• Int J Epidemiol · Oct 2017

    Adherence to a healthy lifestyle and the risk of type 2 diabetes in Chinese adults.

    • Jun Lv, Canqing Yu, Yu Guo, Zheng Bian, Ling Yang, Yiping Chen, Ximin Hu, Wei Hou, Junshi Chen, Zhengming Chen, Lu Qi, Liming Li, and China Kadoorie Biobank Collaborative Group.
    • Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
    • Int J Epidemiol. 2017 Oct 1; 46 (5): 1410-1420.

    BackgroundSimultaneously adhering to multiple healthy lifestyle factors has been related to up to 90% reduction in type 2 diabetes (T2DM) incidence in White populations; however, little is known about whether such protective effects persist in other non-White populations.MethodsWe examined the associations of six lifestyle factors with T2DM in the China Kadoorie Biobank of 461 211 participants aged 30-79 years without diabetes, cardiovascular diseases or cancer at baseline. We defined low-risk lifestyle factors as non-smoking or having stopped for reasons other than illness; alcohol consumption of <30 g/day; upper quarter of the physical activity level; diet rich in vegetables and fruits, low in red meat and with some degree of replacement of rice with wheat; body mass index (BMI) of 18.5-23.9 kg/m2; and waist-to-hip ratio (WHR) <0.90 (men)/<0.85 (women).ResultsDuring a median of 7.2 years of follow-up, we identified 8784 incident T2DM. In multivariable-adjusted analyses, two important risk factors for developing T2DM were higher BMI and WHR. Compared with participants without any low-risk factors, the hazard ratio [95% confidence interval (CI)] for those with at least three low-risk factors was 0.20 (0.19, 0.22). Approximately 72.6% (64.2%, 79.3%) of the incident diabetes were attributable to the combination of BMI, WHR, diet and physical activity. The population attributable risk percentage (PAR%) of diabetes appeared to be similar for men and women, and higher among urban, older and obese participants.ConclusionsOur findings indicate that adherence to a healthy lifestyle may substantially lower the burden of T2DM in the Chinese population.© The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association

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