Low-cost exercise interventions improve long-term cardiometabolic health independently of a family history of type 2 diabetes: a randomized parallel group trial

Niko S Wasenius, Bo A Isomaa, Bjarne Östman, Johan Söderström, Björn Forsén, Kaj Lahti, Liisa Hakaste, Johan G Eriksson, Leif Groop, Ola Hansson, Tiinamaija Tuomi, Niko S Wasenius, Bo A Isomaa, Bjarne Östman, Johan Söderström, Björn Forsén, Kaj Lahti, Liisa Hakaste, Johan G Eriksson, Leif Groop, Ola Hansson, Tiinamaija Tuomi

Abstract

Introduction: To investigate the effect of an exercise prescription and a 1-year supervised exercise intervention, and the modifying effect of the family history of type 2 diabetes (FH), on long-term cardiometabolic health.

Research design and methods: For this prospective randomized trial, we recruited non-diabetic participants with poor fitness (n=1072, 30-70 years). Participants were randomly assigned with stratification for FH either in the exercise prescription group (PG, n=144) or the supervised exercise group (EG, n=146) group and compared with a matched control group from the same population study (CON, n=782). The PG and EG received exercise prescriptions. In addition, the EG attended supervised exercise sessions two times a week for 60 min for 12 months. Cardiometabolic risk factors were measured at baseline, 1 year, 5 years, and 6 years. The CON group received no intervention and was measured at baseline and 6 years.

Results: The EG reduced their body weight, waist circumference, diastolic blood pressure, and low-density lipoprotein-cholesterol (LDL-C) but not physical fitness (p=0.074) or insulin or glucose regulation (p>0.1) compared with the PG at 1 year and 5 years (p≤0.011). The observed differences were attenuated at 6 years; however, participants in the both intervention groups significantly improved their blood pressure, high-density lipoprotein-cholesterol, and insulin sensitivity compared with the population controls (p≤0.003). FH modified LDL-C and waist circumference responses to exercise at 1 year and 5 years.

Conclusions: Low-cost physical activity programs have long-term beneficial effects on cardiometabolic health regardless of the FH of diabetes. Given the feasibility and low cost of these programs, they should be advocated to promote cardiometabolic health.

Trial registration number: ClinicalTrials.gov identifier NCT02131701.

Keywords: cardiorespiratory fitness; diabetes mellitus; exercise; metabolism; type 2.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

Figures

Figure 1
Figure 1
Mean change in fitness index (A and B), LDL-cholesterol (C and D) and waist circumference (E and F) in the prescription group (black square) and in the exercise intervention group (white square) in people with (FH+) or without (FH−) family history of diabetes. Error bars indicate 95% CI. FH, family history of type 2 diabetes; LDL, low-density lipoprotein.

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