Consistent resistance training (RT) may be an important component of type 2 diabetes (T2D) prevention recommendations, especially when combined with adequate aerobic activity and limited sedentary behavior, according to a prospective cohort study published June 22 in JAMA.

Tianyue Zhang, MD, et al., examined data from three ongoing studies in the U.S. of health care professionals: Nurses' Health Study (2002 to 2021), Nurses' Health Study II (2003 to 2021) and Health Professionals Follow-up Study (1992 to 2021). RT was assessed at least three times in participants between ages 40 and 60 years for trajectory analysis. Data were analyzed from April 30, 2025, to September 30, 2025.

Every two to four years, researchers evaluated the amount of time participants engaged in RT and grouped them into five categories: consistently low, high to low, low to high and consistently high. Researchers defined long-term RT patterns using cumulative averages and trajectory analyses from ages 40 to 60 within the Nurses' Health Study II.

Over the nearly 20 years of follow-up, 10,038 of the 143,715 study participants developed T2D, the primary study outcome. Most study participants were White (97%), 78% women and their mean age was 56 years. Notably, there was a 27% lower risk of developing T2D among participants who engaged in two or more hours of RT compared with no RT.

Trajectory analyses showed that participants who maintained consistently high levels of RT (≥0.5 h/week during midlife) had a 42% lower risk of T2D, while those with low to high levels had a 21% lower risk, compared with individuals with consistently low engagement.

The lowest risk for T2D (62% lower) was found among participants who met recommendations for both aerobic activity (≥15 total metabolic equivalent-hours/week) and resistance training (≥1 h/week) and reported limited television viewing (<2 h/day) (hazard ratio, 0.38).

"Our findings align with and extend prior evidence that resistance training is inversely associated with T2D risk," write the authors. "...these findings underscore the importance of integrated prevention approaches that combine structured resistance and aerobic activity with reductions in sedentary time to optimize diabetes risk."