Physical Activity and the Development of Islet Autoimmunity and Type 1 Diabetes in 5- to 15-Year-Old Children Followed in the TEDDY Study
Authors: Liu Xiang , Johnson Suzanne Bennett , Lynch Kristian F. , Cordan Kerry , Pate Russell , Butterworth Martha D. , Lernmark Åke , Hagopian William A. , Rewers Marian J. , McIndoe Richard A. , Toppari Jorma , Ziegler Anette-G. , Akolkar Beena , Krischer Jeffrey P. , Yang Jimin ,   The TEDDY Study Group, Rewers Marian , Bautista Kimberly , Baxter Judith , Felipe-Morales Daniel , Frohnert Brigitte I. , Stahl Marisa , Flores Garcia Isabel , Gesualdo Patricia , Hays Sierra , Hoffman Michelle , Karban Rachel , Liu Edwin , Loaiza Leila , Norris Jill , O’Donnell Holly , Thorndahl Loana , Steck Andrea , Waugh Kathleen , Toppari Jorma , Simell Olli G. , Adamsson Annika , Ahonen Suvi , Åkerlund Mari , Anttila Sirpa , Hakola Leena , Hekkala Anne , Honkanen Tiia , Hyöty Heikki , Ilonen Jorma , Jokipuu Sanna , Karjalainen Taru , Karlsson Leena , Kero Jukka , Koskenniemi Jaakko J. , Kähönen Miia , Knip Mikael , Koivikko Minna-Liisa , Kokkonen Katja , Koskinen Merja , Koreasalo Mirva , Kurppa Kalle , Kuusela Salla , Kytölä Jarita , Laiho Jutta , Latva-aho Tiina , Leisku Siiri , Leppänen Laura , Lindfors Katri , Lönnrot Maria , Mäntymäki Elina , Mattila Markus , Miettinen Maija , Mykkänen Teija , Niininen Tiina , Niinistö Sari , Nurminen Noora , Oikarinen Sami , Oinas Hanna-Leena , Ollikainen Paula , Othmani Zhian , Pohjola Sirpa , Raja-Hanhela Solja , Rautanen Jenna , Riikonen Anne , Romo Minna , Rönkä Juulia , Rönkä Nelli , Simell Satu , Tossavainen Päivi , Vähä-Mäkilä Mari , Varjonen Eeva , Veijola Riitta , Viinikangas Irene , Vilmi Silja , Virtanen Suvi M. , McIndoe Richard , Schatz Desmond , Hopkins Diane , Haller Michael , Bernard Risa , Gardiner Melissa , Sharma Ashok , Jacobsen Laura , Hosford Jennifer , Petty Kennedy , Myers Leah , Salmon Chelsea , Ziegler Anette G. , Bonifacio Ezio , Gezginci Cigdem , Grätz Willi , Heublein Anja , Hohoff Eva , Hummel Sandra , Knopff Annette , Köger Melanie , Koletzko Sibylle , Ramminger Claudia , Roth Roswith , Schmidt Jennifer , Scholz Marlon , Stock Joanna , Warncke Katharina , Wendel Lorena , Winkler Christiane , Lernmark Åke , Agardh Daniel , Andrén Aronsson Carin , Bennet Rasmus , Cilio Corrado , Dahlberg Susanne , Fält Ulla , Goldman Tsubarah Malin , Ericson-Hallström Emelie , Fransson Lina , Halilovic Emina , Holmén Gunilla , Hyberg Susanne , Jonsdottir Berglind , Karimi Naghmeh , Elding Larsson Helena , Lindström Marielle , Lundgren Markus , Maziarz Marlena , Melin Jessica , Nilsson Caroline , Rahmati Kobra , Ramelius Anita , Salami Falastin , Sjöberg Anette , Tekum Amboh Evelyn , Törn Carina , Ulvenhag Ulrika , Wiktorsson Terese , Wimar Åsa , Hagopian William A. , Killian Michael , Cowen Crouch Claire , Skidmore Jennifer , Bender Trevor , Llewellyn Megan , McCall Cody , Meyer Arlene , Meyer Jocelyn , Mulenga Denise , Powell Nole , Radtke Jared , Roy Shreya , Tucker Preston , Becker Dorothy , Franciscus Margaret , Dalmagro-Elias Smith MaryEllen , Daftary Ashi , Klein Mary Beth , Yates Chrystal , Krischer Jeffrey P. , Adusumali Rajesh , Austin-Gonzalez Sarah , Avendano Maryouri , Baethke Sandra , Burkhardt Brant , Butterworth Martha , Cadigan Nicholas , Clasen Joanna , Counts Kevin , Gandolfo Laura , Garmeson Jennifer , Gowda Veena , Karges Christina , Liu Shu , Liu Xiang , Lynch Kristian , Malloy Jamie , Mramba Lazarus , McCarthy Cristina , Moreno Jose , Parikh Hemang M. , Remedios Cassandra , Shaffer Chris , Smith Susan , Sulman Noah , Tamura Roy , Tewey Dena , Thuma Henri , Toth Michael , Uusitalo Ulla , Vehik Kendra , Vijayakandipan Ponni , Wroble Melissa , Yang Jimin , Young Kenneth , Akolkar Beena , Abbondondolo Michael , Ballard Lori , Brown Rasheedah , Cuthbertson David , Dankyi Stephen , Eberhard Christopher , Fiske Steven , Hadley David , Heyman Kathleen , Hsiao Belinda , Perez Laras Francisco , Lee Hye-Seung , Li Qian , Maguire Colleen , McLeod Wendy , Merrell Aubrie , Meulemans Steven , Quigley Ryan , Smith Laura , Briese Thomas , Brusko Todd , Buckner Teresa , Bennett Johnson Suzanne , McKinney Eoin , Pastinen Tomi , Ullitz Thorsen Steffen , Triplett Eric 
Published: May 2023

OBJECTIVE
This study investigated physical activity and its association with the development of islet autoimmunity and type 1 diabetes in genetically at-risk children aged 5–15 years.

RESEARCH DESIGN AND METHODS
As part of the longitudinal Environmental Determinants of Diabetes in the Young (TEDDY) study, annual assessment of activity using accelerometry was conducted from age 5 years. Time-to-event analyses using Cox proportional hazard models were used to assess the association between time spent in moderate to vigorous physical activity per day and the appearance of one or several autoantibodies and progression to type 1 diabetes in three risk groups: 1) 3,869 islet autoantibody (IA)-negative children, of whom 157 became single IA positive; 2) 302 single IA–positive children, of whom 73 became multiple IA positive; and 3) 294 multiple IA–positive children, of whom 148 developed type 1 diabetes.

RESULTS
No significant association was found in risk group 1 or risk group 2. A significant association was seen in risk group 3 (hazard ratio 0.920 [95% CI 0.856, 0.988] per 10-min increase; P = 0.021), particularly when glutamate decarboxylase autoantibody was the first autoantibody (hazard ratio 0.883 [95% CI 0.783, 0.996] per 10-min increase; P = 0.043).

CONCLUSIONS
More daily minutes spent in moderate to vigorous physical activity was associated with a reduced risk of progression to type 1 diabetes in children aged 5–15 years who had developed multiple IAs.