08/22/2026
Exercise and diabetes risk.
Remember properly performed t'ai chi ch'uan is an aerobic exercise. Many don't understand that, but it is low to moderate aerobic exercise. Pa-kua chang is also an aerobic exercise and can be much higher intensity aerobic exercise than some types of t'ai chi ch'uan. Fast t'ai chi ch'uan is higher intensity but the short duration makes it appropriate for interval training. Harvey Kurland
Both Weight Training and Aerobic Exercise Lower Diabetes Risk
News Author:Troy Brown
CME Author: Désirée Lie, MD, MSEd
According to the current study, achieving moderate or vigorous physical activity of at least 30 minutes/day is associated with a substantial reduction in the risk for type 2 diabetes mellitus (T2DM). However, although the role of aerobic exercise in reducing T2DM risk is well documented, there is inadequate evidence for the role of weight training.
This is a longitudinal observational study to examine the association between weight training and risk for T2DM in men in the Health Professionals Follow- up Study (HPFS) who were observed biennially for 18 years.
Weight training and aerobic exercise are each associated with a significantly lower risk for T2DM in men, and the benefits are even greater when the 2 activities are combined, according to a study published online August 6 in the Archives of Internal Medicine.
Anders Grøntved, MPH, MSc, a doctoral student at the Institute of Sport Science and Clinical Biomechanics, Exercise Epidemiology Research Unit, and Centre of Research in Childhood Health at the University of Southern Denmark in Odense and a visiting researcher in the Department of Nutrition at the Harvard School of Public Health in Boston, Massachusetts, and colleagues wanted to study the association between weight training and risk for T2DM.
"[W]hereas the evidence that regular aerobic exercise can prevent T2DM is compelling, to our knowledge, no studies have examined the role of weight training in the primary prevention of T2DM," the authors write.
The researchers analyzed data from the HPFS, an ongoing prospective cohort study of 51,529 male health professionals who were aged 40 to 75 years in 1986. Cohort participants are sent a questionnaire biennially about health issues including dietary intake, exercise, disease, height, and weight.
From 1990 forward, the questionnaires asked men to describe their weekly amount of all physical activity and television viewing. The researchers analyzed data for patients who were diagnosed with T2DM between the return of the 1990 questionnaire and January 31, 2008.
For the current analysis, men who reported a history of diabetes, myocardial infarction, angina, coronary artery bypass graft, other heart conditions, stroke, pulmonary embolism, or cancer on the baseline questionnaire in 1986, in 1988, or in 1990 were excluded. This left a study population of 32,002 participants.
Participants were placed into 1 of 4 categories, based on the total number of minutes they spent on aerobic exercise of at least moderate intensity: 0, 1 to 59, 60 to 149, and at least 150 minutes per week. Men were placed in the same categories for weight training. The team also constructed a variable to measure unstructured physical activity of at least moderate intensity, such as heavy outdoor work and stair climbing.
During 508,332 person-years of follow-up (18 years), 2278 new cases of T2DM were documented.
Compared with men who reported no weight training at baseline, men who performed at least 150 minutes/week of weight training did more aerobic exercise, had a healthier dietary intake (except for glycemic load), drank less alcohol, were less likely to smoke, and viewed less television.
Men who performed weight training from 1 to 59 minutes/week had a relative risk (RR) for T2DM of 0.88 compared with nonexercisers in a multivariable-adjusted analysis. For men who performed from 60 to 149 minutes of weight training/week, the relative risk was 0.75, and for those in the highest category of weight training (150 minutes or more/week), it was 0.66 (P < .001 for trend). The multivariable model was adjusted for age, smoking, alcohol consumption, coffee intake, race, family history, dietary factors, and aerobic activity.
Even smaller amounts of weight training were helpful, however. Men who reported any amount of weight training at all had a 48% (95% confidence interval [CI], 1% - 72%) lower risk than men who did no weight training.
For men who reported 1 to 59, 60 to 149, and at least 150 minutes per week of aerobic exercise, the RRs of T2DM were .93, 0.69, and 0.48, respectively (P < .001 for trend) compared with men who did not do aerobic exercise.
The researchers found a dose-response relationship for weight training: the risk for T2DM decreased by 13% (95% CI, 6% - 19%; P < .001) for each 60 minutes of weight training performed per week. The strongest association was found at the lower level of aerobic exercise (P < .001 for the nonlinear response).
Men who performed at least 150 minutes of aerobic exercise per week and at least 150 minutes of weight training per week obtained the most benefit (RR, 0.41; 95% CI, 0.27 - 0.61; P = .26 for multiplicative interaction).
"These results support that weight training serves as an important alternative for individuals who have difficulty adhering to aerobic exercise, but the combination of weight training with aerobic exercise conferred an even greater benefit," the authors write.
Because the study participants were mostly white men, the results may not be generalizable to women or other ethnic or racial groups.
The study is supported by grants from the National Institutes of Health. The authors have disclosed no relevant financial relationships.
Arch Intern Med. Published online August 6, 2012. Full text
The HPFS is an ongoing prospective cohort study of 51,529 male health professionals aged 40 to 75 years at baseline in 1986.
Every 2 years, participants are sent a questionnaire about medical illness and personal and lifestyle factors, such as height, weight, smoking status, dietary intake (food frequency questionnaire), and physical activity.
94% of men in the cohort completed at least 1 follow-up questionnaire.
This study excluded men who reported a history of diabetes, cancer, myocardial infarction, angina, coronary artery bypass graft, other heart conditions, stroke, or pulmonary embolism on the baseline questionnaire in 1986, in 1988, and in 1990.
The study population consisted of 32,002 men.
From 1990 on, participants reported their average weekly amount of weight training, other physical activity, and television viewing biennially.
Other physical activities included walking, jogging, running, bicycling, swimming, tennis, squash, calisthenics/rowing, and heavy outdoor work.
Participants were also asked about the daily number of flights of stairs climbed and usual walking pace.
Brisk walking, jogging, running, bicycling, swimming, tennis, squash, and calisthenics/rowing were considered aerobic exercises of at least moderate intensity.
There were 13 response categories for aerobic and weight training physical activities, going from no activity to more than 40 hours of activity per week.
There were 4 categories of moderate intensity aerobic exercise: 0, 1 to 59, 60 to 149, and at least 150 minutes per week.
Covariates included dietary intake by calories, source of calories, body mass index, coffee and alcohol intake, and comorbidities.
A diagnosis of T2DM was ascertained by self-report in the questionnaires and confirmed by follow-up questionnaire about tests and diagnosis.
The National Death Index and next of kin were sources used to track deaths.
The cumulative averages of weight training and aerobic physical activity from baseline to censoring time were calculated to minimize measurement error and characterize long-term exposure status.
There were 2278 new cases of T2DM during 508,332 person-years of follow-up (over the course of 18 years).
The percentage of men who engaged in weight training increased to 29% in 2006, but the average time spent weight training was stable over time.
Men who reported weight training at least 150 minutes per week at baseline performed more aerobic exercise, viewed less television, drank less alcohol, were less likely to smoke, and had a healthier dietary intake compared with men who reported no weight training.
In adjusted analysis including aerobic exercise, compared with men reporting no weight training, "men performing weight training 1 to 59, 60 to 149, and at least 150 minutes per week had RRs of 0.88, 0.75, and 0.66 for lower risk for T2DM (P < .001 for trend), respectively."
For aerobic exercise, the RRs of T2DM for men reporting 1 to 59, 60 to 149, and at least 150 minutes of activity per week compared with men reporting no aerobic exercise were 0.93, 0.69, and 0.48, respectively (P < .001 for trend).
The protective effect of weight training was independent of the effect of aerobic exercise.
Any weight training was associated with 48% (95% CI, 1% - 72%) lower risk compared with no weight training.
The risk reduction associated with weight training was comparable with that of aerobic exercise, with risk reductions of approximately 35% and 50% for at least 150 minutes/week of weight training or aerobic exercise, respectively.
The authors conclude that men who engaged in weight training had a reduced risk for T2DM and that the association was independent of aerobic exercise: Even a modest amount of time engaged in weight training seemed beneficial.
Thus, weight training is a valuable alternative for individuals who have difficulty adhering to aerobic exercise, and adding weight training to aerobic exercise gives further protection from T2DM.
Weight training of even 1 to 59 minutes weekly is associated with reduced risk for T2DM.
In men, the benefits of weight training are similar to that of aerobic training for reduction in risk for T2DM.
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