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Walking speed and the risk of type 2 diabetes: a systematic review and meta-analysis
  1. Ahmad Jayedi1,
  2. Mahdieh-Sadat Zargar2,
  3. Alireza Emadi3,
  4. Dagfinn Aune4,5,6
  1. 1Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
  2. 2Clinical Research Development Unit, Kowsar Educational, Research and Therapeutic Hospital, Semnan University of Medical Sciences, Semnan, Iran
  3. 3Food Safety Research Center (salt), Semnan University of Medical Sciences, Semnan, Iran
  4. 4Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
  5. 5Department of Nutrition, Oslo New University College, Oslo, Norway
  6. 6Department of Research, The Cancer Registry of Norway, Oslo, Norway
  1. Correspondence to Dr Ahmad Jayedi, Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran; ahmadjayedi{at}yahoo.com

Abstract

Objective To investigate the association between walking speed and the risk of type 2 diabetes.

Design Systematic review and meta-analysis.

Data sources PubMed, Scopus, CENTRAL and Web of Science to 30 May 2023.

Eligibility criteria for selecting studies We included cohort studies that explored the association between walking speed and the risk of type 2 diabetes in adults. We used random-effects meta-analyses to calculate relative risk (RR) and risk difference (RD). We rated the credibility of subgroup differences and the certainty of evidence using the Instrument to assess the Credibility of Effect Modification ANalyses (ICEMAN) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) tools, respectively.

Results Ten cohort studies were included. Compared with easy/casual walking (<3.2 km/hour), the RR of type 2 diabetes was 0.85 (95% CI 0.70 to 1.00); RD=0.86 (95% CI 1.72 to 0) fewer cases per 100 patients; n=4, GRADE=low) for average/normal walking (3.2–4.8 km/hour), 0.76 (95% CI 0.65 to 0.87); RD=1.38 (95% CI 2.01 to 0.75) fewer cases per 100 patients; n=10, GRADE=low) for fairly brisk walking (4.8–6.4 km/hour) and 0.61 (95% CI 0.49 to 0.73; RD=2.24 (95% CI 2.93 to 1.55) fewer cases per 100 patients; n=6, GRADE=moderate) for brisk/striding walking (>6.4 km/hour). There was no significant or credible difference across subgroups based on adjustment for the total volume of physical activity and time spent walking per day. Dose–response analysis suggested that the risk of type 2 diabetes decreased significantly at a walking speed of 4 km/h and above.

Conclusions Low to moderate certainty evidence, mainly from studies with a high risk of bias, suggests that walking at faster speeds is associated with a graded decrease in the risk of type 2 diabetes.

PROSPERO registration number CRD42023432795.

  • Physical activity
  • Walking

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Twitter @Ahmad Jayedi

  • Contributors AJ conceptualised and designed the study, drafted the initial manuscript, coordinated and supervised data collection, analysed the data and reviewed and revised the manuscript. AE and M-SZ screened articles, abstracted data, drafted the manuscript and reviewed and provided relevant intellectual content. DA critically revised the manuscript. AJ was responsible for the overall content as guarantor. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.