Summary

 It is well known that lifestyle factors have a profound influence on the risk of type 2 diabetes among young and middle aged people.

Now a study shows that factors like physical activity, diet and obesity are also important in the risk of diabetes among a group of average age 73. Therefore, older people have much to gain by making healthy changes in their lifestyle, for diabetes can have a significant impact on health, wellbeing and survival.

Introduction

Type 2 diabetes is on the increase, carrying with it an increased risk of heart disease, kidney problems and other complications. We already know that factors such as overweight, poor diet, increased waist measurement and also poorer glucose control increase the risk of getting type 2 diabetes. But most of this work has been done in younger populations. It’s not been known if the link between lifestyle and diabetes risk applies to older age groups as well. It’d be useful to know whether diabetes is, somehow, an inevitable consequence of aging – or whether something can be done to prevent it.

What was done

As part of the Cardiovascular Health Study, researchers at Brigham and Women’s Hospital and Harvard Medical School looked at the link between various risk factors and incidence of type 2 diabetes. The study group consisted of nearly 5,000 men and women, all over 65 and of average age 73 at the start of the study which ran for 10 years. Nearly 60% of participants were female and 11% were non-white. And about half had never smoked. The researchers looked at factors such as leisure time activity and walking pace, fiber intake, polyunsaturated to saturated fat intake ratio, glycemic index of foods eaten and smoking. Alcohol use, body mass index and waist circumference were also taken into account.

What was found

Each lifestyle factor was independently associated with the risk of diabetes. Overall, each additional lifestyle factor in the ‘low risk’ group (eg high physical activity, high fiber intake and so on) was linked to a 35% lower risk of diabetes. More specifically, those in the low risk group for physical activity and dietary habits had a 46% lower risk of diabetes. When smoking and alcohol intake factors were added, the risk was reduced to 82%. Four out of five new cases of diabetes were attributable to these factors alone. Adding in a healthy weight and waist circumference decreased the risk of developing diabetes by 89%.

What this study means

Older adults have a lot to gain from adopting a healthy lifestyle, with attention to diet, exercise and weight control, in terms of avoiding diabetes. The take home message from this study is that it is never too late to make changes and derive health benefit from them.

Source

Mozzaffarian D, Kamineni A et al Lifestyle risk factors and new onset diabetes in older adults Archives of Internal Medicine April 27; 169:798-807