Health: Reducing the Risk of Diabetes

Five Lifestyle Changes Can Go a Long Way


Toward Cutting the Odds of Type 2


Adults, middle-aged and up, can cut their risk of developing Type 2 diabetes by as much as 80% by adhering to a combination of five healthy-lifestyle habits, a new analysis shows.

Many studies have shown having a healthy diet, exercising, maintaining normal body weight, not smoking and consuming alcohol moderately can lower one’s risk of developing diabetes and other diseases. The new analysis from the National Institutes of Health examined these individual factors to see how each—alone and in combination—contributes to a reduction in the chance a person will get the disease. The research will be published in the Sept. 6 issue of the Annals of Internal Medicine.

The analysis shows keeping just one of these five healthy-lifestyle factors can reduce the risk of developing Type 2 diabetes, the most common form which 26 million people were diagnosed with last year. It is the seventh leading cause of death in the U.S., according to the Centers for Disease Control.

More than 200,000 people who are part of a larger NIH-AARP diet-and-health study and were between ages 50 and 71 when the study began in 1995 were involved in the analysis. At the study’s start, participants had no signs of heart disease, cancer or diabetes.

Study participants filled out detailed questionnaires about what kinds of foods they ate, whether they consumed alcohol and if they were current or former smokers. People were also asked how often they exercised, and provided weight and height so that body mass index, or BMI, could be calculated. Study participants were followed for about 11 years. During that time, about 10% of men in the study and 8% of women developed diabetes.

Researchers led by Jared Reis, an epidemiologist at the National Heart Lung and Blood Institute, grouped study participants into lifestyle categories ranging from “best” to “worst.” People in the best category had all five healthy-lifestyle factors, while those in the worst had none.

For diet, people received a score of one to five based on fruit and vegetable consumption, the amount of and type of fat they ate and other factors. Those who scored in the top 40% were considered to have a healthy diet. Exercising three times a week for at least 20 minutes, and being a nonsmoker for at least 10 years were two additional healthy-lifestyle factors. Alcohol consumption of no more than one drink a day for women and two for men was considered as another factor, along with weight. People with a BMI of between 18.5 and 24.9—a body-mass measure that is considered normal—were counted as being in the lowest-risk category for weight.

Dr. Reis said the average study participant had two out of five healthy lifestyle factors.

Overall, researchers found that body mass index had the strongest association among the factors for diabetes risk. When looking at BMI in isolation, men of normal weight were 70% less likely to develop diabetes than overweight or obese men, while normal weight women were 78% less likely to develop diabetes.

In separate calculations of how factors add up to reduce risk, researchers found that men and women whose diet and exercise both were considered in the healthy range were just under 30% less likely to develop diabetes. When being a nonsmoker was added to diet and exercise, those people were about one-third less likely to develop the disease.

Men who also consumed alcohol moderately, in addition to the previous three factors, were 39% less likely to develop diabetes while women had 57% lower odds, suggesting the alcohol factor played a bigger role in women than men. And when BMI was added to the other healthy lifestyle factors, men were 72% less likely to develop diabetes, while women had an 84% lower risk.

Although weight is one of the most important factors in diabetes development, Dr. Reis said that even overweight people can lower their odds of developing diabetes if they adopt just one other healthy lifestyle habit such as exercising three times a week.


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