Home / Resources / Articles / Higher Fitness Levels Reduce Risk for Developing Diabetes

Higher Fitness Levels Reduce Risk for Developing Diabetes

Jun 4, 2016

Higher level of cardiorespiratory fitness (CRF) over two decades was shown to reduce risk for developing prediabetes and T2, even after adjusting for changes in BMI.

A recent study examined whether maintaining a high level of cardiorespiratory fitness reduces diabetes risk. The prospective association between cardiorespiratory fitness (CRF) measured in young adulthood and middle age on development of prediabetes, defined as impaired fasting glucose and/or impaired glucose tolerance, or diabetes by middle age remains unknown. It was hypothesized that higher fitness levels would be associated with reduced risk for developing incident prediabetes/diabetes by middle age.


One of the main researchers Lisa S. Chow, MD, MS, associate professor of medicine in the division of diabetes, endocrinology and metabolism at the University of Minnesota, noted in an interview, “A number of previous studies have shown people who maintain or increase their CRF through adulthood have a lower risk of developing diabetes, abnormal metabolic measures, cardiovascular disease and cardiovascular mortality than those whose CRF declines. However, these previous studies are limited for several reasons, including use of a largely male population, measurement of fitness over a limited duration (5-7 years) or measurement of fitness at varying intervals prospectively. In this new research, the authors used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study to objectively and rigorously analyze the link between CRF and development of either prediabetes or diabetes over a 20-year period.”

The study used participants who were free from prediabetes/diabetes at baseline (year 0 [Y0]: 1985–1986). CRF was quantified by treadmill duration (converted to metabolic equivalents [METs]) at Y0, Y7 and Y20 and prediabetes/diabetes status was assessed at Y0, Y7, Y10, Y15, Y20 and Y25. An extended Cox model with CRF was used as the primary time-varying exposure. BMI was included as a time-varying covariate. The outcome was development of either prediabetes or diabetes after Y0. Model 1 included age, race, sex, field center, CRF and BMI. Model 2 additionally included baseline (Y0) smoking, energy intake, alcohol intake, education, systolic BP, BP medication use and lipid profile.

The authors conclude that in examining participants who had fitness measured from young adulthood to middle age, it was found that fitness was associated with lower risk for developing prediabetes/diabetes, even when adjusting for BMI over this time period. These findings emphasize the importance of fitness in reducing the health burden of prediabetes and diabetes.

Practice Pearls:

  • Participants who developed diabetes or prediabetes by year 25 had lower cardiorespiratory fitness at baseline.
  • An 8% to 11% higher fitness level reduced the risk for developing prediabetes or type 2 diabetes by 0.1%.
  • The main finding is that higher CRF is associated with lower risk for developing prediabetes and diabetes, even when adjusting for prospective changes in body mass index.

“Twenty year fitness trends in young adults and incidence of prediabetes and diabetes: the CARDIA study.”
http://link.springer.com/article/10.1007/s00125-016-3969-5. Chow LS, et al. Diabetologia. 2016;doi:10.1007/s00125-016-3969-5.
 May 16, 2016

“Higher Lifetime Cardiac Fitness Linked To Lower Risk of Diabetes.” Interview with Dr. Lisa Chow. http://medicalresearch.com/author-interviews/higher-lifetime-cardiac-fitness-linked-to-lower-risk-of-diabetes/24297/.May 17, 2016