Understanding the Role of Integrated Grip Strength, Physical Activity, Diet, and Adiposity-related Body Composition in the Development of Type 2 Diabetes - Insights from the UK Biobank Cohort - Abstract

Sep 15, 2026

Type 2 diabetes (T2D) is a major contributor to cardiovascular disease risk and global mortality. This thesis examines how modifiable lifestyle behaviours and sociodemographic context shape the relationship between traditional and emerging cardiometabolic risk factors—grip strength, physical activity, dietary patterns, and obesity-related body composition markers—and the incidence of T2D. Using UK Biobank data, grip strength, objectively measured activity, anthropometry-derived indicators, and T2D outcomes from care and hospital records are analyzed with harmonised cohort methods.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages328

Reading Time13 h 47 min

AccessFree to download

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Boonpor, Jirapitcha (2025) Understanding the role of integrated grip strength, physical activity, diet, and adiposity-related body composition in the development of type 2 diabetes: insights from the UK Biobank cohort. PhD thesis. [https://theses.gla.ac.uk/85638/](https://theses.gla.ac.uk/85638/) Copyright and moral rights for this work are retained by the author A copy can be downloaded for personal non-commercial research or study, without prior permission or charge This work cannot be reproduced or quoted extensively from without first obtaining permission in writing from the author The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the author When referring to this work, full bibliographic details including the author, title, awarding institution and date of the thesis must be given Enlighten: Theses [https://theses.gla.ac.uk/](https://theses.gla.ac.uk/) [research-enlighten@glasgow.ac.uk](research-enlighten@glasgow.ac.uk) Understanding the Role of Integrated Grip Strength, Physical Activity, Diet, and Adiposity-related Body Composition in the Development of Type 2 Diabetes: Insights from the UK Biobank Cohort Jirapitcha Boonpor MSc, MSc, BSc, RD Submitted in fulfilment of the requirement for the Degree of Doctor of Philosophy University of Glasgow School of Cardiovascular and Metabolic Health College of Medical, Veterinary & Life Sciences University of Glasgow Abstract Type 2 diabetes (T2D) is a major contributor to cardiovascular disease risk and global mortality. T2D develops through complex biological pathways influenced by modifiable lifestyle behaviours and sociodemographic context. Accordingly, this thesis explores the relationship between traditional and emerging cardiometabolic risk factors, such as grip strength, physical activity (PA), dietary patterns, and obesity-related indicators, with the incidence of T2D. This research uses data from the UK Biobank, a large-scale population-based prospective study encompassing over 500,000 participants from across the UK. Dietary exposures were self-reported, while PA was objectively quantified using wrist-worn accelerometers. Grip strength was assessed using a hand dynamometer, and obesity-related indicators were derived from anthropometric measurements taken by trained personnel. The incidence of T2D was obtained from primary care and hospital records. Cohort analyses were conducted using harmonised methods across exposures, including multivariable Cox regression, subgroup analysis, and mediation modelling. The findings of this thesis reveal that lower absolute or relative (kg, or kg/body mass) grip strength is linked with an increased risk of developing T2D in both women and men, compared to those with normal grip strength. Notably, relative grip strength exhibits a more pronounced association with T2D risk than absolute grip strength (12% for men and 20% for women vs. 11% for men and 12% for women) . Furthermore, low grip strength may serve as an early indicator of heightened T2D risk. In terms of PA, adherence to the WHO’s PA guidelines, as measured by accelerometers, is associated with a reduced risk of T2D (50%-70% depending on intensity and time spent) . The magnitude of these associations is significantly greater than those reported in previous studies based on selfreported PA. Dietary analysis indicates that fish eaters (pesco-vegetarians) and those consuming fish and poultry have a lower risk of T2D (42% and 28%, respectively) compared to omnivores, while vegetarian diets show no significant association. This discrepancy may be due to a poor quality of diet, underreporting, or misclassification. Additionally, among 11 obesity-related markers evaluated for T2D risk prediction, 9 demonstrate an association, with the waist-to-height ratio (WHtR) showing the strongest predictive value, which could potentially benefit clinical screening practices. Sociodemogra

FAQs

What main factors does the thesis evaluate for T2D development?

The thesis evaluates grip strength, physical activity, dietary patterns, and adiposity-related body composition indicators as risk factors linked to the incidence of type 2 diabetes.

How is physical activity measured in the UK Biobank cohort analysis?

Physical activity is objectively quantified using wrist-worn accelerometers.

What is the overall conclusion about prevention implications from the findings?

The results support integrated prevention strategies that address behavioural, physiological, and sociodemographic dimensions, including central adiposity measures such as waist-to-height ratio for screening relevance.

Sep 15, 2026

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