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Abstract Introduction It is well-documented that increasing leisure-time physical activity (LTPA) reduces the risk of type 2 diabetes (T2D), whereas the role of occupational physical activity (OPA) in T2D risk is unclear. The objective of this study was to assess the independent and joint associations of OPA and LTPA with T2D risk. Methods This prospective cohort included 1,406 workers without diabetes at baseline (2004-2006) from the population-based Mid-Life in the United States study. High OPA was defined by engagement in physical tasks at work and high LTPA was classified as participation in moderate-to-vigorous LTPA at least once per week. Associations of OPA and LTPA at baseline with incident T2D during 9 years of follow-up were examined using modified Poisson regression models with adjustment for potential confounders such as sociodemographic factors and job strain. Results High OPA was associated with a 52% (adjusted RR=1.52; 95% CI: 1.04, 2.22) higher risk of T2D compared to low OPA, while high LTPA was associated with a 44% lower risk of T2D compared to low LTPA (0.66; 0.44, 0.97). Diabetes risk was 2.30 times higher (1.30, 4.07) among workers with high OPA and low LTPA than those with low OPA and high LTPA. Discussion In a population-based prospective cohort study of U.S. workers, we found OPA and LTPA had opposite associations with diabetes risk, highlighting the potential detrimental role of OPA in cardiometabolic health. Conclusion Our findings support the physical activity paradox for diabetes risk. Workers with high OPA and low LTPA could be considered a high-risk population for diabetes prevention.
Chen et al. (Mon,) studied this question.