Modest Levels of Physical Activity Are Associated With a Lower Incidence of Diabetes in a Population With a High Rate of Obesity: The Strong Heart Family Study

OBJECTIVE: To examine the association of objectively measured participation in low levels of physical activity with incident type 2 diabetes. RESEARCH DESIGN AND METHODS: The study population included participants free of diabetes and cardiovascular disease at baseline (n = 1,826) who participated in a follow-up examination. Generalized estimating equations were used to examine the association of steps per day with incident diabetes. RESULTS: During 5 years of follow-up, 243 incident cases of diabetes were identified. When compared with participants in the lowest quartile of steps per day (<3,500 steps), participants in the upper three quartiles of steps per day had lower odds for diabetes, consistent with a threshold effect. Contrasting the three upper quartiles with the lowest quartile, the odds ratio of diabetes was 0.71 (95% CI 0.51–0.98). CONCLUSIONS: Modest levels of physical activity are associated with a lower risk of incident diabetes, compared with lower levels of activity.