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T1D – No effect on BMI or blood pressure

Evidence Summary

A systematic review of 48 articles in 2011 found that physical activity (any type for more than 7 days) does not improve blood pressure [1]. A meta-analysis of 24 studies (998 participants; any age or sex diagnosed with T1DM) also indicates that no significant difference was found in individuals who exercised (aerobic, resistance and/or combined exercise for no less than 4 weeks) with respect to BMI or blood pressure [2]. A clinical trial with 21 male participants (mean age 37 years) to assess whether aerobic or resistance training had greater benefits found no significant difference in body mass between the two groups [3].

A systematic review in 2017 (26 studies) found that there was evidence of improvements in a number of health markers, including body composition, which could suggest that exercise leads to a decrease in BMI [4]. BMI was also found to be decreased with exercise by another systemic review done in 2017 (596 participants), which found that in exercised adults there were significant improvements in BMI (mean difference: 0.39 kg/m2 , 95% CI 0.75–0.02, p = 0.04) [5]. The review looked at prospective randomised or controlled trials of exercise training lasting 12 weeks or more.

Quality of Evidence

A – Consistent evidence from systematic review and meta-analysis

Strength of Recommendation

2 – No effect found for physical activity on BMI or blood pressure.

Conclusion

Exercise and physical activity has been found to decrease BMI slightly in some systemic reviews, but not in other meta-analyses and trials. Overall there is no conclusive evidence that exercise has a significant effect on the BMI. No evidence was found that physical activity has an effect on blood pressure, regardless of whether it is aerobic or resistance training.

References

1 Chimen, M., Kennedy, A., Nirantharakumar, K. et al. What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia 55, 542–551 (2012). https://doi.org/10.1007/s00125-011-2403-2

2 Wu N, Bredin SSD, Guan Y, Dickinson K, Kim DD, Chua Z, Kaufman K, Warburton DER. Cardiovascular Health Benefits of Exercise Training in Persons Living with Type 1 Diabetes: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2019; 8(2):253. https://doi.org/10.3390/jcm8020253

3 Wróbel, M., Rokicka, D., Czuba, M., Gołaś, A., Pyka, Ł., Greif, M., … Gąsior, M. (2018). Aerobic as well as resistance exercises are good for patients with type 1 diabetes. Diabetes Research and Clinical Practice, 144, 93–101.

4 Codella, R., Terruzzi, T. and Luzi, L. (2017). Why should people with type 1 diabetes exercise regularly? Acta Diabetologica, 54(7), pp. 615-630.

5 Ostman C, Jewiss D, King N, Smart NA. Clinical outcomes to exercise training in type 1 diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract. 2018 May;139:380-391. doi: 10.1016/j.diabres.2017.11.036. Epub 2017 Dec 6. PMID: