Summary

Objective

Although 30 minutes/day of moderate-intensity physical activity is recommended for preventing type 2 diabetes (T2D), current recommendations are based only on self-reports and rarely consider genetic risk. We examined prospective dose-response relationships between specific total/intensity physical activity and T2D events calculated and stratified by different levels of genetic risk.

method

This prospective cohort study is based on 59,325 UK Biobank participants (mean age = 61.1 years in 2013-2015). Specific total/intensity physical activity was collected using accelerometers and linked to national records up to September 30, 2021.

We examined the shape of the dose-response relationship between physical activity and T2D events using fitted restricted cubic splines stratified by polygenic hazard score (based on 424 selected single-nucleotide polymorphisms) using the Cox proportional hazard model.

Results

During the median follow-up of 6.8 yearsthere is a strong linear dose-response relationship between moderate to vigorous intensity physical activity (MVPA) and the incidence of T2D, even after adjusting for genetic risk.

Compared with less active participants, the HR (95% CI) for the higher MVPA rate was: 0.63 (0.53 to 0.75) for 5.3 to 25.9 minutes/day, 0.41 (0 .34 to 0.51) for 26.0 to 68.4 min/day and 0.26 (0.18 to 0.38) for >68.4 min/day.

Although no significant multiplicative interaction was found between physical activity measures and genetic risk, we did find a significant additive interaction between the MVPA and the genetic risk score, indicating a greater difference in absolute risk by MVPA level among those with increased genetic risk.

Conclusion

Participation in physical activity should be promoted, especially in MVPA, especially in those with a high genetic risk of T2D. There may be no minimum or maximum threshold for benefits. These findings may inform the development of future guidelines and interventions to prevent T2D.