following: Significant predictors for BMI, with or without WHR specified, included the neuroendocrine factors, menopausal weight gain, smoking, mean fitness (i.e., difficulty performing physical activities), fat as percent of total calories, moderate drinking and being Asian or Black. When WHR was not included, total calories and socioeconomic status also entered the model. The statistical predictors of WHR in the total study population with BMI in the equation included BMI and the neuroendocrine variables of FSH, E2, but not ERT, as well as the interaction of higher intensity exercise fitness with frequency, socioeconomic status and being American Indian or Asian. When BMI was not included in the model, in addition to the neuroendocrine factors, the interaction of lower intensity exercise fitness with frequency, fat as percent of total calories, age living alone and being American Indian or and Black were significant predictors of WHR. The predictors of both BMI and WHR were found to differ among individual racial and ethnic groups.Conclusions: Given the role of increased body fat and obesity in disease risk and the substantial differences in life expectancy among the racial and ethnic groups, the findings of this study, particularly in contrast to literature reports, strongly suggest that a whole variety of factors including hormonal status and race need to be considered when examining the role of dietary factors and physical activity in relation to estimates of body fat mass and disease risk.

Physical activity in relation to cardiovascular disease and total mortality among men with type 2 diabetes.

The present study was conducted to examine the relationship of physical activity with risk of cardiovascular disease (CVD) and mortality among men with type 2 diabetes. CVD risk and mortality are increased in type 2 diabetes. Few epidemiological studies have investigated the effect of physical activity on these outcomes among type 2 diabetics. Of the 3058 men who reported a diagnosis of diabetes at age 30 years or older in the Health Professionals' Follow-up Study (HPFS), we excluded 255 who reported a physical impairment. In the remaining 2803 men, physical activity was assessed every 2 years; 266 new cases of CVD and 355 deaths of all causes were identified during 14 years of follow-up. Relative risks of CVD and death were estimated from Cox proportional hazards analysis with adjustment for potential confounders. The multivariate relative risks of CVD incidence corresponding to quintiles of total physical activity were 1.0, 0.87, 0.64, 0.72, and 0.67 (Ptrend=0.07). The corresponding multivariate relative risks for total mortality were 1.0, 0.80, 0.57, 0.58, and 0.58 (Ptrend=0.005). Walking was associated with reduced risk of total mortality. Relative risks across quintiles of walking were 1.0, 0.97, 0.87, 0.97, and 0.57 (Ptrend=0.002). Walking pace was inversely associated with CVD, fatal CVD, and total mortality independently of walking hours. Physical activity was associated with reduced risk of CVD, cardiovascular death, and total mortality in men with type 2 diabetes. Walking and walking pace were associated with reduced total mortality.

Occupational, commuting, and leisure-time physical activity in relation to risk for Type 2 diabetes in middle-aged Finnish men and women.

Leisure-time physical activity can reduce the risk of Type 2 diabetes, but the potential effect of different types of physical activity is still uncertain. This study is to examine the relationship of occupational, commuting and leisure-time physical activity with the incidence of Type 2 diabetes. We prospectively followed 6898 Finnish men and 7392 women of 35 to 64 years of age without a history of stroke, coronary heart disease, or diabetes at baseline. Hazards ratios of incidence of Type 2 diabetes were estimated by levels of occupational, commuting, and leisure-time physical activity. During a mean follow-up of 12 years, there were 373 incident cases of Type 2 diabetes. In both men and women combined, the hazards ratios of diabetes associated with light, moderate and active work were 1.00, 0.70 and 0.74 (p=0.020 for trend) after adjustment for confounding factors (age, study year, sex, systolic blood pressure, smoking, education, the two other types of physical activity and BMI). The multivariate-adjusted hazards ratios of diabetes with none, 1 to 29, and more than 30 min of walking or cycling to and from work were 1.00, 0.96, and 0.64 (p=0.048 for trend). The multivariate-adjusted hazards ratios of diabetes for low, moderate, high levels of leisure-time physical activity were 1.00, 0.67, and 0.61 (p=0.001 for trend); after additional adjustment for BMI, the hazards ratio was no longer significant. Moderate and high occupational, commuting or leisure-time physical activity independently and significantly reduces risk of Type 2 diabetes among the middle-aged general population.