The role of physical activity in the management of impared glucose tolerance: a systematic review.

Although physical activity is widely reported to reduce the risk of type 2 diabetes in individuals with prediabetes, few studies have examined this issue independently of other lifestyle modifications. The aim of this review is to conduct a systematic review of controlled trials to determine the independent effect of exercise on glucose levels and risk of type 2 diabetes in people with prediabetes (IGT and/or IFG). A detailed search of MEDLINE (1966–2006) and EMBASE (1980–2006) found 279 potentially relevant studies, eight of which met the inclusion criteria for this review. All eight studies were controlled trials in individuals with impaired glucose tolerance. Seven studies used a multi-component lifestyle intervention that included exercise, diet and weight loss goals and one used a structured exercise training intervention. Four studies used the incidence of diabetes over the course of the study as an outcome variable and four relied on 2-h plasma glucose as an outcome measure. In the four studies that measured the incidence of diabetes as an outcome, the risk of diabetes was reduced by approximately 50% (range 42–63%); as these studies reported only small changes in physical activity levels, the reduced risk of diabetes is likely to be attributable to factors other than physical activity. In the remaining four studies, only one reported significant improvements in 2-h plasma glucose even though all but one reported small to moderate increases in maximal oxygen uptake. These results indicate that the contribution of physical activity independent of dietary or weight loss changes to the prevention of type 2 diabetes in people with prediabetes is equivocal

Rationale, design and baseline data from the PREPARE (Pre-diabetes Risk Education and Physical Activity Recommendation and Encouragement) programme study: a randomized controlled trial.

Objective: The PREPARE programme study is a randomized controlled trial which aims to determine whether structured education can be used to increase physical activity and improve glucose tolerance in individuals with impaired glucose tolerance (IGT). This paper outlines the rationale, design and baseline data from the PREPARE programme study. Methods: Individuals with IGT were recruited from ongoing diabetes screening programmes. Outcomes included an oral glucose tolerance test, physical activity (piezoelectric pedometer) and psychological determinants. Results: 103 individuals (male n=65; female n=38) were recruited, 28% of whom were from a South Asian ethnic background. At baseline the participants mean age and BMI were 64 ± 9 years and 29.4 ± 4.5 kg/m2 respectively. Steps per day were associated with 2-h glucose (ρ = -0.22, p = 0.03), fasting glucose (ρ = -0.22, p = 0.04), HDL-cholesterol (ρ = 0.23, p = 0.02), triglycerides (ρ = -0.22, p = 0.03) and body fat percentage (ρ = -0.26, p = 0.01). Mean selfefficacy scores were significantly (p<0.01) higher for walking than for any other form of exercise. Participants reported high levels of concern about their IGT status but were confident that exercise would help treat/control IGT. Conclusion: This study demonstrates the importance of developing effective physical activity and self-management programmes for individuals with IGT. Practical implications: This study provides a detailed framework for the promotion of physical activity in a population identified with an increased risk of developing type 2 diabetes which, if successful, could feasibly be implemented in a primarily health care or community setting

Additional file 1: of Safe RESIDential Environments? A longitudinal analysis of the influence of crime-related safety on walking

Relationship between crimes reported to police and walking inside the neighbourhood (min/week). (DOC 29 kb

Chronological and Discovery Age for all employees (total), men and women

<p><b>Copyright information:</b></p><p>Taken from "Chronic disease risk factors, healthy days and medical claims in South African employees presenting for health risk screening"</p><p>http://www.biomedcentral.com/1471-2458/8/228</p><p>BMC Public Health 2008;8():228-228.</p><p>Published online 4 Jul 2008</p><p>PMCID:PMC2475536.</p><p></p

Walking and Inflammatory Markers in Individuals Screened for Type 2 Diabetes.

Objective: To investigate the association of walking activity with inflammatory markers and fasting insulin in a bi-ethnic population screened for type 2 diabetes in Leicester, United Kingdom, between 2005 and 2006. Method: Physical activity, adipocytokine, high-sensitivity C-reactive protein and fasting insulin measurements were available for 400 individuals screened for type 2 diabetes. Of the 400 participants, 56% were diagnosed with normal glucose control, 36% with prediabetes and 8% with diabetes. Results: Multivariate statistical analysis showed that those who reported walking for at least 30 minutes on at least five days per week had lower levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α compared to those who reported lower walking activity levels, after adjustment for other modes of moderate-to-vigorous physical activity, age, ethnicity, sex, social deprivation and smoking staus. Further adjustment for waist circumference attenuated the association of walking with tumor necrosis factor-α. Conclusion: Walking activity, independent of other forms of physical activity, is associated with lower levels of circulating pro-inflammatory markers