Aims. Cross‐country skiing is associated with reduction in risk of adverse vascular outcomes, but its association with type 2 diabetes is uncertain. We aimed to assess the associations between leisure‐time cross‐country skiing habits and incident type 2 diabetes.

Methods. We analyzed data of 2,483 middle‐aged men with no history of diabetes at baseline in the KIHD prospective study. The frequency, average duration, and intensity of leisure cross‐country skiing were assessed at baseline using a 12‐month physical activity questionnaire. Hazard ratios (HRs) (95% CIs) for type 2 diabetes were estimated.

Results. During a median follow‐up of 21.6 years, 539 men developed type 2 diabetes. Type 2 diabetes risk decreased with increasing total volume of cross‐country skiing up to 1,215 MET hours/year. In analyses adjusted for several established risk factors, when compared to men with no cross‐country skiing activity, the HRs (95% CIs) for type 2 diabetes were 0.75 (0.62‐0.92) and 0.59 (0.46‐0.76) for men who did 1‐200 and >200 MET hours/year of cross‐country skiing respectively. Compared to men with no cross‐country skiing activity, the corresponding adjusted HRs (95% CIs) for type 2 diabetes were 0.73 (0.60‐0.89) and 0.64 (0.50‐0.82) for men who did 1‐60 and >60 mins/week of cross‐country skiing respectively. The associations remained consistent following further adjustment for prevalent comorbidities.

Conclusion. Total volume and duration of leisure‐time cross‐country skiing are each inversely and independently associated with future type 2 diabetes risk in a male population. Cross‐country skiing undertaken as a leisure activity has the potential to promote public health.