Association of physical activity with all-cause, cardiovascular, and cancer mortality among adults with diabetes: Mexico City Prospective Study

Q: What are the key findings of this study?

High physical activity volume was associated with lower all-cause (HR 0.85; 95% CI 0.80–0.91) and cardiovascular mortality (HR 0.82; 95% CI 0.73–0.92) compared with low volume in adults with diabetes.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Diabetes mellitus (n=28573). Intervention: High physical activity volume vs. Low physical activity volume. Primary outcome: All-cause mortality (HR 0.85, 95% CI 0.80-0.91, p=<0.001).

Q: What question did this study set out to answer?

To evaluate the associations between physical activity frequency, duration, and volume and all-cause, cardiovascular, and cancer mortality among adults with diabetes.

Eduardo Rossato de Victo; Leandro F. M. Rezende; Bianca de Almeida-Pititto; Jacqueline Wahrhaftig; Weder Alves da Silva; Diego Giulliano Destro Christófaro; Adilson Marques; Miguel Peralta; Yafeng Wang; Guillermo Daniel Felipe Barahona-Fuentes; Gerson Ferrari

doi:10.1038/s41598-026-76026-6

October 16, 2026Scientific ReportsOpen Access

Association of physical activity with all-cause, cardiovascular, and cancer mortality among adults with diabetes: Mexico City Prospective Study

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Key result

High physical activity volume is linked to ~15% lower all-cause mortality in adults with diabetes.

HR 0.85
95% CI 0.80-0.91
P<0.001
n=28,573

Why the study?

Does higher frequency, duration, and volume of leisure-time physical activity reduce all-cause, cardiovascular, and cancer mortality in Mexican adults with diabetes?

Key Points

To evaluate the associations between physical activity frequency, duration, and volume and all-cause, cardiovascular, and cancer mortality among adults with diabetes.
Prospective cohort study analyzing 28,573 adults aged ≥ 35 years with diabetes from the Mexico City Prospective Study followed for a mean of 15.2 ± 5.7 years.
Self-reported physical activity was evaluated by frequency (< 1, 1–2, or ≥ 3 times/week), session duration (< 30, 30–60, or > 60 min), and total volume (low, medium, high).
Hazard ratios were estimated using multivariable models adjusted for age, sex, education, household income, body mass index, smoking, alcohol use, and fruit and vegetable intake.
High versus low physical activity volume was associated with lower risk of all-cause mortality (HR: 0.85; 95% CI: 0.80–0.91; p < 0.001) and cardiovascular mortality (HR: 0.82; 95% CI: 0.73–0.92; p < 0.001).
High versus low frequency was linked to lower all-cause mortality (HR: 0.89; 95% CI: 0.84–0.94; p < 0.001) and cardiovascular mortality (HR: 0.89; 95% CI: 0.81–0.99; p = 0.025); high duration similarly reduced both risks (HR: 0.83; 95% CI: 0.76–0.91 and HR: 0.83; 95% CI: 0.71–0.97, respectively).

Study Design

Type

Cohort (n=28,573)

Multicenter

No

Structured PICO

Does higher frequency, duration, and volume of leisure-time physical activity reduce all-cause, cardiovascular, and cancer mortality in Mexican adults with diabetes?

P

Population

28,573 Mexican adults aged ≥ 35 years with diabetes (mean age 58.4 years, 66.7% female) from the Mexico City Prospective Study followed for a mean of 15.2 years.

E

Exposure

Self-reported leisure-time physical activity categorized by frequency (< 1, 1–2, or ≥ 3 times/week), session duration (< 30, 30–60, or > 60 min/session), and total volume (low, medium, or high combination of frequency and duration).

C

Comparator

Low physical activity category: low frequency (no exercise/sports or < 1 time/week), low duration (< 30 min/session), or low volume.

O

Outcome

All-cause mortality, cardiovascular mortality (death from any vascular cause), and cancer mortality (death from any neoplasm) over a mean follow-up of 15.2 ± 5.7 years, ascertained via linkage with the national death registry (ICD-10).hard clinical

Main Result

Hazard Ratio: 0.85 (95% CI 0.8–0.91)

Absolute Event Rate: 35% vs 37.8%

Absolute Risk Reduction: 4.7%

p-value: p=<0.001

Limitations

Self-report assessments of physical activity may have introduced information bias due to memory issues and social desirability bias
Physical activity was assessed only at a single baseline time point, with modest stability at re-survey 14.9 years later (Cohen's kappa 0.20)
The physical activity questionnaire lacked details on activity intensity and occupational physical activity
Limited number of cancer deaths in the medium and high physical activity categories reduced statistical power
Income was recorded as personal rather than household income, with 52.8% reporting no personal income
Self-reported physical activity assessment subject to recall and social desirability bias
Physical activity assessed only at baseline single time point with modest longitudinal stability (Cohen's kappa 0.20)
Lack of data on physical activity intensity and occupational physical activity
Limited number of cancer deaths in medium and high physical activity categories limiting statistical power
Income recorded as personal rather than household income (52.8% reported no personal income)

Implication

In a large Latin American cohort of adults with diabetes, higher frequency, duration, and total volume of leisure-time physical activity were independently associated with significant reductions in 15-year all-cause and cardiovascular mortality.

Abstract

This study examined the association between physical activity (PA) and all-cause, cardiovascular, and cancer mortality among adults with diabetes. A total of 28,573 individuals aged ≥ 35 years from the Mexico City Prospective Study were included. PA was self-reported and categorized by frequency (< 1, 1–2, or ≥ 3 times/week), duration (< 30, 30–60, or > 60 min/session), and volume (combination of frequency and duration). Mean follow-up was 15.2 ± 5.7 years. For all-cause mortality, high PA frequency was associated with lower risk compared with low frequency (HR: 0.89; 95% CI: 0.84–0.94). High PA duration and volume were also associated with lower risk compared with low (HR: 0.83; 95% CI: 0.76–0.91 and HR: 0.85; 95% CI: 0.80–0.91, respectively); high volume was also associated with lower risk compared with medium volume (HR: 0.89; 95% CI: 0.81–0.98). For cardiovascular mortality, high PA frequency, duration and volume were associated with lower risk compared with low levels (HR: 0.89; 95% CI: 0.81–0.99; HR: 0.83; 95% CI: 0.71–0.97; and HR: 0.82; 95% CI: 0.73–0.92, respectively). PA was not associated with cancer mortality.

Discussion

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Cite This Study

Victo et al. (2026) conducted a cohort in Diabetes mellitus (n=28,573). High physical activity volume vs. Low physical activity volume was evaluated on All-cause mortality (HR 0.85, 95% CI 0.80-0.91, p=<0.001). High physical activity volume was associated with lower all-cause (HR 0.85; 95% CI 0.80–0.91) and cardiovascular mortality (HR 0.82; 95% CI 0.73–0.92) compared with low volume in adults with diabetes.

synapsesocial.com/papers/6ad5b29111891a29b4487985 https://doi.org/10.1038/s41598-026-76026-6

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Association of physical activity with all-cause, cardiovascular, and cancer mortality among adults with diabetes: Mexico City Prospective Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Association of physical activity with all-cause, cardiovascular, and cancer mortality among adults with diabetes: Mexico City Prospective Study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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