biostudies-literatureUnknown25(7)Boonpor JNorthwest Regional Development AgencyMedical Research CouncilWellcome TrustScottish Government<h4>Aims</h4>To investigate the combined association of adiposity and walking pace with incident type 2 diabetes.<h4>Methods</h4>We undertook a prospective cohort study in 194 304 White-European participants (mean age 56.5 years, 55.9% women). Participants' walking pace was self-reported as brisk, average or slow. Adiposity measures included body mass index (BMI), waist circumference (WC) and body fat percentage (BF%). Associations were investigated using Cox proportional hazard models, with a 2-year landmark analysis. A four-way decomposition analysis was used for mediation and additive interaction.<h4>Results</h4>The median (interquartile range) follow-up was 5.4 (4.8-6.3) years. During the follow-up period, 4564 participants developed type 2 diabetes. Compared to brisk-walking participants with normal BMI, those with obesity who walked briskly were at an approximately 10- to 12-fold higher risk of type 2 diabetes (hazard ratio [HR] 9.64, 95% confidence interval [CI] 7.24-12.84, in women; HR 11.91, 95% CI 8.80-16.12, in men), whereas those with obesity and walked slowly had an approximately 12- to 15-fold higher risk (HR 12.68, 95% CI 9.62-16.71, in women; HR 15.41, 95% CI 11.27-21.06, in men). There was evidence of an additive interaction between WC and BF% and walking pace among women, explaining 17.8% and 47.9% excess risk respectively. Obesity mediated the association in women and men, accounting for 60.1% and 44.9%, respectively.<h4>Conclusions</h4>Slow walking pace is a risk factor for type 2 diabetes independent of adiposity. Promoting brisk walking as well as weight management might be an effective type 2 diabetes prevention strategy given their synergistic effects.Diabetes, obesity & metabolism1900-1910https://www.ebi.ac.uk/biostudies/studies/S-EPMC10947435biostudies-literatureAssociation between walking pace and incident type 2 diabetes by adiposity level: A prospective cohort study from the UK Biobank.PMC10947435Lynskey NTalebi ACelis-Morales CASattar NGray SRRaisi AHo FKGore JWelsh PPell JPBoonpor JParra-Soto SGill JMRfalseAssociation between walking pace and incident type 2 diabetes by adiposity level: A prospective cohort study from the UK Biobank.<h4>Aims</h4>To investigate the combined association of adiposity and walking pace with incident type 2 diabetes.<h4>Methods</h4>We undertook a prospective cohort study in 194 304 White-European participants (mean age 56.5 years, 55.9% women). Participants' walking pace was self-reported as brisk, average or slow. Adiposity measures included body mass index (BMI), waist circumference (WC) and body fat percentage (BF%). Associations were investigated using Cox proportional hazard models, with a 2-year landmark analysis. A four-way decomposition analysis was used for mediation and additive interaction.<h4>Results</h4>The median (interquartile range) follow-up was 5.4 (4.8-6.3) years. During the follow-up period, 4564 participants developed type 2 diabetes. Compared to brisk-walking participants with normal BMI, those with obesity who walked briskly were at an approximately 10- to 12-fold higher risk of type 2 diabetes (hazard ratio [HR] 9.64, 95% confidence interval [CI] 7.24-12.84, in women; HR 11.91, 95% CI 8.80-16.12, in men), whereas those with obesity and walked slowly had an approximately 12- to 15-fold higher risk (HR 12.68, 95% CI 9.62-16.71, in women; HR 15.41, 95% CI 11.27-21.06, in men). There was evidence of an additive interaction between WC and BF% and walking pace among women, explaining 17.8% and 47.9% excess risk respectively. Obesity mediated the association in women and men, accounting for 60.1% and 44.9%, respectively.<h4>Conclusions</h4>Slow walking pace is a risk factor for type 2 diabetes independent of adiposity. Promoting brisk walking as well as weight management might be an effective type 2 diabetes prevention strategy given their synergistic effects.2023-01-01T00:00:00Z2023 Jul2026-06-23T03:18:42.062Z2025-05-29T22:16:51.184ZS-EPMC109474353695168310.1111/dom.15053