Elsevier

Preventive Medicine

Volume 39, Issue 1, July 2004, Pages 164-167
Preventive Medicine

Exercise protects against glucose intolerance in individuals with a small body size at birth

https://doi.org/10.1016/j.ypmed.2004.01.035Get rights and content

Abstract

Background. Small body size at birth is a risk factor for Type 2 diabetes. We investigated whether regular exercise is related to lower rates of glucose intolerance in individuals with a small body size at birth and whether birth size affects exercise habits in adulthood.

Methods. Five hundred subjects aged 65–75 years with data on birth measurements underwent an oral glucose tolerance test. They reported their weekly exercise frequency and intensity and yearly physical leisure time activity.

Results. Frequent (≥3/week) or moderate weekly exercise and yearly physical activity were all related to lower rates of glucose intolerance. This effect was, however, dependent on birth size, being strongest among subjects with a small body size at birth (birth weight ≤3000 g and/or ponderal index ≤26 kg/m3). Among men, frequency (P = 0.033) and intensity (P = 0.030) of exercise as well as yearly physical activity (P = 0.005) correlated inversely with birth size.

Conclusions. Subjects predisposed to Type 2 diabetes due to a small birth size are strongly protected from glucose intolerance by regular exercise. Although a small body size at birth is related to a smaller muscle mass in adulthood, men born thin exercised more in adulthood than those not born thin. In these elderly subjects this might indicate the survival of the fittest.

Introduction

Type 2 diabetes develops in genetically predisposed individuals who encounter certain environmental risk factors. Classical risk factors include obesity and a sedentary lifestyle. More recently, a small body size at birth has been established as an important environmental risk factor for Type 2 diabetes and related metabolic disorders [1], [2], [3].

Large-scale epidemiological studies have shown that individuals who are physically active have a lower risk of developing Type 2 diabetes [4], [5]. The protective effect of exercise was most pronounced among high-risk individuals, for example, in subjects with obesity, hypertension or a family history of Type 2 diabetes [4], [5]. We investigated whether regular exercise had a protective effect against glucose intolerance among individuals with a small body size at birth – a more recent risk factor for glucose intolerance.

Since small birth size may indicate relatively small muscle mass compared to adipose tissue [1], [6] and thus affect performance in physical activities and willingness to exercise; we also investigated whether birth size was related to exercise habits at older age.

Section snippets

Methods

The original epidemiological study cohort comprised 7,086 subjects with data on birth measurements who were born as singletons at Helsinki University Central Hospital during 1924–1933. Details of these birth records have been described previously [2], [6]. Six hundred seventy-four people from the cohort known to be living in the greater Helsinki area were invited to attend a clinical study. The study protocol was approved by the Ethics Committee of the National Public Health Institute. Five

Results

The mean age of the participating women was 69.7 years (SD 2.7), BMI 27.8 kg/m2 (SD 4.6), birth weight 3,296 g (SD 464), length at birth 49.7 cm (SD 1.8) and ponderal index 26.7 kg/m3 (SD 2.3). The corresponding values among the men were 69.4 years (SD 2.9), BMI 27.3 kg/m2 (SD 3.9), birth weight 3,445 g (SD 458), length at birth 50.2 cm (SD 1.7) and ponderal index 27.1 kg/m3 (SD 2.4). The birth measurements did not differ from the values in the whole epidemiological cohort.

The glucose tolerance

Conclusions

Regular and moderate exercise protects against glucose intolerance in elderly people who are at increased risk of developing Type 2 diabetes because they were born thin or small. The sufficient intensity of exercise was comparable to brisk walking.

Insulin resistance is the major metabolic derangement in Type 2 diabetes and potentially the primary underlying cause leading to manifest disease. A small body size at birth is associated with muscular insulin resistance [1], [9]. This link would

Acknowledgements

The study was funded by British Heart Foundation, Finska Läkaresällskapet and Jahnsson foundation. The study was initiated and analyzed by the authors.

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