Lifestyle factors and mortality risk in individuals with diabetes mellitus: are the associations different from those in individuals without diabetes
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- 作者：Diewertje Sluik (1) (2)
Heiner Boeing (1)
Kuanrong Li (3)
Rudolf Kaaks (3)
Nina Fns Johnsen (4)
Anne Tjnneland (4)
Larraitz Arriola (5) (6)
Aurelio Barricarte (6) (7)
Giovanna Masala (8)
Sara Grioni (9)
Rosario Tumino (10)
Fulvio Ricceri (11)
Amalia Mattiello (12)
Annemieke M. W. Spijkerman (13)
Daphne L. van der A (14)
Ivonne Sluijs (15)
Paul W. Franks (16) (17)
Peter M. Nilsson (18)
Marju Orho-Melander (19)
Eva Fhrm (20)
Olov Rolandsson (21)
Elio Riboli (22)
Dora Romaguera (22) (23)
Elisabete Weiderpass (24) (25) (26) (27)
Emilio Schez-Cantalejo (28) (6)
Ute Nthlings (1) (29) (30) - 关键词：Adiposity ; Alcohol ; Diabetes ; Lifestyle ; Mortality ; Nutrition ; Physical activity ; Smoking
- 刊名：Diabetologia
- 出版年：2014
- 出版时间：January 2014
- 年：2014
- 卷：57
- 期：1
- 页码：63-72
- 全文大小：
- 作者单位：Diewertje Sluik (1) (2)
Heiner Boeing (1)
Kuanrong Li (3)
Rudolf Kaaks (3)
Nina Fns Johnsen (4)
Anne Tjnneland (4)
Larraitz Arriola (5) (6)
Aurelio Barricarte (6) (7)
Giovanna Masala (8)
Sara Grioni (9)
Rosario Tumino (10)
Fulvio Ricceri (11)
Amalia Mattiello (12)
Annemieke M. W. Spijkerman (13)
Daphne L. van der A (14)
Ivonne Sluijs (15)
Paul W. Franks (16) (17)
Peter M. Nilsson (18)
Marju Orho-Melander (19)
Eva Fhrm (20)
Olov Rolandsson (21)
Elio Riboli (22)
Dora Romaguera (22) (23)
Elisabete Weiderpass (24) (25) (26) (27)
Emilio Schez-Cantalejo (28) (6)
Ute Nthlings (1) (29) (30)
1. Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
2. Division of Human Nutrition, Wageningen University, P.O. Box 8129, 6700, EV, Wageningen, the Netherlands
3. Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany
4. Danish Cancer Society, Copenhagen, Denmark
5. Public Health Division of Gipuzkoa BIO-Donostia Basque Government, San Sebastian, Spain
6. Consortium for Biomedical Research in Epidemiology and Public Health, Murcia, Spain
7. Navarre Public Health Institute, Pamplona, Spain
8. Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute, Florence, Italy
9. Epidemiology and Prevention Unit, National Cancer Institute, Milan, Italy
10. Cancer Registry and Histopathology Unit, ivile.P. ArezzoHospital, Ragusa, Italy
11. Human Genetics Foundation, Turin, Italy
12. Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy
13. Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
14. National Institute for Public Health and the Environment, Bilthoven, the Netherlands
15. Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht, the Netherlands
16. Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Skne University Hospital, Lund University, Malm, Sweden
17. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
18. Department of Clinical Sciences, Lund University, University Hospital, Malm, Sweden
19. Department of Clinical Sciences, Diabetes and Cardiovascular Disease Genetic Epidemiology, Lund University, Malm, Sweden
20. Family Medicine, Institution of Public Health and Clinical Medicine, Ume University, Ume, Sweden
21. Department of Public Health and Clinical Medicine, Family Medicine, Ume University, Ume, Sweden
22. School of Public Health, Imperial College London, London, UK
23. CIBER Fisiopatolog de la Obesidad y Nutrici (CIBER-OBN), Spain www.ciberobn.es
24. Department of Community Medicine, Faculty of Health Sciences, University of Troms, The Arctic University of Norway, Troms, Norway
25. Department of Research, Cancer Registry of Norway, Oslo, Norway
26. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
27. Samfundet Folkhlsan, Helsinki, Finland
28. Andalusian School of Public Health, Granada, Spain
29. Epidemiology Section, Institute for Experimental Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
30. Institute for Nutrition and Food Science, University of Bonn, Bonn, Germany - ISSN：1432-0428
文摘
Aims/hypothesis Thus far, it is unclear whether lifestyle recommendations for people with diabetes should be different from those for the general public. We investigated whether the associations between lifestyle factors and mortality risk differ between individuals with and without diabetes. Methods Within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort was formed of 6,384 persons with diabetes and 258,911 EPIC participants without known diabetes. Joint Cox proportional hazard regression models of people with and without diabetes were built for the following lifestyle factors in relation to overall mortality risk: BMI, waist/height ratio, 26 food groups, alcohol consumption, leisure-time physical activity, smoking. Likelihood ratio tests for heterogeneity assessed statistical differences in regression coefficients. Results Multivariable adjusted mortality risk among individuals with diabetes compared with those without was increased, with an HR of 1.62 (95% CI 1.51, 1.75). Intake of fruit, legumes, nuts, seeds, pasta, poultry and vegetable oil was related to a lower mortality risk, and intake of butter and margarine was related to an increased mortality risk. These associations were significantly different in magnitude from those in diabetes-free individuals, but directions were similar. No differences between people with and without diabetes were detected for the other lifestyle factors. Conclusions/interpretation Diabetes status did not substantially influence the associations between lifestyle and mortality risk. People with diabetes may benefit more from a healthy diet, but the directions of association were similar. Thus, our study suggests that lifestyle advice with respect to mortality for patients with diabetes should not differ from recommendations for the general population.