Habitual exercise is associated with reduced risk of diabetes regardless of air pollution: a longitudinal cohort study

Cui Guo; Hsiao Ting Yang; Ly-yun Chang; Yacong Bo; Changqing Lin; Yiqian Zeng; Tony Tam; Alexis K.H. Lau; Gerard Hoek; Xiang Qian Lao

doi:10.1007/s00125-021-05408-4

Habitual exercise is associated with reduced risk of diabetes regardless of air pollution: a longitudinal cohort study

Cui Guo
, Hsiao Ting Yang
, Ly-yun Chang
, Yacong Bo
, Changqing Lin
, Yiqian Zeng
, Tony Tam
, Alexis K.H. Lau
, Gerard Hoek
, Xiang Qian Lao^*

^*Corresponding author for this work

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

23 Citations (Scopus)

Abstract

Aims/hypothesis: Physical activity may increase a person’s inhalation of air pollutants and exacerbate the adverse health effects. This study aimed to investigate the combined associations of chronic exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM_2.5) and habitual physical activity with the incidence of type 2 diabetes in Taiwan.

Methods: We selected 156,314 non-diabetic adults (≥18 years old) who joined an ongoing longitudinal cohort between 2001 and 2016. Incident type 2 diabetes was identified at the follow-up medical examinations. Two-year mean PM_2.5 exposure was estimated at each participant’s address using a satellite-based spatiotemporal model. Information on physical activity and a wide range of covariates was collected using a standard self-administered questionnaire. We analysed the data using a Cox regression model with time-varying covariates. An interaction term between PM_2.5 and physical activity was included to examine the overall interaction effects.

Results: Compared with high physical activity, moderate and inactive/low physical activity were associated with a higher risk of diabetes (HR [95% CI] 1.31 [1.22, 1.41] and 1.56 [1.46, 1.68], respectively). Participants with moderate/high PM_2.5 had a higher risk of type 2 diabetes than the participants exposed to low PM_2.5 (HR 1.31 [1.22, 1.40] and 1.94 [1.76, 2.14], respectively). The participants with high physical activity and low PM_2.5 had a 64% lower risk of type 2 diabetes than those with inactive/low physical activity and high PM_2.5.

Conclusions/interpretation: Higher physical activity and lower PM_2.5 exposure are associated with lower risk of type 2 diabetes. Habitual physical activity can reduce the risk of diabetes regardless of the levels of PM_2.5 exposure. Our results indicate that habitual physical activity is a safe diabetes prevention strategy for people residing in relatively polluted regions.

Original language	English
Pages (from-to)	1298-1308
Number of pages	11
Journal	Diabetologia
Volume	64
Issue number	6
Online published	4 Mar 2021
DOIs	https://doi.org/10.1007/s00125-021-05408-4
Publication status	Published - Jun 2021
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.

Funding

This work was supported by RGC General Research Fund (14603019) and Environmental Health Research Fund of the Chinese University of Hong Kong (7104946). CG is in part supported by the Faculty Postdoctoral Fellowship Scheme of the Faculty of Medicine of the Chinese University of Hong Kong. YB and YZ are supported by the PhD Studentship of the Chinese University of Hong Kong.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Research Keywords

Chinese adults
Long-term exposure
Physical activity
PM air pollution
Type 2 diabetes

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Cite this

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title = "Habitual exercise is associated with reduced risk of diabetes regardless of air pollution: a longitudinal cohort study",

abstract = "Aims/hypothesis: Physical activity may increase a person{\textquoteright}s inhalation of air pollutants and exacerbate the adverse health effects. This study aimed to investigate the combined associations of chronic exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and habitual physical activity with the incidence of type 2 diabetes in Taiwan. Methods: We selected 156,314 non-diabetic adults (≥18 years old) who joined an ongoing longitudinal cohort between 2001 and 2016. Incident type 2 diabetes was identified at the follow-up medical examinations. Two-year mean PM2.5 exposure was estimated at each participant{\textquoteright}s address using a satellite-based spatiotemporal model. Information on physical activity and a wide range of covariates was collected using a standard self-administered questionnaire. We analysed the data using a Cox regression model with time-varying covariates. An interaction term between PM2.5 and physical activity was included to examine the overall interaction effects. Results: Compared with high physical activity, moderate and inactive/low physical activity were associated with a higher risk of diabetes (HR [95\% CI] 1.31 [1.22, 1.41] and 1.56 [1.46, 1.68], respectively). Participants with moderate/high PM2.5 had a higher risk of type 2 diabetes than the participants exposed to low PM2.5 (HR 1.31 [1.22, 1.40] and 1.94 [1.76, 2.14], respectively). The participants with high physical activity and low PM2.5 had a 64\% lower risk of type 2 diabetes than those with inactive/low physical activity and high PM2.5. Conclusions/interpretation: Higher physical activity and lower PM2.5 exposure are associated with lower risk of type 2 diabetes. Habitual physical activity can reduce the risk of diabetes regardless of the levels of PM2.5 exposure. Our results indicate that habitual physical activity is a safe diabetes prevention strategy for people residing in relatively polluted regions. ",

keywords = "Chinese adults, Long-term exposure, Physical activity, PM air pollution, Type 2 diabetes",

author = "Cui Guo and Yang, \{Hsiao Ting\} and Ly-yun Chang and Yacong Bo and Changqing Lin and Yiqian Zeng and Tony Tam and Lau, \{Alexis K.H.\} and Gerard Hoek and Lao, \{Xiang Qian\}",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.",

year = "2021",

month = jun,

doi = "10.1007/s00125-021-05408-4",

language = "English",

volume = "64",

pages = "1298--1308",

journal = "Diabetologia",

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T1 - Habitual exercise is associated with reduced risk of diabetes regardless of air pollution

T2 - a longitudinal cohort study

AU - Guo, Cui

AU - Yang, Hsiao Ting

AU - Chang, Ly-yun

AU - Bo, Yacong

AU - Lin, Changqing

AU - Zeng, Yiqian

AU - Tam, Tony

AU - Lau, Alexis K.H.

AU - Hoek, Gerard

AU - Lao, Xiang Qian

PY - 2021/6

Y1 - 2021/6

N2 - Aims/hypothesis: Physical activity may increase a person’s inhalation of air pollutants and exacerbate the adverse health effects. This study aimed to investigate the combined associations of chronic exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and habitual physical activity with the incidence of type 2 diabetes in Taiwan. Methods: We selected 156,314 non-diabetic adults (≥18 years old) who joined an ongoing longitudinal cohort between 2001 and 2016. Incident type 2 diabetes was identified at the follow-up medical examinations. Two-year mean PM2.5 exposure was estimated at each participant’s address using a satellite-based spatiotemporal model. Information on physical activity and a wide range of covariates was collected using a standard self-administered questionnaire. We analysed the data using a Cox regression model with time-varying covariates. An interaction term between PM2.5 and physical activity was included to examine the overall interaction effects. Results: Compared with high physical activity, moderate and inactive/low physical activity were associated with a higher risk of diabetes (HR [95% CI] 1.31 [1.22, 1.41] and 1.56 [1.46, 1.68], respectively). Participants with moderate/high PM2.5 had a higher risk of type 2 diabetes than the participants exposed to low PM2.5 (HR 1.31 [1.22, 1.40] and 1.94 [1.76, 2.14], respectively). The participants with high physical activity and low PM2.5 had a 64% lower risk of type 2 diabetes than those with inactive/low physical activity and high PM2.5. Conclusions/interpretation: Higher physical activity and lower PM2.5 exposure are associated with lower risk of type 2 diabetes. Habitual physical activity can reduce the risk of diabetes regardless of the levels of PM2.5 exposure. Our results indicate that habitual physical activity is a safe diabetes prevention strategy for people residing in relatively polluted regions.

AB - Aims/hypothesis: Physical activity may increase a person’s inhalation of air pollutants and exacerbate the adverse health effects. This study aimed to investigate the combined associations of chronic exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and habitual physical activity with the incidence of type 2 diabetes in Taiwan. Methods: We selected 156,314 non-diabetic adults (≥18 years old) who joined an ongoing longitudinal cohort between 2001 and 2016. Incident type 2 diabetes was identified at the follow-up medical examinations. Two-year mean PM2.5 exposure was estimated at each participant’s address using a satellite-based spatiotemporal model. Information on physical activity and a wide range of covariates was collected using a standard self-administered questionnaire. We analysed the data using a Cox regression model with time-varying covariates. An interaction term between PM2.5 and physical activity was included to examine the overall interaction effects. Results: Compared with high physical activity, moderate and inactive/low physical activity were associated with a higher risk of diabetes (HR [95% CI] 1.31 [1.22, 1.41] and 1.56 [1.46, 1.68], respectively). Participants with moderate/high PM2.5 had a higher risk of type 2 diabetes than the participants exposed to low PM2.5 (HR 1.31 [1.22, 1.40] and 1.94 [1.76, 2.14], respectively). The participants with high physical activity and low PM2.5 had a 64% lower risk of type 2 diabetes than those with inactive/low physical activity and high PM2.5. Conclusions/interpretation: Higher physical activity and lower PM2.5 exposure are associated with lower risk of type 2 diabetes. Habitual physical activity can reduce the risk of diabetes regardless of the levels of PM2.5 exposure. Our results indicate that habitual physical activity is a safe diabetes prevention strategy for people residing in relatively polluted regions.

KW - Chinese adults

KW - Long-term exposure

KW - Physical activity

KW - PM air pollution

KW - Type 2 diabetes

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C2 - 33660006

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SN - 0012-186X

VL - 64

SP - 1298

EP - 1308

JO - Diabetologia

JF - Diabetologia

IS - 6

ER -

Habitual exercise is associated with reduced risk of diabetes regardless of air pollution: a longitudinal cohort study

Abstract

Bibliographical note

Funding

UN SDGs

Research Keywords

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