Exercise

Your risk of developing type 2 diabetes is about three times greater if someone in your immediate family (parent, sibling) has it. In a study looking at the effects of exercise on this group, it was found that men who have a family member with type 2 diabetes had to expend more energy than a control group, to achieve the same benefits.

The study involved 35 unfit, slightly overweight but completely healthy men aged 30-45 who, for seven months, exercised regularly at a fitness centre. Half of them had relatives with type 2 diabetes, and half did not. (It's perhaps worth noting that 50 men began the study, but didn't continue — these were roughly evenly divided between the two groups.) Three hour-long exercise sessions were available each week, and participants went to 39 sessions on average (the range was large though: 11-107).

Those with family members with diabetes tended to go to the gym more often (group average was 59% more sessions), and this may be due to their increased motivation.

It must be emphasized that both groups lost weight, reduced their waist size, increased their fitness, and showed similar improvements in gene expressions. So exercise was a good idea for both groups. However, statistical analysis indicates that the at-risk group had to do more exercise than the control group to achieve the same benefit. The findings support earlier findings that those with close relatives with type 2 diabetes show smaller physiological changes to exercise, compared to those without such familial links.

http://www.eurekalert.org/pub_releases/2015-10/lu-eig100215.php

Ekman, C., Elgzyri, T., Ström, K., Almgren, P., Parikh, H., Nitert, M. D., … Hansson, O. (2015). Less pronounced response to exercise in healthy relatives to type 2 diabetic subjects compared with controls. Journal of Applied Physiology, 119(9), 953–960. http://doi.org/10.1152/japplphysiol.01067.2014

In a study involving 52 sedentary, overweight, middle-aged men and women (aged 45-65), both exercise and calorie restriction had positive — and equal — effects on insulin sensitivity, but a combination of both had twice as much benefit for glucoregulation as either single approach. All three programs were designed to achieve about the same amount of weight loss (6-8%).

The study also indicated that both exercise and calorie restriction improve regulation of glucose levels through weight loss, but also through mechanisms that are independent of weight loss.

What all this suggests is that, even if you're maintaining a healthy weight, how much you eat, and whether you exercise, are factors that have health implications.

http://www.eurekalert.org/pub_releases/2015-05/slu-ido050615.php

Weiss, E. P., Albert, S. G., Reeds, D. N., Kress, K. S., Ezekiel, U. R., McDaniel, J. L., … Villareal, D. T. (2015). Calorie Restriction and Matched Weight Loss From Exercise: Independent and Additive Effects on Glucoregulation and the Incretin System in Overweight Women and Men. Diabetes Care, 38(7), 1253–1262. http://doi.org/10.2337/dc14-2913

Mouse and human immune cells have demonstrated that a compound produced by the body when dieting or fasting (β-hydroxybutyrate — BHB) directly inhibits a protein, NLRP3, which is part of a complex set of proteins that drive the inflammatory response in several disorders, including autoimmune diseases, type 2 diabetes, Alzheimer's disease, atherosclerosis, and autoinflammatory disorders.

BHB is produced in response to fasting, high-intensity exercise, caloric restriction, or consumption of the low-carbohydrate ketogenic diet.

The finding helps explain why calorie restriction reduces inflammation.

http://www.eurekalert.org/pub_releases/2015-02/yu-amo021315.php

Youm, Y.-H., Nguyen, K. Y., Grant, R. W., Goldberg, E. L., Bodogai, M., Kim, D., … Dixit, V. D. (2015). The ketone metabolite β-hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease. Nature Medicine, 21(3), 263–269. http://doi.org/10.1038/nm.3804

A review of studies investigating lifestyle interventions that can delay or prevent the onset of type 2 diabetes in people with prediabetes and focusing specifically on ones that looked at gender differences, found that both men and women benefited equally from the interventions. The review of 12 studies found that those who received lifestyle interventions (including diet and exercise) were 40% less likely to progress to type 2 diabetes after 1 year, and 37% less likely to progress after 3 years.

People involved in lifestyle interventions also experienced greater weight reductions, and greater reductions of fasting plasma glucose.

http://www.eurekalert.org/pub_releases/2014-11/d-bit112614.php

Glechner, A., Harreiter, J., Gartlehner, G., Rohleder, S., Kautzky, A., Tuomilehto, J., … Kautzky-Willer, A. (2014). Sex-specific differences in diabetes prevention: a systematic review and meta-analysis. Diabetologia, 58(2), 242–254. http://doi.org/10.1007/s00125-014-3439-x

A Canadian study comparing neighborhoods that varied in “walkability” found that people living in neighborhoods with greater walkability had an average 13% lower likelihood of developing type 2 diabetes over 10 years, compared to those living in less walkable neighborhoods. However, walkability was only protective in those who were younger and middle aged; those who were age 65 or older saw no benefit from living in a walkable neighborhood.

Over the ten years of the study, the incidence of diabetes fell 7% in the most walkable neighborhoods, but rose 6% in the least walkable neighborhoods. Similarly, the incidence of excess weight (being overweight or obese) fell by 9% in the most walkable neighborhoods and rose 13% in the least walkable neighborhoods.

People who lived in the most walkable neighborhoods were three times more likely to walk or bicycle and half as likely to drive as a means of transportation.

The study was presented at the American Diabetes Association's 74th Scientific Session.

http://www.eurekalert.org/pub_releases/2014-06/ada-dn060214.php

A ten-year study involving 4,207 older adults (73+) demonstrates that even in this older age group, modest physical activity was associated with a lower risk of cardiovascular disease. Among both men and women in good health:

• those who were more active had significantly lower risk of future heart attacks and stroke
• those who walked faster than three miles per hour had a 50% lower risk than those who walked at a pace of less than two mph (50%, 53%, 50% lower risk of coronary heart disease, stroke and total CVD, respectively)
• those who walked an average of seven blocks per day or more had a similar advantage compared to those who walked up to five blocks per week (36%, 54% and 47% lower risk of CHD, stroke and total CVD, respectively)
• those who engaged in leisure activities such as lawn-mowing, raking, gardening, swimming, biking and hiking, also had a lower risk of CHD, stroke and total CVD, compared to those who did not engage in leisure-time activities

http://www.eurekalert.org/pub_releases/2015-11/tuhs-wfo111915.php

Soares-Miranda, L., Siscovick, D. S., Psaty, B. M., Longstreth, W. T., & Mozaffarian, D. (2015). Physical Activity and Risk of Coronary Heart Disease and Stroke in Older Adults: The Cardiovascular Health Study. Circulation, CIRCULATIONAHA.115.018323. http://doi.org/10.1161/CIRCULATIONAHA.115.018323

A very large British study involving 1.1 million middle-aged women without prior vascular disease has found, over nine or so years, those who performed strenuous physical activity two to three times a week were about 20% less likely to develop heart disease, strokes or blood clots, compared to participants who reported little or no activity. However, those who reported doing strenuous activity daily had higher risk compared to those who only engaged in moderate amounts of activity.

http://www.eurekalert.org/pub_releases/2015-02/aha-waa021115.php

Armstrong, M. E. G., Green, J., Reeves, G. K., Beral, V., & Cairns, B. J. (2015). Frequent Physical Activity May Not Reduce Vascular Disease Risk as Much as Moderate Activity Large Prospective Study of Women in the United Kingdom. Circulation, 131(8), 721–729. http://doi.org/10.1161/CIRCULATIONAHA.114.010296