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The association between physical activity with incident obesity, coronary heart disease, diabetes and hypertension in adults: a systematic review of longitudinal studies published after 2012

BMC Public Health volume 20, Article number: 726 (2020) Cite this article

Abstract

Background

A growing body of studies that investigated the longitudinal association between physical activity (PA) and the outcome of incident obesity, coronary heart disease (CHD), diabetes and hypertension has become available in recent years. Thus, the purpose of this systematic review was to provide an update on the association between PA and onset of obesity, CHD, diabetes and hypertension in individuals aged ≥18 years who were free of the respective conditions at baseline.

Methods

We systematically searched OVID, Pubmed, and Web of Science databases for pertinent literature published between January of 2012 and February of 2019. To ensure that conclusions are based on high quality evidence, we only included longitudinal studies conducted in samples of ≥500 participants and with ≥5 years of follow-up.

Result

The search yielded 8929 records of which 26 were included in this review. Three studies were conducted on the outcome of incident obesity, eight on incident CHD, nine on incident diabetes, four on incident hypertension, one on the outcome of both diabetes and hypertension, and one on the outcome of CHD, diabetes and hypertension. Overall, there was an association between PA and lower risk of incident obesity, CHD and diabetes, but not hypertension. Higher levels or amount of PA were associated with a reduced risk of new onset of the respective diseases in 20 studies (77%). Whereas four studies reported an elevated risk of incidence of diseases with lower PA levels (15%). PA was not associated with incidence of diseases in two studies (8%).

Conclusion

Higher levels of PA are likely associated with a lower risk of becoming obese, develop CHD or diabetes. These findings replicate and strengthen conclusions from earlier reviews underlining the importance of promoting PA in adults. The associations between PA and incident hypertension were less consistent. More research, particularly using prospective cohort designs in large population-based samples, is needed to further untangle the association between PA and incident hypertension.

Trail registration

CRD42019124474 (PROSPERO Protocol registration). Date of registration in PROSPERO 27 February 2019.

Peer Review reports

Background

The World Health Organization identified non-communicable diseases (NCDs), such as diabetes mellitus or cardiovascular diseases to be a major threat to economies and societies [1]. NCDs are implicated in 73% of all global deaths in 2017, with 28.8 million deaths attributed to risk factors like high blood pressure, high blood glucose, or high body mass index (BMI) [2]. Furthermore, NCDs are forecasted to account for 81% of all global deaths in 2040 [3].

NCDs usually develop over a long time period and may be impacted by an individual’s health behaviors [4]. As such, many NCDs may be preventable by decreasing metabolic risk factors such as hypertension, overweight and obesity, or hyperglycemia, as well as by decreasing behavioral risk factors like tobacco or alcohol use, an unhealthy diet, and physical inactivity [1, 5].

A growing body of research suggests that high levels of physical activity (PA) may have a protective effect on various health conditions including but not limited to overweight and obesity [6], coronary heart disease (CHD) [7, 8], type 2 diabetes mellitus [9, 10], hypertension [11, 12], and hyperglycemia [13, 14]. In addition, several longitudinal studies have become available that examine the association between PA and new onset of NCDs [15,16,17,18,19,20].

The current systematic review presents an update of a previously published review by our group [20], that examined the long-term effects of PA on type 2 diabetes mellitus, CHD, overweight/obesity and dementia by including studies published before 2012. Given the high significance of this topic and since we expected a substantial amount of relevant studies published after 2012, we provide an updated review of longitudinal studies on the association between PA and incident obesity, CHD, diabetes and hypertension over the past 7 years. Hypertension has been added to the current review as it is widely regarded as a major risk factor for several NCDs [21].

Methods

This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline [22]. The protocol was registered in the PROSPERO register of systematic reviews (CRD42019124474).

Search strategy

Pertinent articles published between January of 2012 and February of 2019 were searched in electronic databases (PubMed, Web of Science and EMBASE by OVID) by applying a combination of one or more of the following search terms: “longitudinal and/or long-term”; “physical activity/exercise”; “adult”; “overweight and/or obesity”, “coronary heart disease and/or coronary artery disease and/or ischemic disease”, “diabetes mellitus and/or diabetes type 2”, “hypertension and/or blood pressure”. Both titles and abstracts were searched. After identification of studies, their bibliographies were searched manually to identify additional relevant studies.

Study inclusion & exclusion criteria

We defined the following inclusion criteria for this systematic review: (1) Longitudinal, i.e. prospective cohort study design; (2) Studies reporting the association between PA and new onset of obesity, CHD, type 2 diabetes mellitus and/or hypertension; (3) Studies providing information on the assessment of PA (predictor variable). PA could be leisure-time/habitual PA, work-related PA, transportation related PA, organized and unorganized PA, etc.; (4) Only studies with ≥5 years of follow-up were included to allow for a meaningful conclusion on the longitudinal association between PA and selected outcomes of interest; (5) Studies with males and females aged ≥18 years, that were free of the diseases of interest at baseline; (6) Studies with more than 500 participants were included, to improve the probability to capture a substantial amount of incidence cases; and (7) articles written in English.

Excluded from this review were (1) studies investigating the effect of a specific PA intervention, as well as (2) clinical trials, cross-sectional studies, systematic reviews and meta-analyses.

Screening & data extraction

All pertinent studies detected after searching the electronic databases were imported to a reference manager software (Citavi 6) and duplicates were removed. The study selection process was divided into three phases. Two independent reviewers (LC & JKR) screened the titles of the articles, followed by the abstracts, and finally the full-texts based on the inclusion criteria. All studies meeting the eligibility criteria were included in this review. Disagreement was resolved by consensus or by consulting a third author (CN). The following information was extracted by one reviewer (LC): first author’s name, publication year, study design, study setting, sample size, follow-up time, participant characteristics (e.g. age, sex, BMI) at baseline, assessment and type of PA (e.g. type, duration, intensity), assessment and type of outcomes of interest (i.e. obesity, CHD, diabetes and hypertension), and main results/ findings of the study (e.g. hazard ratios, relative risk). Extracted data were verified by another author (JKR).

Quality assessment and risk of bias

The quality of included studies was evaluated independently by two authors (LC & JKR) using the 22-item Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement version 4 [23]. Similarly, potential risk of bias of each study included in this systematic review was assessed through the Tool to Assess Risk of Bias in Cohort Studies [24] by the same authors (LC & JKR). Any discrepancies between the two reviewers were resolved by discussion or by consulting a third reviewer (CN).

Results

Overall, we identified 8929 articles, of which 8903 articles were excluded as they did not meet the inclusion criteria as described above. The reader is referred to Fig. 1 for a flow chart summarizing the search process and number of studies at each step. Twenty-six studies were included in this review with a combined N of 1,145,298 participants, and follow-up times ranging between 5 and 34 years. Three articles examined the association between PA and incident obesity [25,26,27], eight studies examined the association between PA and incident CHD [28,29,30,31,32,33,34,35], nine studies examined the association between PA and incident diabetes [36,37,38,44], and four studies examined the association between PA and incident hypertension [45,46,47,48]. In addition, one study reported the association between both PA and diabetes as well as PA and hypertension [49], and another study reported the association between PA and CHD, diabetes, and hypertension [50].

Fig. 1
figure 1

Flow Chart (modified based on [22]). * = main reasons for exclusion of studies (n = 35 other outcomes of interest; n = 24 other definition of PA; n = 10 other study designs; n = 6 follow-up time < 5 years; n = 20 other reasons)

Full size image

Association between PA and obesity

The studies included in this review showed an overall association between higher PA and lower risk of incident obesity. Two out of three studies reported a reduced risk of becoming obese for individuals with high PA levels as compared to low PA [25, 27]. One study showed an elevated risk (142%) of becoming obese for persons who were physically inactive [26]. The characteristics of the included studies are summarized in Table 1.

Table 1 Overview of longitudinal studies on the association between PA and the outcome of obesity (BMI ≥ 30 kg/m2)
Full size table

Association between PA and CHD

Overall, there was an association between higher levels or amount of PA and a decreased risk of incident CHD. Seven out of nine studies reported a reduced risk of new onset of CHD with increasing PA levels as compared to low or no PA [28, 32,33,34,35], whereas one study revealed an association between PA and decreased CHD risk only for vigorous intensity PA [29]. One study did not find a significant association for occupational PA and CHD risk [30]. Two out of nine studies examined the impact of change in PA levels over time as predictor variable and failed to detect a significant association with incident CHD [31, 33]. Please refer to Table 2 for a summary of studies on PA and incident CHD.

Table 2 Overview of longitudinal studies on the association between PA and the outcome of CHD
Full size table

Association between PA and diabetes

The studies included in this review provide evidence of an association between increasing PA levels and a decreased risk of incident diabetes. Nine out of 11 studies reported a gradual inverse association between increasing PA levels with up to high/vigorous-intensity and a decreased risk of incident diabetes [36,37,38,39, 40,41,42, 44, 50], whereas one study revealed an association only between moderate intensity PA and reduced diabetes risk [39]. Two out of 11 studies reported an increased risk of incident diabetes (179 and 145%, respectively) for participants engaging in low amount of leisure time PA as compared to the highly active reference group [43, 49]. For a summary of included studies on the association between PA and diabetes please refer to Table 3.

Table 3 Overview of longitudinal studies on the association between PA and the outcome of diabetes
Full size table

Association between PA and hypertension

Overall, there was no consistent association between PA and incident hypertension. Three out of six studies reported a gradual inverse association between PA levels (running and walking, moderate and moderate-vigorous PA) and incident hypertension [46, 48, 50], whereas one study found an association only for a specific age group (51–60 years) [48]. Two out of six studies found no significant association between PA and incident hypertension [45, 47]. One out of six studies reported an increased risk of incident hypertension (137%) for persons with low leisure time PA as compared to the highly active reference group [49]. Please refer to Table 4 for an overview of included studies.

Table 4 Overview of longitudinal studies on the association between PA and the outcome of hypertension
Full size table

Discussion

The purpose of this research was to review studies published after January of 2012 and up to February of 2019 that investigated the long-term association between PA and new onset of obesity, CHD, diabetes and hypertension. Overall, we observed an association between PA and a decreased risk of incident obesity, CHD and diabetes but not hypertension. This is in line with systematic reviews published by our group and others that also found beneficial associations of PA with overweight/obesity, CHD and diabetes [20, 51,52,53]. Furthermore, it is also consistent with our hypothesis derived from both interventional and observational studies [54,55,56,57].

The included studies that examined the association between PA and incident hypertension reported conflicting results. This is partly in accordance with two other meta-analyses [58, 59]. One meta-analysis reported a reduction of incident hypertension by 6% for each 10 metabolic equivalent of task hours per week increment of leisure time PA [58]. However, another meta-analysis detected an inverse association for recreational PA and incident hypertension but not for occupational PA [59]. Of note, the causes of hypertension are multifactorial and the way they interact and ultimately contribute to the development of hypertension is unclear. Thus, potential mechanisms for prevention of hypertension through PA also remain unclear.

Some studies included in this review also reported findings stratified by sex and body weight. For example, one study observed a gradual inverse association between frequency, duration and intensity of PA and risk of incident diabetes in males, but only a gradual inverse association between frequency and intensity of PA and risk of incident diabetes in females [37]. Additionally, another study reported that, while overall PA irrespective of body weight was not associated with the outcome of incident hypertension, obese males with high PA had a significantly lower risk of hypertension than obese males with low PA [47].

The quality of included studies was independently assessed by two reviewers and was rated as moderate to good, with scores ranging between 16 and 22 (total range: 0–22). This is not surprising since we only included studies published in or after 2012 that may already have followed quality guidelines on reporting findings of observational studies such as STROBE [23]. The potential risk of bias was rated moderate to poor and there were several concerns that warrant brief discussion: 1) All studies included in this review assessed PA through self-reported questionnaires which may be prone to recall bias. However, given the large sample sizes and since the baseline measurements of PA of many studies took place several years or even decades ago, objective measurement of PA might not have been feasible. There is good reason to believe that more longitudinal studies using novel objective techniques such as accelerometry (e.g. [60, 61]) will become available in the near future. 2) The studies differed regarding the assessment of the outcomes of interest, e.g. some studies objectively measured blood glucose levels or blood pressure (e.g. [47, 49]) whereas others relied on self-reported information by the study participants and/or medical chart review (e.g. [40, 48]). 3) The studies differed in terms of adjustment for potential confounders and mediators which makes a comparison of findings between studies difficult. 4) Five studies were conducted only among males [30, 31, 38, 40, 44] and five studies were conducted only among females [28, 41, 43, 46, 48].

We did not investigate potential mechanisms underlying the associations between PA and incident obesity, diabetes and CHD. However, it has previously been postulated that there are acute and chronic effects of PA on insulin resistance, which may account for improvements in insulin action and decreased blood glucose levels as a response to engagement in PA [62]. Additionally, PA impacts energy balance by increasing total energy expenditure, which in turn causes an energy deficit and may lead to lower body weight [63]. Stimulating responses in adipose and body tissues by PA may also influence total energy balance and body composition [63]. Furthermore, studies suggest that regular PA increases capillarization and may reverse endothelial alterations, which is a major risk factor for CHD [64].

The strengths of this review are the rigorous search and selection strategy following published guidelines and conducted by two reviewers. Also, both quality and potential risk of bias were assessed by two authors independently. We deliberately focused on studies published after January of 2012 in order to provide an update of a systematic review previously published by our group [20]. In addition, even though unintentional, our review included studies from various countries such as Sweden, Norway, UK, Greece, Mexico, China, Australia, Italy, US, the Netherlands, Germany, France, Spain and Denmark which may add to the generalizability of our observations. The major limitations of this review pertain to the relatively small number of included studies. This may be due to the fact that we only included studies with large sample size (N ≥ 500) and relatively long follow-up time of ≥5 years. However, we believe that these criteria ensure validity of our conclusions and a higher probability of generalizability of the study findings. In addition, a large body of research on PA and overweight/obesity published after 2012 focused on change in BMI or body weight over time. We opted to not include these studies in our review as we chose our outcome of interest to be incident obesity, and information on change in BMI or body weight over time is thus not sufficient. For instance, a person could be underweight at baseline and an increase in BMI or weight might actually reflect progression to a healthier body constitution. At the same time, we also acknowledge that particularly obesity and hypertension are conditions for which individuals can take action to improve, i.e., a person develops incident obesity but may be able to decrease body weight in order to progress back to overweight or normal weight. Furthermore, our search terms may have been too narrow or not comprehensive enough and there may be published studies that we were not able to identify. However, in order to compensate for this potential shortcoming, we also manually searched bibliographies of included studies. Finally, the studies differed with regard to the depth of investigating PA variables. As such, PA was only one of many predictors in some studies (e.g. [36, 42]) and thus only one finding related to PA and the outcome of interest was reported. Whereas in other studies, the association between various PA parameters (e.g. type, intensity, frequency, duration) and the outcome of interest was examined (e.g. [30, 47]).

More research to untangle the association and potential underlying mechanisms between PA and the outcome of incident overweight, CHD, diabetes and hypertension is needed, preferably using prospective cohort studies with large sample sizes, long follow-up and objective measurement of both predictor variable (i.e. PA) and the outcomes of interest. In addition, meta-analytic approaches to address research questions pertaining the association between PA and various health outcomes are warranted.

Conclusion

Overall, this systematic review replicates, updates, and extends the growing body of research on the associations between PA and incident obesity, CHD and diabetes. No clear association between PA and reduced risk for hypertension was detected. This review emphasises the contribution of PA in the prevention of various chronic diseases. Reducing the risk of new onset of NCDs and thereby reducing the economic burden on health systems is of high importance to societies worldwide. Regional and global action plans and preventive strategies (e.g. [65]) should highlight the beneficial impact of regular PA and support national governments in the implementation of concrete actions towards achieving a higher engagement in PA among individuals across all ages.

Availability of data and materials

All data generated or analyzed during this study are included in this published article.

Abbreviations

BMI:

Body mass index

CHD:

Coronary heart disease

NCDs:

Non-communicable diseases

PA:

Physical activity

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analysis

References

  1. World Health Organization. Global status report on noncommunicable diseases 2014. Geneva: World Health Organization; 2014.

  2. The Lancet. GBD 2017: a fragile world. Lancet. 2018;392:1683. https://doi.org/10.1016/S0140-6736(18)32858-7.

    Article  CAS  Google Scholar 

  3. Foreman KJ, Marquez N, Dolgert A, Fukutaki K, Fullman N, McGaughey M, et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016–40 for 195 countries and territories. Lancet. 2018;392:2052–90. https://doi.org/10.1016/S0140-6736(18)31694-5 .

    Article  PubMed  PubMed Central  Google Scholar 

  4. Arts J, Fernandez ML, Lofgren IE. Coronary heart disease risk factors in college students. Adv Nutr. 2014;5:177–87. https://doi.org/10.3945/an.113.005447 .

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Forouzanfar MH, Afshin A, Alexander LT, Anderson HR, Bhutta ZA, Biryukov S, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the global burden of disease study 2015. Lancet. 2016;388:1659–724. https://doi.org/10.1016/S0140-6736(16)31679-8 .

    Article  Google Scholar 

  6. Madjd A, Taylor MA, Shafiei Neek L, Delavari A, Malekzadeh R, Macdonald IA, Farshchi HR. Effect of weekly physical activity frequency on weight loss in healthy overweight and obese women attending a weight loss program: a randomized controlled trial. Am J Clin Nutr. 2016;104:1202–8. https://doi.org/10.3945/ajcn.116.136408 .

    Article  CAS  PubMed  Google Scholar 

  7. Hambrecht R, Wolf A, Gielen S, Linke A, Hofer J, Erbs S, et al. Effect of exercise on coronary endothelial function in patients with coronary artery disease. N Engl J Med. 2000;342:454–60. https://doi.org/10.1056/NEJM200002173420702 .

    Article  CAS  PubMed  Google Scholar 

  8. Colditz GA, Philpott SE, Hankinson SE. The impact of the Nurses' health study on population health: prevention, translation, and control. Am J Public Health. 2016;106:1540–5. https://doi.org/10.2105/AJPH.2016.303343 .

    Article  PubMed  PubMed Central  Google Scholar 

  9. Johannsen NM, Swift DL, Lavie CJ, Earnest CP, Blair SN, Church TS. Categorical analysis of the impact of aerobic and resistance exercise training, alone and in combination, on cardiorespiratory fitness levels in patients with type 2 diabetes: results from the HART-D study. Diabetes Care. 2013;36:3305–12. https://doi.org/10.2337/dc12-2194 .

    Article  PubMed  PubMed Central  Google Scholar 

  10. Church TS, Blair SN, Cocreham S, Johannsen N, Johnson W, Kramer K, et al. Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial. JAMA. 2010;304:2253–62. https://doi.org/10.1001/jama.2010.1710 .

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Stewart KJ, Bacher AC, Turner KL, Fleg JL, Hees PS, Shapiro EP, et al. Effect of exercise on blood pressure in older persons: a randomized controlled trial. Arch Intern Med. 2005;165:756–62. https://doi.org/10.1001/archinte.165.7.756 .

    Article  PubMed  Google Scholar 

  12. Nelson L, Esler M, Jennings G, Korner P. Effect of changing levels of physical activity on blood-pressure and haemodynamics in essential hypertension. Lancet. 1986;328:473–6. https://doi.org/10.1016/S0140-6736(86)90354-5 .

    Article  Google Scholar 

  13. Avery MD, Walker AJ. Acute effect of exercise on blood glucose and insulin levels in women with gestational diabetes. J Matern Fetal Neonatal Med. 2001;10:52–8. https://doi.org/10.1080/jmf.10.1.52.58-4 .

    Article  CAS  Google Scholar 

  14. Fritz T, Rosenqvist U. Walking for exercise? Immediate effect on blood glucose levels in type 2 diabetes. Scand J Prim Health Care. 2001;19:31–3. https://doi.org/10.1080/pri.19.1.31.33 .

    Article  CAS  PubMed  Google Scholar 

  15. Leon AS. Leisure-time physical activity levels and risk of coronary heart disease and death. JAMA. 1987;258:2388. https://doi.org/10.1001/jama.1987.03400170074026 .

    Article  CAS  PubMed  Google Scholar 

  16. Sesso HD, Paffenbarger RS, Lee IM. Physical activity and coronary heart disease in men: the Harvard alumni health study. Circulation. 2000;102:975–80.

    Article  CAS  PubMed  Google Scholar 

  17. Paffenbarger RS, Laughlin ME, Gima AS, Black RA. Work activity of longshoremen as related to death from coronary heart disease and stroke. N Engl J Med. 1970;282:1109–14. https://doi.org/10.1056/NEJM197005142822001 .

    Article  PubMed  Google Scholar 

  18. Sherman SE, D'Agostino RB, Cobb JL, Kannel WB. Does exercise reduce mortality rates in the elderly? Experience from the Framingham heart study. Am Heart J. 1994;128:965–72.

    Article  CAS  PubMed  Google Scholar 

  19. Kannel WB, Belanger A, D'Agostino R, Israel I. Physical activity and physical demand on the job and risk of cardiovascular disease and death: the Framingham study. Am Heart J. 1986;112:820–5. https://doi.org/10.1016/0002-8703(86)90480-1 .

    Article  CAS  PubMed  Google Scholar 

  20. Reiner M, Niermann C, Jekauc D, Woll A. Long-term health benefits of physical activity-a systematic review of longitudinal studies. BMC Public Health. 2013;13:813. https://doi.org/10.1186/1471-2458-13-813 .

    Article  PubMed  PubMed Central  Google Scholar 

  21. World Health Organization. A global brief on Hypertension. 2013. http://apps.who.int/iris/bitstream/handle/10665/79059/WHO_DCO_WHD_2013.2_eng.pdf;jsessionid=9E19A6932A6A21A76238A0826D725EC9?sequence=1. Accessed 9 Jan 2019.

  22. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097. https://doi.org/10.1371/journal.pmed.1000097 .

    Article  PubMed  PubMed Central  Google Scholar 

  23. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370:1453–7. https://doi.org/10.1016/S0140-6736(07)61602-X .

    Article  Google Scholar 

  24. Tool to Assess Risk of Bias in Cohort Studies. http://methods.cochrane.org/sites/methods.cochrane.org.bias/files/public/uploads/Tool%20to%20Assess%20Risk%20of%20Bias%20in%20Cohort%20Studies.pdf. Accessed 15 Apr 2019.

  25. Bell JA, Hamer M, Batty GD, Singh-Manoux A, Sabia S, Kivimaki M. Combined effect of physical activity and leisure time sitting on long-term risk of incident obesity and metabolic risk factor clustering. Diabetologia. 2014;57:2048–56. https://doi.org/10.1007/s00125-014-3323-8 .

    Article  PubMed  PubMed Central  Google Scholar 

  26. Montgomerie AM, Chittleborough CR, Taylor AW. Physical inactivity and incidence of obesity among south Australian adults. PLoS One. 2014;9:e112693. https://doi.org/10.1371/journal.pone.0112693 .

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Pavey TG, Peeters GMEE, Gomersall SR, Brown WJ. Long-term effects of physical activity level on changes in healthy body mass index over 12 years in young adult women. Mayo Clin Proc. 2016;91:735–44. https://doi.org/10.1016/j.mayocp.2016.03.008 .

    Article  PubMed  Google Scholar 

  28. Chomistek AK, Henschel B, Eliassen AH, Mukamal KJ, Rimm EB. Frequency, type, and volume of leisure-time physical activity and risk of coronary heart disease in young women. Circulation. 2016;134:290–9. https://doi.org/10.1161/CIRCULATIONAHA.116.021516 .

    Article  PubMed  PubMed Central  Google Scholar 

  29. Delaney JAC, Jensky NE, Criqui MH, Whitt-Glover MC, Lima JAC, Allison MA. The association between physical activity and both incident coronary artery calcification and ankle brachial index progression: the multi-ethnic study of atherosclerosis. Atherosclerosis. 2013;230:278–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Ferrario MM, Roncaioli M, Veronesi G, Holtermann A, Clays E, Borchini R, et al. Differing associations for sport versus occupational physical activity and cardiovascular risk. Heart. 2018;104:1165–72. https://doi.org/10.1136/heartjnl-2017-312594 .

    Article  CAS  PubMed  Google Scholar 

  31. Jefferis BJ, Whincup PH, Lennon LT, Papacosta O, Goya Wannamethee S. Physical activity in older men: Longitudinal associations with inflammatory and hemostatic biomarkers, N-terminal pro-brain natriuretic peptide, and onset of coronary heart disease and mortality. J Am Geriatr Soc. 2014;62:599–606.

    Article  PubMed  Google Scholar 

  32. Koolhaas CM, Dhana K, Golubic R, Schoufour JD, Hofman A, Van Rooij FJA, Franco OH. Physical Activity Types and Coronary Heart Disease Risk in Middle-Aged and Elderly Persons: The Rotterdam Study. Am J Epidemiol. 2016;183:729–38.

    Article  PubMed  Google Scholar 

  33. Petersen CB, Gronbaek M, Helge JW, Thygesen LC, Schnohr P, Tolstrup JS. Changes in physical activity in leisure time and the risk of myocardial infarction, ischemic heart disease, and all-cause mortality. Eur J Epidemiol. 2012;27:91–9.

    Article  PubMed  Google Scholar 

  34. Soares-Miranda L, Siscovick DS, Psaty BM, Longstreth WT, Mozaffarian D. Physical activity and risk of coronary heart disease and stroke in older adults. Circulation. 2016;133:147–55.

    Article  PubMed  Google Scholar 

  35. Tikkanen E, Gustafsson S, Ingelsson E. Associations of fitness, physical activity, strength, and genetic risk with cardiovascular disease longitudinal analyses in the UK biobank study. Circulation. 2018;137:2583–91. https://doi.org/10.1161/CIRCULATIONAHA.117.032432 .

    Article  PubMed  PubMed Central  Google Scholar 

  36. Carlsson S, Ahlbom A, Lichtenstein P, Andersson T. Shared genetic influence of BMI, physical activity and type 2 diabetes: a twin study. Diabetologia. 2013;56:1031–5. https://doi.org/10.1007/s00125-013-2859-3 .

    Article  CAS  PubMed  Google Scholar 

  37. Hjerkind KV, Stenehjem JS, Nilsen TIL. Adiposity, physical activity and risk of diabetes mellitus: prospective data from the population-based HUNT study. Norway Bmj Open. 2017;7:e013142. https://doi.org/10.1136/bmjopen-2016-013142 .

    Article  PubMed  Google Scholar 

  38. Jefferis BJ, Lennon L, Whincup PH, Wannamethee SG. Longitudinal associations between changes in physical activity and onset of type 2 diabetes in older British men: the influence of adiposity. Diabetes Care. 2012;35:1876–83.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Koloverou E, Panagiotakos DB, Pitsavos C, Chrysohoou C, Georgousopoulou EN, Tousoulis D, Stefanadis C. The long term effect of dietary habits and physical activity on type 2 diabetes incidence: 10-year follow up of the ATTICA study (2002-2012): diet, physical activity and diabetes. Hellenic J Atherosclerosis. 2018;9:5–16.

    Google Scholar 

  40. Elwood P, Galante J, Pickering J, Palmer S, Bayer A, Ben-Shlomo Y, et al. Healthy lifestyles reduce the incidence of chronic diseases and dementia: evidence from the Caerphilly cohort study. PLoS One. 2013;8:e81877. https://doi.org/10.1371/journal.pone.0081877 .

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Grøntved A, Pan A, Mekary RA, Stampfer M, Willett WC, Manson JE, Hu FB. Muscle-strengthening and conditioning activities and risk of type 2 diabetes: a prospective study in two cohorts of US women. PLoS Med. 2014;11:e1001587. https://doi.org/10.1371/journal.pmed.1001587 .

    Article  PubMed  PubMed Central  Google Scholar 

  42. Ekelund U, Palla L, Brage S, Franks PW, Peters T, Balkau B, et al. Physical activity reduces the risk of incident type 2 diabetes in general and in abdominally lean and obese men and women: the EPIC-InterAct study. Diabetologia. 2012;55:1944–52. https://doi.org/10.1007/s00125-012-2532-2 .

    Article  CAS  PubMed  Google Scholar 

  43. Mehlig K, Skoog I, Waern M, Miao Jonasson J, Lapidus L, Björkelund C, et al. Physical activity, weight status, diabetes and dementia: a 34-year follow-up of the population study of women in Gothenburg. Neuroepidemiology. 2014;42:252–9. https://doi.org/10.1159/000362201 .

    Article  PubMed  Google Scholar 

  44. Shi L, Shu X-O, Li H, Cai H, Liu Q, Zheng W, et al. Physical activity, smoking, and alcohol consumption in association with incidence of type 2 diabetes among middle-aged and elderly Chinese men. PLoS One. 2013;8:e77919. https://doi.org/10.1371/journal.pone.0077919 .

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Lu Y, Lu M, Dai H, Yang P, Smith-Gagen J, Miao R, et al. Lifestyle and risk of hypertension: follow-up of a young pre-hypertensive cohort. Int J Med Sci. 2015;12:605–12. https://doi.org/10.7150/ijms.12446 .

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Pavey TG, Peeters G, Bauman AE, Brown WJ. Does vigorous physical activity provide additional benefits beyond those of moderate? Med Sci Sports Exerc. 2013;45:1948–55. https://doi.org/10.1249/MSS.0b013e3182940b91 .

    Article  PubMed  Google Scholar 

  47. Stenehjem JS, Hjerkind KV, Nilsen TIL. Adiposity, physical activity, and risk of hypertension: prospective data from the population-based HUNT study, Norway. J Human Hypertens. 2018;32:278–86.

    Article  Google Scholar 

  48. Cohen L, Curhan GC, Forman JP. Influence of age on the association between lifestyle factors and risk of hypertension. J Am Soc Hypertens. 2012;6:284–90. https://doi.org/10.1016/j.jash.2012.06.002 .

    Article  PubMed  PubMed Central  Google Scholar 

  49. Medina C, Janssen I, Barquera S, Bautista-Arredondo S, Gonzalez ME, Gonzalez C. Occupational and leisure time physical inactivity and the risk of type II diabetes and hypertension among Mexican adults: a prospective cohort study. Sci Rep. 2018. https://doi.org/10.1038/s41598-018-23553-6 .

  50. Williams PT, Thompson PD. Walking versus running for hypertension, cholesterol, and diabetes mellitus risk reduction. Arterioscler Thromb Vasc Biol. 2013;33:1085–91. https://doi.org/10.1161/ATVBAHA.112.300878 .

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Aune D, Norat T, Leitzmann M, Tonstad S, Vatten LJ. Physical activity and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis. Eur J Epidemiol. 2015;30:529–42. https://doi.org/10.1007/s10654-015-0056-z .

    Article  PubMed  Google Scholar 

  52. Sattelmair J, Pertman J, Ding EL, Kohl HW, Haskell W, Lee I-M. Dose response between physical activity and risk of coronary heart disease: a meta-analysis. Circulation. 2011;124:789–95. https://doi.org/10.1161/CIRCULATIONAHA.110.010710 .

    Article  PubMed  PubMed Central  Google Scholar 

  53. Chin S-H, Kahathuduwa CN, Binks M. Physical activity and obesity: what we know and what we need to know. Obes Rev. 2016;17:1226–44. https://doi.org/10.1111/obr.12460 .

    Article  PubMed  Google Scholar 

  54. Shaw K, Gennat H, O'Rourke P, Del Mar C. Exercise for overweight or obesity. Cochrane Database Syst Rev. 2006:CD003817. https://doi.org/10.1002/14651858.CD003817.pub3 .

  55. Tam G, Yeung MPS. A systematic review of the long-term effectiveness of work-based lifestyle interventions to tackle overweight and obesity. Prev Med. 2018;107:54–60. https://doi.org/10.1016/j.ypmed.2017.11.011 .

    Article  PubMed  Google Scholar 

  56. Rodrigues AL, Ball J, Ski C, Stewart S, Carrington MJ. A systematic review and meta-analysis of primary prevention programmes to improve cardio-metabolic risk in non-urban communities. Prev Med. 2016;87:22–34. https://doi.org/10.1016/j.ypmed.2016.02.011 .

    Article  PubMed  Google Scholar 

  57. Wilks DC, Besson H, Lindroos AK, Ekelund U. Objectively measured physical activity and obesity prevention in children, adolescents and adults: a systematic review of prospective studies. Obes Rev. 2011;12:e119–29. https://doi.org/10.1111/j.1467-789X.2010.00775.x .

    Article  CAS  PubMed  Google Scholar 

  58. Liu X, Zhang D, Liu Y, Sun X, Han C, Wang B, et al. Dose-response association between physical activity and incident hypertension: a systematic review and meta-analysis of cohort studies. Hypertension. 2017;69:813–20. https://doi.org/10.1161/HYPERTENSIONAHA.116.08994 .

    Article  CAS  PubMed  Google Scholar 

  59. Huai P, Xun H, Reilly KH, Wang Y, Ma W, Xi B. Physical activity and risk of hypertension: a meta-analysis of prospective cohort studies. Hypertension. 2013;62:1021–6. https://doi.org/10.1161/HYPERTENSIONAHA.113.01965 .

    Article  CAS  PubMed  Google Scholar 

  60. Lee I-M, Shiroma EJ, Evenson KR, Kamada M, LaCroix AZ, Buring JE. Accelerometer-measured physical activity and sedentary behavior in relation to all-cause mortality: the Women's health study. Circulation. 2018;137:203–5. https://doi.org/10.1161/CIRCULATIONAHA.117.031300 .

    Article  PubMed  Google Scholar 

  61. LaCroix AZ, Bellettiere J, Rillamas-Sun E, Di C, Evenson KR, Lewis CE, et al. Association of Light Physical Activity Measured by Accelerometry and incidence of coronary heart disease and cardiovascular disease in older women. JAMA Netw Open. 2019;2:e190419. https://doi.org/10.1001/jamanetworkopen.2019.0419 .

    Article  PubMed  PubMed Central  Google Scholar 

  62. Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010;33:e147–67. https://doi.org/10.2337/dc10-9990 .

    Article  PubMed  PubMed Central  Google Scholar 

  63. Jakicic JM, Rogers RJ, Davis KK, Collins KA. Role of physical activity and exercise in treating patients with overweight and obesity. Clin Chem. 2018;64:99–107. https://doi.org/10.1373/clinchem.2017.272443 .

    Article  CAS  PubMed  Google Scholar 

  64. Winzer EB, Woitek F, Linke A. Physical activity in the prevention and treatment of coronary artery disease. J Am Heart Assoc. 2018. https://doi.org/10.1161/JAHA.117.007725 .

  65. Mnich C. Is there Europeanization of physical activity promotion? - a neofunctional approach. Health Policy. 2019;123:317–26. https://doi.org/10.1016/j.healthpol.2019.01.004 .

    Article  PubMed  Google Scholar 

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CN received funding by the German Academic Exchange Service (DAAD) for a visiting professorship at KIT.

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Authors and Affiliations

  1. Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany

    Laura Cleven, Janina Krell-Roesch, Claudio R. Nigg & Alexander Woll

  2. Translational Neuroscience and Aging Laboratory, Mayo Clinic, Scottsdale, AZ, USA

    Janina Krell-Roesch

  3. Present address: Institute of Sports Science, University of Bern, Bern, Switzerland

    Claudio R. Nigg

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LC & JKR conducted the literature search, and extracted and interpreted data. LC wrote the first draft of the manuscript. JKR, CN and AW revised the manuscript. All authors read and approved the final manuscript.

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Cleven, L., Krell-Roesch, J., Nigg, C.R. et al. The association between physical activity with incident obesity, coronary heart disease, diabetes and hypertension in adults: a systematic review of longitudinal studies published after 2012. BMC Public Health 20, 726 (2020). https://doi.org/10.1186/s12889-020-08715-4

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