Quantifying the association between physical activity and cardiovascular disease & diabetes: A systematic review and meta-analysis

Abdul Ahad Wahid, Nishma Manek, melanie Nicols, Paul Kelly, Premila Webster, Asha Kaur, Claire Friedemann, Elizabeth Wilkins, Mike Rayner, Nia Roberts, Peter Scarborough

Research output: Contribution to journalArticlepeer-review


Background: The relationships between physical activity (PA) and both cardiovascular disease (CVD) and Type II Diabetes (T2DM) have predominantly been estimated using categorical measures of PA, masking the shape of the dose response relationship.

In this systematic review and meta-analysis, for the very first time we are able to derive a single continuous PA metric to compare the association between PA and CVD/T2DM, both before and after adjustment for a measure of body weight.

Methods and Results: The search was applied to MEDLINE and EMBASE electronic databases for all studies published from January 1981 to March 2014. A total of thirty-six studies (3,439,874 participants and 179,393 events, during an average follow up period of 12.3 years) were included in the analysis (33 pertaining to CVD and 3 to T2DM).

An increase from being inactive to achieving recommended PA levels 150 minutes of moderateintensity aerobic activity per week).was associated with lower risk of CVD by 23%, CVD incidence by 17% and T2DM incidence by 26% (RR 0.77 (0.71-0.84)), (RR 0.83 (0.77-0.89)) and (RR 0.74 (0.72-0.77)) respectively, after adjustment for body weight.

Conclusions: By using a single continuous metric for PA levels we were able to make a comparison of the effect of physical activity on CVD incidence and mortality including myocardial infarct (MI), stroke and heart failure, as well as type II diabetes. Effect sizes were generally similar for CVD and type II diabetes, and suggested that the greatest gain in health is associated with moving from
inactivity to small amounts of PA.


  • physical activity
  • cardiovascular diseases
  • systematic review
  • meta-analysis


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