The adoption of several healthy habits can reduce your risk of type 2 diabetes, but new research reveals that body weight management remains the key engine, especially in different ethnic groups.
Study: Prospective association of a lifestyle risk factor with type 2 diabetes in the multiethnic cohort. Image credit: New Africa / Shutterstock
In a recent study published in the European Nutrition JournalA group of researchers studied the relationship between a lifestyle risk factor (IRSR) and the incidence of type 2 diabetes mellitus (T2DM) in a multi -thnical population.
Background
All out of 10 adults in the world Live with diabetesAnd by 2045, more than 780 million people should be affected and more than 90% will have a T2DM. Modifiable genetics and lifestyle factors, such as smoking, physical activity, unhealthy food and alcohol, influence T2DM. T2DM is associated with various complications, such as chronic kidney disease, eye lesions, peripheral neuropathy (causing amputation of the lower limbs), and all causes and cardiovascular mortality significantly higher, as well as the blinds and amputations of the limbs.
Studies show that the combination of these behaviors in a lifestyle index can better predict the risk of illness than evaluating them individually. However, previous studies have concentrated on short monitoring periods. The substantial economic impact of T2DM, both through direct medical costs and indirect costs such as reducing work capacity and life expectancy, underlines the need for effective prevention. Consequently, additional research is necessary to understand how the behaviors combined in the lifestyle influence the T2DM risk in various populations over time.
About the study
This prospective cohort study used data from the multi -thnical cohort (MEC), which included 215,903 adults aged 45 to 75 years in Hawaii and California, representing five ethnic groups: African-American, Native Hawaiian, Latin, American and European Japanese. After excluding participants with incomplete data, those with T2DM at the start and ethnic groups outside the five main groups, 165,383 individuals remained for analysis.
The researchers used a reference questionnaire to collect data on demography, the body mass index (BMI), smoking status, alcohol consumption, physical activity and eating habits. The allocation of ethnicity was based on a priority classification when mixed ancestors have been reported. It should be noted that the data on lifestyle factors have been collected at the start and not updated for changes over time.
T2DM cases have been identified via auto -declared diagnoses, the use of drugs and pretext medication data until 2016. Cardiometabolic food recommendations.
These seven food recommendations included: ≥3 portions per day of fruit, ≥3 portions per day of vegetables, ≥3 portions per day of whole grain, ≥ 2 portions per week of fish, ≤1.5 portions per day of refined grain (with only 3% of participants who respond to these directives), ≤1 portions per week of meat meat (24%) and ≤ 1.5 portions per week of meat week (with 24%) and ≤ 1.5 portions per week of fishing meat (24%) and ≤ 1.5 services per week of fishing meat (with 24%) and ≤ 1.5 portions per week of fishing meat (with 24%) and ≤ 1.5 portions per week of fishing meat (24%) and ≤ 1.5 services per week of non-procedure meat (24%) and ≤ 1.5 services per week of non-procedure meat (24%) and ≤ ≤ 1.5 services per week of non-procedure meat (24%) and ille 6% membership).
COX regression models have been used to calculate risk reports (HR) and confidence intervals (CIS), adaptation of age, education and BMI. Subgroup analyzes were carried out by sex and ethnicity to explore the variations in T2DM risk associations.
Membership of IRSR components and food recommendations (%) by ethnic group. Adhesion by ethnic group: (a) Irsri components and (b) Food recommendations in percentage (%) 1 ≥3 of 7 foods, no current smoking, ≤ 2 (men) or ≤ 1 (women) alcoholic drinks / day, ≥ 150 min / week physical activity 2 Serr 1.5 per day of refined grains, ≤ 1 per week of transformed meat and ≤.
Study results
During an average follow -up of 17.2 years, 44,518 participants (27%) developed an T2DM incident. The largest ethnic group was Japanese American (29%), followed by European (27%), Latin (22%), African-American (16%) and Native Hawai (7%). The average LSRI score was 2.73, most of the participants marking 2 or 3 points.
Although only 22%of participants respected food membership directives, membership was the highest among consumers of moderate alcohol (86%), followed by those who were not current smokers (84%) and those who respond to the recommendations of physical activity (81%).
Membership of most individual food components was very low, with the exception of fish consumption. For reference, only 3%of participants respected the recommendation of refined grains and only 6%for unprocessed red meat, with intermediate membership for fruits (24%), vegetables (22%) and transformed meats (24%) and the highest membership for fish (73%).
The incidence of T2DM was inversely associated with Irsri scores. Participants marking 4 points had a risk of T2DM of 16% lower than those of 0-1 (HR = 0.84; 95% CI: 0.80-0.88), even after adjustment for BMI. Each increase in 1 point, the IRSRI was associated with a reduced risk of 6% of developing T2DM (HR = 0.94; 95% CI: 0.93-0.95).
Among the individual components, no current smoking and adequate physical activity has shown strong reversed associations with T2DM in all models, while moderate alcohol consumption was surprisingly linked to an increased risk of 19%. It is important to note that the group “moderate alcohol” (≤ 1 drink per day for women, ≤2 for men) also included abstainers.
Food adhesion, although low, was weakly associated with a reduced risk of T2DM in models excluding the BMI, but not in models adjusted to BMI. Sensitivity analyzes using an IRSRI composed only of smoking and physical activity have given similar reversed associations or slightly stronger with T2DM, which indicates that these two factors were the main engines of the composite index.
When examined in different ethnic groups, higher IRS scores are significantly correlated with a risk of lower 2 diabetes in African-Americans (27%reduction for the highest and lowest AVRIs), Latinos (18%) and European Americans (14%). However, no significant association was found in Americans of Japanese origin or native Hawaiians after the IMC adjustment. Membership of physical activity was significantly lower in Latinos and African-Americans, while food membership was generally poor in all groups, with only a fish consumption exceeding 50%.
The BMI had a stronger association with the T2DM risk than the Irsri. Participants classified as obese (BMI on 30 kg / m²) were more than three times more likely to develop the T2DM compared to those who have normal weight. The effect of the BMI also varied between ethnic groups, being particularly pronounced in Americans of Japanese origin and indigenous Hawaiians, perhaps due to differences in the distribution of visceral fats.
Conclusions
To summarize, this study highlights the value of the combination of modifiable lifestyles such as non-fusion, physical activity, moderate alcohol consumption and healthy diet in an ISRI composite to assess the T2DM risk. A higher IRSRI score was linked to a significantly lower T2DM incidence, especially among African-American, Latin and American groups. However, all lifestyle factors did not have an equal influence and the BMI played a stronger role in forecasting the risk of diabetes.
The irreck was not associated with the T2DM risk in Americans of Japanese origin or indigenous Hawaiians after the adjustment of the BMI, stressing the importance of considering physiological differences, such as the distribution of visceral fats, in T2DM development in these groups.
A key limitation is that the LSRI supposes an equal weighting of each component, which does not precisely reflect their true importance for the T2DM risk, and the lifestyle was only evaluated at the start rather than over time. These results suggest the need for public health strategies adapted to culture which promote sustainable lifestyle improvements while approaching obesity to effectively reduce diabetes Type 2 (T2DM) in various populations.