Physical activity

Physical activity is one of the primary determinants of energy balance and obesity. It is also one of the factors that has undergone recent decreases in developing countries around the world. The potential for the prevention of diabetes by increases in physical activity has been attractive for many years1. Physiological studies have shown that physical activity increases insulin sensitivity and reduces insulin secretion, which may be the primary conduit through which most behavioral risk factors travel to increase diabetes risk. They can be reversed by inactivity91.

Physical activity has also been shown to reduce obesity and central fat distribution in short-term clinical studies91. As physical activity patterns in free living populations are complex, so is the assessment of physical activity in epidemiological studies91. Many have used questionnaires to assess leisure-time physical activity, which in many urban populations is the primary determinant of differences in energy expenditure between individuals. This is not the case in rural populations, where a more comprehensive evaluation of work activities is required92,93. More exact measures are needed to account for all components of total energy expenditure (including resting metabolic rate and the thermic effect of food), but these are not feasible in large populations over extended periods of time91. A number of review papers91,93-98 and an NIH consensus statement99 have summarized prior work on physical activity.

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