Incorporating Weight Training Into Physical Activity Regimen Linked to Reduced Mortality in Type 2 Diabetes

Integration of weight training into weekly physical activity regimens was linked to a decreased risk of all-cause mortality among people with and without type 2 diabetes, according to an analysis of data from male health professionals in the US.

An analysis of data from the Health Professional Follow-up Study, results of the study, which included more than 30,000 men and 26 years of follow-up data, indicate integration of long-term weight training was associated with a reduction in all-cause mortality among participants without type 2 diabetes, even with adjustment for aerobic activity, while the benefits of weight training on all-cause mortality in those with type 2 diabetes appeared to be more complicated.

“Our study supports the current physical activity guidelines and provides additional evidence for the optimal amount of long-term weight training independently and jointly with aerobic activity to maximize longevity benefits in adults with and without type 2 diabetes," wrote investigators.

As the knowledge base surrounding the impact of different forms of aerobic and anaerobic activities, debate has emerged regarding the ideal amount of each form of activity as part of a person’s lifestyle routine. Without a dedicated randomized controlled trial, clinicians and researchers have turned to observational data and retrospective analyses to better understand what constitutes optimal levels of each form of physical activity in different patient groups.

To develop a greater understanding of the associations of long-term weight training and mortality in men, investigators designed the current study as an analysis of data recorded within the Health Professional Follow-up Study. Launched in 1986, the study enrolled 51,529 male health professionals aged 40-75 years. As part of the follow-up protocol, the study assessed patient information via a biennial questionnaire, which began assessments of weight training as part of their evaluations of physical activity in 1990.

Limiting their analyses to those with at least one 1 measure of weight training at baseline, investigators identified 31,140 men without type 2 diabetes and 2,588 men with type 2 diabetes for inclusion in the current study. The aforementioned questionnaires asked participants to report average weekly time spent weightlifting or using a nautilus or weight machine, with the options including 0 minutes, 1-4 min, 5-19 min, 20-59 min, 1 hour, 1-1.5 hours, 2-3 hours, 4-6 hours, 7-10 hours, or 11 or more hours. Investigators noted up to 13 repeated measures of weight training information were collected during the follow-up period, with a median of 11 measures occurring per participant.

For the purpose of analysis, Cox regression was used to estimate hazard ratios (HRs) for all-cause mortality. These models were adjusted for age, height, race, smoking status, family history of myocardial infarction, family history of cancer, baseline hypertension, alcohol consumption, AHEI score 2010, total calorie intake, time spent sitting to watch television, BMI, and aerobic activity level.

Among the 33,728 individuals included in the study, 12,607 deaths were documented, with 988 deaths occurring among men with type 2 diabetes. Upon analysis, results suggested 1-59 and 60-149 minutes per week of long-term weight training were associated with 14% (HR, 0.86 [95% CI, 0.82-0.89]) and 8% (HR, 0.92 [95% CI, 0.85-0.99]) lower mortality versus no weight training, respectively, among those without type 2 diabetes after adjustment for aerobic activity. Further analysis among men without type 2 diabetes indicated long-term weight training 150 minutes or more per week was not significantly associated with mortality (HR, 1.05 [95% CI, 0.91-1.20]; overall P-trend=.94; P quadratic <.001).

Among men with type 2 diabetes, results of the investigators’ analysis indicated those with 1-59 and 60-149 minutes per week of prediagnosis weight training had 32% (HR, 0.68 [95% CI, 0.48-0.96]) and 27% (HR, 0.73 [95% CI, 0.54-0.99]) lower risks of all-cause mortality, respectively. No decreased risk of mortality was observed for those with 150 minutes or more of per week weight training prediagnosis (HR, 1.11 [95% CI, 0.80-1.55]). Further analysis of this cohort suggested a weak inverse association between moderate levels of postdiagnosis weight training with all-cause mortality, but the association became nonsignificant after additional adjustment for postdiagnosis aerobic activity.

“Engaging in 30-60 minutes per week of long-term weight training was associated with lower risks of all-cause and cause-specific mortality, independently of aerobic activities. Moreover, the optimal benefit of mortality risk reduction was found in individuals performing above the recommended aerobic activity and any weight training,” investigators concluded. “Similar findings were observed in adults with type 2 diabetes, suggesting the benefit of engaging in moderate levels of pre- and postdiagnosis weight training, with aerobic activity, to reduce mortality.”

This study, “Long-term Weight Training and Mortality in U.S. Male Health Professionals With and Without Type 2 Diabetes,” was published in Diabetes Care.