The dose-response association between wearables-quantified incidental physical activity and type 2 diabetes: a prospective cohort study

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ID: 329668
2026
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Abstract
Abstract Aim This prospective cohort study aimed to quantify dose–response associations between intensity-specific incidental physical activity (IPA) and the incidence of type 2 diabetes (T2D) in a large cohort of UK adults. A secondary aim was to estimate the T2D-specific equivalence of 1 minute of vigorous-intensity IPA relative to moderate- and light-intensity IPA. Methods Participants were adults from the UK Biobank accelerometry sub-study who self-reported as nonexercisers. Individuals were excluded if they had T2D at baseline, were using insulin therapy, or received a T2D diagnosis within 12 months of follow-up. T2D status was primarily derived from primary care records. Device-measured IPA was categorized into light (LIPA; 1.5 to <3 METs), moderate (MIPA; 3 to <6 METs), and vigorous (VIPA; ≥6 METs) intensities. Additional analyses examined the T2D-specific equivalence of 1 minute of VIPA to MIPA and LIPA. The reference group comprised participants accumulating neither MIPA nor VIPA. Results The primary analysis included 22 857 nonexercisers (mean age 62.1 ± 7.7 years, 42.8% male). Over a 7.8-year follow-up period, 721 (3.2%) participants developed T2D. MIPA and VIPA, but not LIPA, exhibited near-linear inverse associations with T2D risk. Median VIPA (4.75 minutes/day) was associated with a hazard ratio (HR) 0.62 [95% confidence interval (CI) 0.53-0.73], and median MIPA (23.70 minutes/day) showed a HR of 0.67 (95% CI: 0.52-0.86). One minute of VIPA/day was associated with an equivalent T2D risk reduction of 5.9 minutes MIPA/day and 46.6 minutes LIPA/day. Conclusion MIPA and VIPA were associated with lower T2D risk in a dose-dependent manner. Although median LIPA was linked to reduced risk, it did not demonstrate a consistent dose–response relationship.
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Authors Angelo Sabag, Raaj Kishore Biswas, Nicholas A. Koemel, Monique E. François, Shelley Elizabeth Keating, Martin J. Gibala, Jonathan P. Little, Nathan Anthony Johnson, Emmanuel Stamatakis, Matthew N. Ahmadi
Journal the journal of clinical endocrinology & metabolism
Year 2026
DOI
10.1210/clinem/dgag316
URL
Keywords Keywords not found

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