Match!

DIET, LIFESTYLE, AND THE RISK OF TYPE 2 DIABETES MELLITUS IN WOMEN

Published on Sep 13, 2001in The New England Journal of Medicine70.67
· DOI :10.1056/NEJMoa010492
Frank B. Hu205
Estimated H-index: 205
(Harvard University),
JoAnn E. Manson235
Estimated H-index: 235
(Harvard University)
+ 4 AuthorsBarry M. Popkin323
Estimated H-index: 323
(Harvard University)
Sources
Abstract
Background Previous studies have examined individual dietary and lifestyle factors in relation to type 2 diabetes, but the combined effects of these factors are largely unknown. Methods We followed 84,941 female nurses from 1980 to 1996; these women were free of diagnosed cardiovascular disease, diabetes, and cancer at base line. Information about their diet and lifestyle was updated periodically. A low-risk group was defined according to a combination of five variables: a body-mass index (the weight in kilograms divided by the square of the height in meters) of less than 25; a diet high in cereal fiber and polyunsaturated fat and low in trans fat and glycemic load (which reflects the effect of diet on the blood glucose level); engagement in moderate-to-vigorous physical activity for at least half an hour per day; no current smoking; and the consumption of an average of at least half a drink of an alcoholic beverage per day. Results During 16 years of follow-up, we documented 3300 new cases of type 2 diabetes. Overweight or obesity was the single most important predictor of diabetes. Lack of exercise, a poor diet, current smoking, and abstinence from alcohol use were all associated with a significantly increased risk of diabetes, even after adjustment for the body-mass index. As compared with the rest of the cohort, women in the low-risk group (3.4 percent of the women) had a relative risk of diabetes of 0.09 (95 percent confidence interval, 0.05 to 0.17). A total of 91 percent of the cases of diabetes in this cohort (95 percent confidence interval, 83 to 95 percent) could be attributed to habits and forms of behavior that did not conform to the low-risk pattern. Conclusions Our findings support the hypothesis that the majority of cases of type 2 diabetes could be prevented by the adoption of a healthier lifestyle.
Figures & Tables
  • References (34)
  • Citations (2099)
📖 Papers frequently viewed together
651 Citations
1,621 Citations
199751.27JAMA
1,457 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
References34
Newest
#1Frank B. Hu (Harvard University)H-Index: 205
#2Rob M. van DamH-Index: 87
Last. Simin Liu (Brigham and Women's Hospital)H-Index: 104
view all 3 authors...
Although diet and nutrition are widely believed to play an important part in the development of Type II (non-insulin-dependent) diabetes mellitus, specific dietary factors have not been clearly defined. Much controversy exists about the relations between the amount and types of dietary fat and carbohydrate and the risk of diabetes. In this article, we review in detail the current evidence regarding the associations between different types of fats and carbohydrates and insulin resistance and Type...
623 CitationsSource
Background: The long-term relations between specific types of dietary fat and risk of type 2 diabetes remain unclear. Objective: Our objective was to examine the relations between dietary fat intakes and the risk of type 2 diabetes. Design: We prospectively followed 84204 women aged 34–59 y with no diabetes, cardiovascular disease, or cancer in 1980. Detailed dietary information was assessed at baseline and updated in 1984, 1986, and 1990 by using validated questionnaires. Relative risks of type...
651 CitationsSource
Background Type 2 diabetes mellitus is increasingly common, primarily because of increases in the prevalence of a sedentary lifestyle and obesity. Whether type 2 diabetes can be prevented by interventions that affect the lifestyles of subjects at high risk for the disease is not known. Methods We randomly assigned 522 middle-aged, overweight subjects (172 men and 350 women; mean age, 55 years; mean body-mass index [weight in kilograms divided by the square of the height in meters], 31) with impa...
8,240 CitationsSource
#1Simin Liu (Harvard University)H-Index: 104
#2JoAnn E. Manson (Harvard University)H-Index: 235
Last. Barry M. Popkin (Harvard University)H-Index: 323
view all 7 authors...
Background: In metabolic studies, both greater carbohydrate intakes and higher glycemic indexes (GIs) raise fasting triacylglycerol concentrations. In epidemiologic studies, dietary glycemic load (GL) is positively associated with risk of coronary artery disease and type 2 diabetes. Objective: We examined both the physiologic relevance of GI and GL and the ability of dietary questionnaires to measure these variables. Design: In the Nurses' Health Study, we measured plasma triacylglycerol concent...
394 CitationsSource
#1Robert W. JefferyH-Index: 94
#2Leonard H. Epstein (UB: University at Buffalo)H-Index: 95
Last. Dana Robin Hill (NIH: National Institutes of Health)H-Index: 3
view all 7 authors...
Intervention strategies for promoting long-term weight loss are examined empirically and conceptually. Weight control research over the last 20 years has dramatically improved short-term treatment efficacy but has been less successful in improving long-term success. Interventions in preadolescent children show greater long-term efficacy than in adults. Extending treatment length and putting more emphasis on energy expenditure have modestly improved long-term weight loss in adults. Fresh ideas ar...
915 CitationsSource
#1JoAnn E. Manson (Brigham and Women's Hospital)H-Index: 235
#2Umed A. Ajani (Brigham and Women's Hospital)H-Index: 40
Last. Charles H. Hennekens (UM: University of Miami)H-Index: 184
view all 5 authors...
Abstract PURPOSE: To determine the association between cigarette smoking and the incidence of type 2 diabetes mellitus. SUBJECTS AND METHODS: We studied 21,068 US male physicians aged 40 to 84 years in the Physicians' Health Study who were initially free of diagnosed diabetes mellitus, cardiovascular disease, and cancer. Information about cigarette smoking and other risk indicators was obtained at baseline. The primary outcome was reported diagnosis of type 2 diabetes mellitus. RESULTS: During 2...
181 CitationsSource
#1Meir J. StampferH-Index: 251
#2Frank B. HuH-Index: 205
Last. Barry M. PopkinH-Index: 323
view all 5 authors...
Background Many lifestyle-related risk factors for coronary heart disease have been identified, but little is known about their effect on the risk of disease when they are considered together. Methods We followed 84,129 women participating in the Nurses' Health Study who were free of diagnosed cardiovascular disease, cancer, and diabetes at base line in 1980. Information on diet and lifestyle was updated periodically. During 14 years of follow-up, we documented 1128 major coronary events (296 de...
1,392 CitationsSource
A high intake of fat may increase the risk of obesity. Obesity, especially abdominal obesity, is an important determinant of the risk of developing insulin resistance and non-insulin-dependent diabetes mellitus. It is suggested that a high proportion of fat in the diet is associated with impaired insulin sensitivity and an increased risk of developing diabetes, independent of obesity and body fat localization, and that this risk may be influenced by the type of fatty acids in the diet. Cross-sec...
245 CitationsSource
#1Umed A. AjaniH-Index: 40
#2Charles H. HennekensH-Index: 184
Last. JoAnn E. MansonH-Index: 235
view all 4 authors...
Objective To examine the association between low to moderate alcohol consumption and the incidence of type 2 diabetes mellitus (DM) in men. Design Prospective cohort study. Subjects and Methods Over an average period of 12.1 years, we evaluated 20,951 participants in the Physicians' Health Study between ages 40 and 84 years who were free of cardiovascular disease, cancer, and diabetes and provided data on alcohol consumption at baseline. Main Outcome Measure Type 2 DM diagnosed after randomizati...
182 CitationsSource
#1Katie A. MeyerH-Index: 13
#2Lawrence H. KushiH-Index: 30
Last. Aaron R. Folsom (UMN: University of Minnesota)H-Index: 159
view all 6 authors...
Dietary carbohydrates may influence the development of type 2 (non-insulin-dependent) diabetes, for example, through effects on blood glucose and insulin concentrations.We examined the relations of baseline intake of carbohydrates, dietary fiber, dietary magnesium, and carbohydrate-rich foods and the glycemic index with incidence of diabetes.This was a prospective cohort study of 35988 older Iowa women initially free of diabetes. During 6 y of follow-up, 1141 incident cases of diabetes were repo...
1,015 CitationsSource
Cited By2099
Newest
#1Xueliang WangH-Index: 1
Last. Guangli YuH-Index: 26
view all 6 authors...
Abstract Agaro- and neoagaro-oligosaccharides with even-numbered sugar units possess a variety of biological activities. However, the effects of the odd-numbered oligosaccharides from Gracilaria agarose (OGAOs) on type 2 diabetes mellitus (T2DM) have not been reported. In this study, we aimed to evaluate the effects of OGAOs on anti-T2DM from different aspects. We found that OGAOs treatment could alleviate oxidative stress, inflammation, and the related hyperglycemia, insulin resistance, lipid a...
Source
#1Liz Ruiz-Estigarribia (University of Navarra)H-Index: 1
Last. Maira Bes-Rastrollo (University of Navarra)H-Index: 41
view all 6 authors...
Introduction Lifestyle-related habits have a strong influence on morbidity and mortality worldwide. This study investigates the association between a multidimensional healthy lifestyle score and all-cause mortality risk, including in the score some less-studied lifestyle-related factors. Methods Participants (n=20,094) of the Seguimiento Universidad de Navarra cohort were followed up from 1999 to 2018. The analysis was conducted in 2019. A 10-point healthy lifestyle score previously associated w...
Source
#1Michael HendryxH-Index: 35
#2Paul C. DinhH-Index: 2
Last. Juhua LuoH-Index: 20
view all 9 authors...
Source
#2Ying Yang (Peking Union Medical College)H-Index: 5
Last. Xu Ma (Peking Union Medical College)H-Index: 26
view all 17 authors...
BACKGROUND: We comprehensively evaluated the association between husbands' smoking amount and wives' dysglycemia status. METHODS: We conducted a cross-sectional study which recruited 12 023 714 reproductive couples who participated in the National Free Pre-Pregnancy Checkups Project (NFPCP) between 2015 and 2016 in China. Multivariable logistic models were used to estimate odds ratio (OR) and 95% CI. Subgroup analysis and stratified analysis were further performed to investigate potential effect...
Source
Source
#1Nikita Modi (MCPHS University)
#2Ronny Priefer (MCPHS University)
Abstract Individuals utilize diets as a way to lose weight. Since not all diets work the same nor do all people have the same metabolism some approaches may be more deleterious than beneficial. For dietitians the dieters alike, an understanding of the options that exist in addition to what they entail is advantageous for all. However, not all diets are feasible for all individuals, either for financial reasons or due to co-morbidities. Diets can generally be categorized into five groups: carbohy...
Source
#1Luann C. Jung (MIT: Massachusetts Institute of Technology)
#2Haiyan Wang (KSU: Kansas State University)
Last. Cen Wu (KSU: Kansas State University)
view all 4 authors...
Source
#1Megan H. PeschH-Index: 6
#2Katherine W. BauerH-Index: 21
Last. Dianne Neumark-SztainerH-Index: 103
view all 5 authors...
Objective: To identify whether picky eating during childhood is associated with dietary intake, weight status and disordered eating behaviour during young adulthood. Design: A population-based study using data from young adults who responded online or by mail to the third wave of the Project EAT (Eating and Activity in Teens and Young Adults) study in 2008–2009. Participants retrospectively reported the extent to which they were a picky eater in childhood, sociodemographic characteristics, disor...
Source
#1Balaji Bhavadharini (Population Health Research Institute)
#2Mahshid Dehghan (Population Health Research Institute)H-Index: 24
Last. Edelweiss Wentzel-Viljoen (NWU: North-West University)H-Index: 14
view all 40 authors...
Objective Our aims were to assess the association of dairy intake with prevalence of metabolic syndrome (MetS) (cross-sectionally) and with incident hypertension and incident diabetes (prospectively) in a large multinational cohort study. Methods The Prospective Urban Rural Epidemiology (PURE) study is a prospective epidemiological study of individuals aged 35 and 70 years from 21 countries on five continents, with a median follow-up of 9.1 years. In the cross-sectional analyses, we assessed the...
Source
#1Xu Han (HUST: Huazhong University of Science and Technology)H-Index: 9
#2Yue Wei (HUST: Huazhong University of Science and Technology)H-Index: 1
Last. Meian He (HUST: Huazhong University of Science and Technology)H-Index: 30
view all 16 authors...
OBJECTIVE: The objective of this study is to examine whether healthy lifestyle could reduce diabetes risk among individuals with different genetic profiles. DESIGN: A prospective cohort study with a median follow-up of 4.6 years from the Dongfeng-Tongji cohort was performed. PARTICIPANTS: A total of 19 005 individuals without diabetes at baseline participated in the study. MAIN VARIABLE MEASURE: A healthy lifestyle was determined based on 6 factors: nonsmoker, nondrinker, healthy diet, body mass...
Source