OBJECTIVE: To examine dose-response associations of vigorous intermittent lifestyle physical activity (VILPA; bouts ≤1 min) and its moderate- to vigorous-intensity equivalent (MV-ILPA; bouts ≤3 min) with incident type 2 diabetes. RESEARCH DESIGN AND METHODS: Prospective data from UK Biobank accelerometry substudy participants who reported no leisure-time exercise and had no type 2 diabetes at baseline were analyzed. Daily duration and frequency of VILPA and MV-ILPA were derived from wrist-worn accelerometers. Incident type 2 diabetes was ascertained through linked primary care, hospital, and death records. Dose-response associations were examined using multivariable-adjusted Fine-Gray subdistribution hazard models accounting for competing risks. RESULTS: Among 22,706 participants (mean age 62.3 years; 56.4% female), 665 developed type 2 diabetes over an average follow-up of 7.9 years. Daily durations of VILPA and MV-ILPA showed inverse, nonlinear L-shaped associations with incident type 2 diabetes. Median durations of 3.9 min/day of VILPA and 25.3 min/day of MV-ILPA were associated with 36% and 46% lower risks of type 2 diabetes, respectively, compared with no VILPA or 3.9 min/day of MV-ILPA. Daily VILPA frequency showed a near-linear inverse association, with 10.4 bouts/day (median) corresponding to a hazard ratio (HR) of 0.64 (95% CI 0.51-0.81) compared with 0 bouts/day. Daily MV-ILPA frequency showed a U-shaped pattern, with risk reductions plateauing at approximately 56 bouts/day (HR 0.54; 95% CI 0.39-0.76). CONCLUSIONS: Among adults who do not engage in leisure-time exercise, accruing brief, intermittent bouts of moderate- to vigorous-intensity physical activity during day-to-day routines may be a promising strategy for prevention of type 2 diabetes.
Chong et al. (Tue,) studied this question.