A new study has found that each of five healthy lifestyle factors incrementally lowered one’s risk of getting diabetes by an additional 31% to 39% in a large 11-year study of approximately 207,000 men and women aged 50 to 71 years. When combined, the five healthy lifestyle factors together lowered the risk of diabetes by approximately 80%.
The study, by Jared P. Reis, PhD of the National Institutes of Health (National Heart, Lung and Blood Institute) along with colleagues from the National Cancer Institute and AARP, was published in the September 6, 2011 issue of the Annals of Internal Medicine, a journal of the American College of Physicians (ACP).
“It is well-documented that lifestyle factors such as diet, weight, physical activity, smoking habits, and alcohol consumption affect a person’s risk for diabetes,” the ACP said in a release about the new study. “Studies have shown that individual lifestyle improvements, such as quitting smoking, can delay or prevent the onset of diabetes. However, it is less clear how multiple changes affect diabetes risk,” the ACP said.
This study was among the first to measure “how combinations of lifestyle risk factors relate to the 11-year risk for incident diabetes.”
The Study Methodology
The researchers reviewed data on 114,996 men and 92,483 women, aged 50 to 71 years, collected in 1995 to 1996, as part of a long-running 11-year study of diet and health factors, known as the National Institutes of Health–AARP Diet and Health Study.
All of the participants had no evidence of heart disease, cancer, or diabetes.
At the beginning of the study, in 1995 and 1996, the participants completed “a comprehensive survey of demographic characteristics and lifestyle factors, including dietary intake, body weight and height, physical activity, smoking, and alcohol consumption.”
The participants were divided into low-risk and high-risk groups according to their initial self reports on each of five lifestyle factors. The characteristics of the low-risk, healthy lifestyle groups for each of the five factors were:
- Normal Weight — The healthy lifestyle, low-risk group were not overweight or obese, and had a Body Mass Index (BMI) below 25 (for example, a BMI below 25 for a female 5’8″ tall would mean she would weigh 164 pounds or less);
- No Smoking — The healthy lifestyle group had never smoked or had not smoked for 10 years or more.
- Physically Active — The healthy lifestyle group engaged in at least 20 minutes of intense aerobic exercise at least three times per week;
- Healthy Diet — The healthy group ate high fiber diets, with little trans fat or refined or sugar-based carbohydrates, and a high ratio of polyunsaturated (good) to saturated (bad) fats.
- Low or No Alcohol Consumption — The healthy group did not consume alcohol, or consumed it in moderation, meaning one or less drink per day for women and two or less drinks per day for men.
The high-risk group for each lifestyle factor reported characteristics opposite to those listed above.
After approximately 10 years, 9.6 percent of all the men in the study, and 7.5 percent of all the women in the study developed physician-diagnosed diabetes, the researchers reported.
The scientists analyzed the relationships between the participants’ lifestyle characteristics (whether high-risk or low-risk) with respect to the above lifestyle factors, individually and combined, and the incidence of diabetes.
Participants who were in the healthy lifestyle group for all five lifestyle factors, combined, were found to have an approximately 80% lower risk of developing diabetes over the 11 years of the study than those in the high risk groups for all of the lifestyle factors.
Healthy weight was the factor that had the most profound affect on lowering one’s risk of diabetes. “Having a normal weight by itself reduced the risk of developing diabetes by 60 to 70 percent,” said Dr. Reis, the study’s lead author.
But, significantly, the researchers found that each of the lifestyle factors had an incremental affect on lowering one’s diabetes risk. “For each additional lifestyle factor in the low-risk group, the odds for diabetes were 31% lower (odds ratio [OR], 0.69 [95% CI, 0.68 to 0.71]) among men and 39% lower (OR, 0.61 [CI, 0.60 to 0.63]) among women,” the researchers wrote.
“What we found was that with each additional life style factor in the healthy range there was about a 31 percent reduction of risk for diabetes among men and a 39 percent reduction of risk for diabetes among women,” said Dr. Reis.
“Results did not differ by family history of diabetes or level of adiposity,” the authors found.
“Lifestyle factors, when considered in combination, are associated with a substantial reduction in risk for diabetes,” the authors concluded.
The American College of Physicians (ACP), in its release accompanying the study, said, “Changes in multiple lifestyle factors can make a big difference in risk, but even small changes can help.”
“This is important because patients often find it easier to make one lifestyle change at a time, in order to lower their risk of developing diabetes,” said Dr. Reis, the study author.
The full study report, “Lifestyle Factors and Risk for New-Onset Diabetes; A Population-Based Cohort Study,” is available online in the September 6, 2011 issue of the Annals of Internal Medicine.
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