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The association of physical activity with obesity, fat distribution and glucose intolerance in Pima Indians

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TLDR
Current physical activity was inversely related to glucose intolerance, obesity and central distribution of fat, particularly in males, suggesting activity may protect against the development of non-insulin-dependent diabetes both directly and through an influence on obesity and fat distribution.
Abstract
The relationships between physical activity, obesity, fat distribution and glucose tolerance were examined in the Pima Indians who have the highest documented incidence of non-insulin-dependent diabetes. Fasting and 2-h post-load plasma glucose concentrations, body mass index, and waist-to-thigh circumference ratios were determined in 1054 subjects aged 15–59 years. Current (during the most recent calendar year) and historical (over a lifetime) leisure and occupational physical activity were determined by questionnaire. Current physical activity was inversely correlated with fasting and 2-h plasma glucose concentrations, body mass index and waist-to-thigh ratios for most sex-age groups even when diabetic subjects were excluded. Controlled for age, obesity and fat distribution, activity remained significantly associated with 2-h plasma glucose concentrations in males. In subjects aged 37–59 years, individuals with diabetes compared to those without reported significantly less leisure physical activity during the teenage years (median hours per week of activity, 9.1 vs 13.2 for men; 1.0 vs 2.2 for women). Controlled for body mass index, sex, age and waist-to-thigh ratio, subjects who reported low levels of historical leisure physical activity had a higher rate of diabetes than those who were more active. In conclusion, current physical activity was inversely related to glucose intolerance, obesity and central distribution of fat, particularly in males. Subjects with diabetes were currently less active and reported less historical physical activity than non-diabetic subjects. These findings suggest that activity may protect against the development of non-insulin-dependent diabetes both directly and through an influence on obesity and fat distribution.

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American College of Sports Medicine position stand. Exercise and type 2 diabetes.

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TL;DR: The effects of exercise and diet in the prevention of chronic disease are discussed, the effects of lifestyle modification for both mitigating disease progression and reversing existing disease are highlighted, and potential mechanisms for beneficial effects are suggested.
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TL;DR: Public policy should focus on ways of increasing volitional and lifestyle activity in older people, as well as on increasing the availability and accessibility of senior and community center programs for promoting physical activity throughout the life span.
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Diet, nutrition and the prevention of type 2 diabetes.

TL;DR: Based on the strength of available evidence regarding diet and lifestyle in the prevention of type 2 diabetes, it is recommended that a normal weight status in the lower BMI range and regular physical activity be maintained throughout adulthood; abdominal obesity be prevented; and saturated fat intake be less than 7% of the total energy intake.
References
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Journal ArticleDOI

Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus.

TL;DR: The protective effect of physical activity was strongest in persons at highest risk for NIDDM, defined as those with a high body-mass index, a history of hypertension, or a parental history of diabetes.
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Physical activity and incidence of non-insulin-dependent diabetes mellitus in women

TL;DR: The results indicate that physical activity may be a promising approach to the primary prevention of NIDDM, and risk reduction with exercise was evident among both obese and nonobese women.
Journal ArticleDOI

Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians.

TL;DR: A physical-activity questionnaire has been developed that is both reliable and feasible to use in the Pima Indian population to evaluate the relationship of physical activity to non-insulin-dependent diabetes mellitus.
Journal ArticleDOI

Diabetes incidence and prevalence in pima indians: a 19-fold greater incidence than in rochester, minnesota

TL;DR: The incidence and prevalence of diabetes mellitus were determined in 3733 Pima Indians aged 5 years or over by periodic examinations over a 10-year period and the high incidence rate was found despite using a more stringent diagnostic criterion than customarily employed.
Journal ArticleDOI

Diabetes mellitus in American (Pima) Indians.

TL;DR: The findings indicate that the Pima Indians have the highest prevalence of diabetes mellitus yet recorded, and that in this population normal and hyperglycaemic groups may be logically separated on the basis of the bimodality of the frequency distributions of two-hour post-load glucose levels.
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