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Original Investigation |

A Prospective Study of Weight Training and Risk of Type 2 Diabetes Mellitus in Men

Anders Grøntved, MPH, MSc; Eric B. Rimm, ScD; Walter C. Willett, MD, DrPH; Lars B. Andersen, PhD, DrMED; Frank B. Hu, MD, PhD
Arch Intern Med. 2012;172(17):1306-1312. doi:10.1001/archinternmed.2012.3138.
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Background  The role of weight training in the primary prevention of type 2 diabetes mellitus (T2DM) is largely unknown.

Methods  To examine the association of weight training with risk of T2DM in US men and to assess the influence of combining weight training and aerobic exercise, we performed a prospective cohort study of 32 002 men from the Health Professionals Follow-up Study observed from 1990 to 2008. Weekly time spent on weight training and aerobic exercise (including brisk walking, jogging, running, bicycling, swimming, tennis, squash, and calisthenics/rowing) was obtained from questionnaires at baseline and biennially during follow-up.

Results  During 508 332 person-years of follow-up (18 years), we documented 2278 new cases of T2DM. In multivariable-adjusted models, we observed a dose-response relationship between an increasing amount of time spent on weight training or aerobic exercise and lower risk of T2DM (< .001 for trend). Engaging in weight training or aerobic exercise for at least 150 minutes per week was independently associated with a lower risk of T2DM of 34% (95% CI, 7%-54%) and 52% (95% CI, 45%-58%), respectively. Men who engaged in aerobic exercise and weight training for at least 150 minutes per week had the greatest reduction in T2DM risk (59%; 95% CI, 39%-73%).

Conclusions  Weight training was associated with a significantly lower risk of T2DM, independent of aerobic exercise. Combined weight training and aerobic exercise conferred a greater benefit.

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Figure 1. Participation in weight training over time (1990-2006). Data are the age-adjusted percentage of men engaged in weight training and mean minutes per week of weight training in men engaged in weight training across study year.

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Figure 2. Dose-response relationship between weight training and risk of type 2 diabetes mellitus. Dotted lines represent 95% CIs for the trend obtained from restricted cubic spline regression (4 knots). The model included the following covariates: age (months), aerobic exercise (0, 1-59, 60-149, or ≥150 minutes per week), other physical activity of at least moderate intensity (quintiles), television viewing (quintiles), smoking (never, past, or current with cigarette use of 1-14, 15-24, or ≥25 per day), alcohol consumption (0, 1-5, 6-10, 11-15, or >15 g/d), coffee intake (0, <1, 1-3, >3-5, >5 cups per day), race (white vs nonwhite), family history of diabetes, intake of total energy, trans fat, polyunsaturated fat to saturated fat ratio, cereal fiber, whole grain, and glycemic load (all dietary factors in quintiles). The analysis was truncated to men reporting no more than 420 minutes per week. P = .59 for the nonlinear relationship.

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Figure 3. Joint association of weight training and aerobic exercise with the risk of type 2 diabetes mellitus. Data are estimates of relative risk with 95% CIs (vertical line) from multivariable Cox proportional hazards regression models adjusted for age (months), other physical activity of at least moderate intensity (quintiles), television viewing (quintiles), smoking (never, past, or current with cigarette use of 1-14, 15-24, or ≥25 per day), alcohol consumption (0, 1-5, 6-10, 11-15, or >15 g/d), coffee intake (0, <1, 1-3, >3-5, or >5 cups per day), race (white vs nonwhite), family history of diabetes, intake of total energy, trans fat, polyunsaturated fat to saturated fat ratio, cereal fiber, whole grain, and glycemic load (all dietary factors in quintiles). Adherence to the recommendations on aerobic exercise is at least 150 minutes per week.

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