Healthiest lifestyle can reduce diabetes risk by 75%
Adults who practice a combination of healthy lifestyle factors, such as not smoking, avoiding alcohol, participating in physical activity and maintaining a normal weight, are 75% less likely to develop type 2 diabetes when compared with adults who maintain an unhealthy lifestyle, according to findings published in Diabetologia.
In a meta-analysis of more than 1 million adults, researchers also found that adults with diabetes who adopted a healthy lifestyle were significantly less likely to develop incident cardiovascular disease or die of any cause when compared with those with diabetes who practiced unhealthy lifestyle habits.
“Individuals from all socioeconomic backgrounds or with different demographic characteristics are encouraged to maintain optimal weight, avoid smoking and heavy drinking, adopt a healthy diet and increase physical activity levels to prevent type 2 diabetes,” An Pan, PhD, professor at Tongji Medical College School of Public Health, Huazhong University of Science and Technology, China, told Endocrine Today. “Individuals with diabetes should also adopt healthy lifestyles to prevent cardiovascular disease and death.”
In a systematic review and meta-analysis, Pan and colleagues analyzed data from 16 prospective studies with 1,116,248 participants assessing the relationship between combined lifestyle factors and incident type 2 diabetes, as well as the risk for total and cause-specific mortality and incident CVD, with follow-up for at least 1 year. Mean baseline age ranged from 38 to 73 years (median, 51 years), with cohort sizes ranging from 1,639 to 461,211. Mean follow-up ranged from 2.7 to 20.8 years (median, 7.8 years). Lifestyle factors analyzed were smoking, alcohol drinking, physical activity or sedentary behavior, diet, overweight or obesity and sleep duration. Some studies also included metabolic factors, such as blood pressure, blood glucose and blood lipid levels from the Life’s Simple 7 score defined by the American Heart Association.
“The healthy lifestyle scores were constructed in multiple ways (different numbers or combinations of lifestyle factors and different weights for certain lifestyle factors) in various studies but were generally reclassified into three, four or five groups based on the distribution of the score in the study population,” the researchers wrote.
Researchers pooled HRs comparing participants in the highest score group with those in the lowest score group to represent the risk estimate comparing the healthiest vs. least-healthy lifestyle.
Compared with participants considered to have the least-healthy lifestyle, those with the healthiest lifestyle had a 75% lower risk for incident type 2 diabetes (HR = 0.25; 95% CI, 0.18-0.35). Results persisted in analyses stratified by socioeconomic background and baseline characteristics.
Among individuals with type 2 diabetes (10 studies with 34,385 participants), those who maintained the healthiest lifestyle had a 56% lower risk for all-cause death (HR = 0.44; 95% CI, 0.33-0.6), a 49% lower risk for CV death (HR = 0.51; 95% CI, 0.3-0.86), a 31% lower risk for cancer death (HR = 0.69; 95% CI, 0.47-1) and a 52% lower risk for incident CVD (HR = 0.48; 95% CI, 0.37-0.63) when compared with those with type 2 diabetes considered to have the least-healthy lifestyle.
“Compared with those with the least-healthy lifestyles, individuals with the healthiest lifestyle displayed a 31% to 56% lower risk for all-cause, CV or cancer mortality and 52% lower risk for incident CVD,” Pan said. “The results support the recommendations from World Health Organization, American Diabetes Association and many other organizations that lifestyle modification should be the cornerstone for the management of diabetes.”
Pan noted that most studies were conducted in high-income countries and most participants were of white ethnicity, adding that evidence from other populations is needed. – by Regina Schaffer
For more information:
An Pan, PhD, can be reached at the Department of Epidemiology and Biostatistics, Tongji Medical College School of Public Health, Huazhong University of Science and Technology, 13 Hangking Road, Wuhan, China; email: firstname.lastname@example.org.
Disclosures: The authors report no relevant financial disclosures.