The Combined Effect of Leisure-Time Physical Activity and Diabetes on Cardiovascular Mortality The Nord-Trondelag Health (HUNT) cohort study, Norway

OBJECTIVE-To examine if leisure-time physical activity could cancel out the adverse effect of diabetes on cardiovascular mortality. RESEARCH DESIGN AND METHODS-This study prospectively examined the combined effect of clinical diabetes and reported leisure-time physical activity on cardiovascular mortality. Data on 53,587 Norwegian men and women participating in the population-based Nord-Trondelag Health (HUNT) Study (1995-1997) were linked with the Cause of Death Registry at Statistics Norway. RESULTS-Overall, 1,716 people died of cardiovascular disease during follow-up through 2008. Compared with the reference group of 3,077 physically inactive people without diabetes, 121 inactive people with diabetes had an adjusted hazard ratio (HR) of 2.81(95% CI 1.93-4.07). The HR (95% Cl) among people who reported >= 3 h of light activity per week was 0.89 (0.48-1.63) if they had diabetes (n = 403) and 0.78 (0.63-0.96) if they did not (n = 17,714). Analyses stratified by total activity level showed a gradually weaker association of diabetes with mortality with increasing activity level (P-interaction = 0.003). CONCLUSIONS-The data suggest that even modest physical activity may cancel out the adverse impact of diabetes on cardiovascular mortality. Diabetes Care 36:690-695, 2013