Regular vigorous activity associated with significantly lower risk of mortality in diabetes
Cardiovascular mortality risk was significantly lower in patients with diabetes who engaged in at least 150 minutes of moderate to vigorous exercise per week, whether it was twice a week (“weekend warriors”) or more frequently, according to an analysis of the National Health Interview Survey.
All methods of meeting recommendations for 150 minutes of moderate to vigorous physical activity a week, even “weekend warrior” patterns done as one or two sessions, were associated with similarly reduced risks for all-cause and cardiovascular (CV) mortality compared to physical inactivity among patients with diabetes, a study found.
The prospective cohort study used data on 51,650 adults with self-reported diabetes who participated in the National Health Interview Survey (NHIS) between 1997 and 2018. Current guidelines recommend at least 150 minutes per week of moderate to vigorous physical activity (MVPA) distributed across a minimum of three days. Study participants were categorized into four activity patterns: inactive (no reported MVPA), insufficiently active (<150 minutes of MVPA per week), weekend warrior (≥150 minutes of MVPA per week across one to two sessions), and regularly active (≥150 minutes of MVPA per week across at least three sessions). The results were published by Annals of Internal Medicine on July 22.
During a median follow-up of 9.5 years, 16,345 deaths had occurred, 5,620 of cardiovascular causes and 2,883 of cancer. Compared with inactive participants, participants who were active had lower multivariable-adjusted hazard ratios (HRs) for all-cause mortality (HRs, 0.90 [95% CI, 0.85 to 0.95] for insufficiently active persons, 0.79 [95% CI, 0.69 to 0.91] for weekend warriors, and 0.83 [95% CI, 0.78 to 0.87] for regularly active persons). These reductions were mostly due to effects on cardiovascular mortality, with significant reductions seen in both the weekend warrior and regularly active groups (HRs, 0.98 [95% CI, 0.89 to 1.07] for insufficiently active persons, 0.67 [95% CI, 0.52 to 0.86] for weekend warriors, and 0.81 [95% CI, 0.74 to 0.88] for regularly active persons).
The study demonstrates the importance of moderate to vigorous physical activity for people with diabetes, the authors wrote. An accompanying editorial cautioned against taking these results too broadly, noting that the results were observational and self-reported and that under the definition of the study, someone with two exercise sessions spread out during the week could be defined as a “weekend warrior.”
“[L]ifestyle changes including physical activity can have major impacts on diabetes-related outcomes and quality of life that are not necessarily reflected in mortality statistics,” the editorial said. “Even if one accepts that exercising once or twice per week for at least 150 minutes total could be just as beneficial for reduction of cardiovascular and overall mortality as exercising more frequently, this does not necessarily mean that less frequent exercise is equally beneficial for all other diabetes-related outcomes.”