Abstract
OBJECTIVE: To investigate the interaction of a family history of diabetes with obesity and physical inactivity on diabetes prevalence in middle-aged and elderly men and women.
DESIGN: A cross-sectional population-based study.
SUBJECTS: 2912 men and 3561 women, aged 45–74 y.
MEASUREMENTS: Body mass index (BMI), HbA1C, self-administered questionnaire including questions on occupational physical activity and personal and family history of diabetes as part of the Norfolk arm of the European Prospective Investigation into Cancer (EPIC-Norfolk).
RESULTS: The prevalence of diabetes increased in a dose–response relationship with increasing BMI. There was an interaction between family history and obesity on diabetes risk in subjects with a BMI of greater than 27.5 kg/m2 (P=0.049). Crude prevalence in individuals without a family history and BMI of 22.5–24.9 kg/m2 was 2.2% compared to 33.3% in those with a family history and BMI over 35 kg/m2. Thirty-eight percent of the excess risk of diabetes in people with a family history could be avoided if their BMI did not exceed 30 kg/m2. Individuals who reported sedentary occupations were at greater risk of diabetes compared to those reporting more active occupations. There was a synergistic effect of family history and self-reported occupational physical activity on diabetes risk.
CONCLUSION: Individuals with a family history of diabetes are at increased risk for the metabolic consequences of obesity and form an easily identifiable group who may benefit from targeted intervention to prevent the development of obesity through increased physical activity.
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References
Bennett PH . Primary prevention of NIDDM: a practical reality Diabetes Metab Rev 1997 13: 105–111.
Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC . Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men Diabetes Care 1994 17: 961–969.
Colditz GA, Willett WC, Rotnitzky A, Manson JE . Weight gain as a risk factor for clinical diabetes mellitus in women Ann Intern Med 1995 122: 481–486.
Perry IJ, Wannamethee SG, Walker MK, Thomson AG, Whincup PH, Shaper AG . Prospective study of risk factors for development of non-insulin dependent diabetes in middle-aged British men BMJ 1995 310: 560–564.
Manson JE, Rimm EB, Stampfer MJ, Colditz GA, Willett WC, Krolewski AS, Rosner B, Hennekens CH, Speizer FE . Physical activity and incidence of non-insulin-dependent diabetes mellitus in women Lancet 1991 338: 774–778.
Manson JE, Nathan DM, Krolewski AS, Stampfer MJ, Willett WC, Hennekens CH . A prospective study of exercise and incidence of diabetes among US male physicians JAMA 1992 268: 63–67.
Kriska AM, LaPorte RE, Pettitt DJ, Charles MA, Nelson RG, Kuller LH, Bennett PH, Knowler WC . The association of physical activity with obesity, fat distribution and glucose intolerance in Pima Indians Diabetologia 1993 36: 863–869.
Heimrich SP, Ragland DR, Leung RW, Paffenbarger RS . Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus New Engl J Med 1991 325: 147–152.
Lynch J, Heimrich SP, Lakka TA, Kaplan GA, Cohen RD, Salonen R, Salonen JT . Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non-insulin-dependent diabetes mellitus in middle-aged men Arch Intern Med 1996 156: 1307–1314.
Pierce M, Keen H, Bradley C . Risk of diabetes in offspring of parents with non-insulin-dependent diabetes Diabetic Med 1995 12: 6–13.
Knowler WC, Pettitt DJ, Savage PJ, Bennett PH . Diabetes incidence in Pima Indians: contributions of obesity and parental diabetes Am J Epidemiol 1981 113: 144–156.
Morris RD, Rimm DL, Hartz AJ, Kalkhoff RK, Rimm AA . Obesity and heredity in the etiology of non-insulin-dependent diabetes mellitus in 32,662 adult white women Am J Epidemiol 1989 130: 112–121.
Riboli E, Kaaks R . The EPIC Project: rationale and study design. European Prospective Investigation into Cancer and Nutrition Int J Epidemiol 1997 26 (Suppl 1): S6–S14.
Day N, Oakes S, Luben R, Khaw KT, Bingham S, Welch A, Wareham N . EPIC in Norfolk: study design and characteristics of the cohort Br J Cancer 1999 80 (Suppl 1): 95–103.
Wareham NJ, Rennie KL, Hennings SJ, Mitchell J, Day NE . Comparison of EPIC physical activity questionnaire with repeated assessment of energy expenditure and fitness Med Sci Sports Exerc 1999 31 (Suppl): S232.
Standing SJ, Taylor RP . Glycated haemoglobin: an assessment of high capacity liquid chromatography and immunoassay methods Ann Clin Biochem 1992 29: 494–505.
Peters AL, Davidson MB, Schriger DL, Hasselblad V . A clinical approach for the diagnosis of diabetes mellitus: an analysis using glycosylated hemoglobin level. Meta-analysis Research Group on the Diagnosis of Diabetes Using Glycated Hemoglobin Levels JAMA 1996 276: 1246–1252.
Mantel N, Haenszel WH . Statistical aspects of the analysis of data from retrospective studies of disease J Natl Cancer Inst 1959 22: 719–748.
Bennett N, Dodd T, Flatley J, Freet S, Bolling K . Health Survey for England 1993 HMSO: London 1995.
Wareham NJ, Wong M-Y, Day NE . Glucose intolerance and physical inactivity: the relative importance of low habitual energy expenditure and cardiorespiratory fitness Am J Epidemiol (in press).
Armstrong BK, White E, Saracci R . Principles of Exposure Measurement in Epidemiology Oxford University Press: Oxford 1994.
Wareham NJ, Byrne CD, Williams DRR, Day NE, Hales CN . Fasting proinsulin concentrations predict the development of Type 2 diabetes Diabetes Care 1999 22: 262–270.
Haffner SM, Stern MP, Hazuda HP, Pugh J, Patterson JK, Malina R . Upper body and centralized adiposity in Mexican Americans and non-Hispanic whites: relationship to body mass index and other behavioural and demographic variables Int J Obes 1986 10: 493–502.
Sonnenschein EG, Kim MY, Pasternack BS, Toniolo PG . Sources of variability in waist and hip measurements in middle-aged women Am J Epidemiol 1993 138: 301–309.
Williamson DF, Madans J, Anda RF, Kleinman JC, Kahn HS, Byers T . Recreational physical activity and ten-year weight change in a US national cohort Int J Obes Relat Metab Disord 1993 17: 279–286.
Coakley EH, Rimm EB, Colditz G, Kawachi I, Willett W . Predictors of weight change in men: results from the Health Professionals Follow-up Study Int J Obes Relat Metab Disord 1998 22: 89–96.
Westerterp KR . Obesity and physical activity Int J Obes Relat Metab Disord 1999 23 (Suppl 1): 59–64.
Lapidus L, Bengtsson C, Lissner L, Smith U . Family history of diabetes in relation to different types of obesity and change of obesity during 12-yr period. Results from prospective population study of women in Goteborg, Sweden Diabetes Care 1992 15: 1455–1458.
Hanson RL, Pettitt DJ, Bennett PH, Narayan KMV, Fernandes R, de Courten M, Knowler WC . Familial relationships between obesity and NIDDM Diabetes 1995 44: 418–422.
Viswanathan M, Snehalatha C, Viswanathan V, Vidyavathi P, Indu J, Ramachandran A . Reduction in body weight helps to delay the onset of diabetes even in non-obese with strong family history of the disease Diabetes Res Clin Pract 1997 35: 107–112.
Pascale RW, Wing RR, Butler BA, Mullen M, Bononi P . Effects of a behavioral weight loss program stressing calorie restriction versus calorie plus fat restriction in obese individuals with NIDDM or a family history of diabetes Diabetes Care 1995 18: 1241–1248.
Wing RR, Venditti E, Jakicic JM, Polley BA, Lang W . Lifestyle intervention in overweight individuals with a family history of diabetes Diabetes Care 1998 21: 350–359.
Hardeman W, Griffin S, Johnson M, Kinmonth AL, Wareham NJ . Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods Int J Obes Relat Metab Disord 2000 24: 131–143.
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Sargeant, L., Wareham, N. & Khaw, KT. Family history of diabetes identifies a group at increased risk for the metabolic consequences of obesity and physical inactivity in EPIC-Norfolk: a population-based study. Int J Obes 24, 1333–1339 (2000). https://doi.org/10.1038/sj.ijo.0801383
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DOI: https://doi.org/10.1038/sj.ijo.0801383
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