Importance of achieving a “fit” cardiorespiratory fitness level for several years on the incidence of type 2 diabetes mellitus: A Japanese cohort study

Haruki Momma, Susumu S. Sawada*, Robert A. Sloan, Yuko Gando, Ryoko Kawakami, Shin Terada, Motohiko Miyachi, Chihiro Kinugawa, Takashi Okamoto, Koji Tsukamoto, Cong Huang, Ryoichi Nagatomi, Steven N. Blair

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: The “Physical Activity Reference for Health Promotion 2013” provides “fit” reference values for cardiorespiratory fitness (CRF) for good health. The importance of achieving a fit CRF level for several years on the subsequent prevention of type 2 diabetes mellitus (T2DM) remains to be clarified. Methods: This cohort study was conducted in 2,235 nondiabetic males aged 21 to 59 years, enrolled in April 1986 through March 1987. We calculated the ratio of the area under the curve (AUCratio) for actual measured values and the AUC for the reference values of CRF in each individual during an 8-year measurement period before the baseline. According to whether they met a fit CRF level or not, participants were categorized into groups based on the AUCratio (FitAUC or UnfitAUC) and initial CRF (Fitinitial or Unfitinitial), respectively. T2DM was evaluated on health checkups until March 2010. Results: During the follow-up period, 400 men developed T2DM. After adjustment for confounders, as compared with those in the FitAUC group, the hazard ratio (HR) for those in the UnfitAUC group was 1.33 (95% confidence interval [CI], 1.06–1.65). A combined analysis with the categories of initial value and AUCratio showed that, compared with the Fitinitial and FitAUC group, the HRs of Fitinitial and UnfitAUC, Unfitinitial and FitAUC, and Unfitinitial and UnfitAUC groups were 1.41 (95% CI, 0.99–2.00), 1.18 (95% CI, 0.81–1.70), and 1.40 (95% CI, 1.08–1.83), respectively. Conclusion: Achievement of a fit CRF level established in the Japan physical activity guideline for several years was associated with lower subsequent risk of T2DM.

Original languageEnglish
Pages (from-to)230-236
Number of pages7
JournalJournal of epidemiology
Issue number5
Publication statusPublished - 2018 May 5
Externally publishedYes


  • Area under the curve
  • Maximal oxygen uptake
  • Metabolic memory
  • Physical activity reference for health promotion 2013

ASJC Scopus subject areas

  • Epidemiology


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