Open AccessQuantifying the Association Between Physical Activity and Cardiovascular Disease and Diabetes: A Systematic Review and Meta‐Analysis
Author(s) -
Wahid Ahad,
Manek Nishma,
Nichols Melanie,
Kelly Paul,
Foster Charlie,
Webster Premila,
Kaur Asha,
Friedemann Smith Claire,
Wilkins Elizabeth,
Rayner Mike,
Roberts Nia,
Scarborough Peter
Publication year - 2016
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.115.002495
Subject(s) - medicine , meta analysis , incidence (geometry) , diabetes mellitus , relative risk , stroke (engine) , confounding , type 2 diabetes , myocardial infarction , disease , cardiology , confidence interval , endocrinology , mechanical engineering , physics , engineering , optics
Background The relationships between physical activity ( PA ) and both cardiovascular disease ( CVD ) and type 2 diabetes mellitus (T2 DM ) have predominantly been estimated using categorical measures of PA , masking the shape of the dose‐response relationship. In this systematic review and meta‐analysis, for the very first time we are able to derive a single continuous PA metric to compare the association between PA and CVD /T2 DM , both before and after adjustment for a measure of body weight. Methods and Results The search was applied to MEDLINE and EMBASE electronic databases for all studies published from January 1981 to March 2014. A total of 36 studies (3 439 874 participants and 179 393 events, during an average follow‐up period of 12.3 years) were included in the analysis (33 pertaining to CVD and 3 to T2 DM ). An increase from being inactive to achieving recommended PA levels (150 minutes of moderate‐intensity aerobic activity per week) was associated with lower risk of CVD mortality by 23%, CVD incidence by 17%, and T2 DM incidence by 26% (relative risk [ RR ], 0.77 [0.71–0.84]), ( RR , 0.83 [0.77–0.89]), and ( RR , 0.74 [0.72–0.77]), respectively, after adjustment for body weight. Conclusions By using a single continuous metric for PA levels, we were able to make a comparison of the effect of PA on CVD incidence and mortality including myocardial infarct ( MI ), stroke, and heart failure, as well as T2DM. Effect sizes were generally similar for CVD and T2DM, and suggested that the greatest gain in health is associated with moving from inactivity to small amounts of PA .