Dataset Information

Association between a mediterranean lifestyle and Type 2 diabetes incidence: a prospective UK biobank study.

ABSTRACT:

Background

There is mounting evidence that the Mediterranean diet prevents type 2 diabetes, but little is known about the role of Mediterranean lifestyles other than diet and among non-Mediterranean populations. This work aimed to examine the association between a comprehensive Mediterranean-type lifestyle and type 2 diabetes incidence in a British adult population.

Methods

We used data from 112,493 individuals free of cardiovascular disease and type 2 diabetes mellitus, aged 40-69 years, from the UK Biobank cohort, who were followed from 2009 to 2010 to 2021. The Mediterranean lifestyle was assessed through the 25-item MEDLIFE index, which comprises three blocks: (a) "Mediterranean food consumption", (b) "Mediterranean dietary habits", (c) "Physical activity, rest, social habits, and conviviality". Diabetes incidence was obtained from clinical records. Cox proportional-hazards regression models were used to analyze associations and adjusted for the main potential confounders.

Results

After a median follow-up of 9.4 years, 2,724 cases of type 2 diabetes were ascertained. Compared to the first quartile of MEDLIFE adherence, the hazard ratios (95% confidence interval) for increasing quartiles of adherence were 0.90 (0.82-0.99), 0.80 (0.72-0.89) and 0.70 (0.62-0.79) (p-trend < 0.001). All three blocks of MEDLIFE were independently associated with lower risk of diabetes.

Conclusions

Higher adherence to the MEDLIFE index was associated with lower risk of type 2 diabetes in the UK Biobank. A Mediterranean-type lifestyle, culturally adapted to non-Mediterranean populations, could help prevent diabetes.

SUBMITTER: Maroto-Rodriguez J

PROVIDER: S-EPMC10552305 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

Association between a mediterranean lifestyle and Type 2 diabetes incidence: a prospective UK biobank study.

Maroto-Rodriguez Javier J Ortolá Rosario R Carballo-Casla Adrián A Iriarte-Campo Víctor V Salinero-Fort Miguel Ángel MÁ Rodríguez-Artalejo Fernando F Sotos-Prieto Mercedes M

Cardiovascular diabetology 20231004 1

<h4>Background</h4>There is mounting evidence that the Mediterranean diet prevents type 2 diabetes, but little is known about the role of Mediterranean lifestyles other than diet and among non-Mediterranean populations. This work aimed to examine the association between a comprehensive Mediterranean-type lifestyle and type 2 diabetes incidence in a British adult population.<h4>Methods</h4>We used data from 112,493 individuals free of cardiovascular disease and type 2 diabetes mellitus, aged 40-6 ...[more]

PMID: 37794451

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Project description:BackgroundPrevious studies primarily targeted the ability of polygenic risk scores (PRSs) to predict a specific disease, and only a few studies have investigated the association between genetic risk scores and cardiovascular (CV) mortality. We assessed PRSs for coronary artery disease (CAD) and type 2 diabetes (T2DM) as the predictive factors for CV mortality, independent of traditional risk factors, and further investigated the additive effect between lifestyle behavior and PRS on CV mortality.MethodsWe used genetic and phenotypic data from UK Biobank participants aged 40-69 years at baseline, collected with standardized procedures. Genome-wide PRSs were constructed using >6 million genetic variants. Cox proportional hazard models were used to analyze the relationship between PRS and CV mortality with stratification by age, sex, disease status, and lifestyle behavior.ResultsOf 377,909 UK Biobank participants having European ancestry, 3,210 (0.8%) died due to CV disease during a median follow-up of 8.9 years. CV mortality risk was significantly associated with CAD PRS [low vs. very high genetic risk groups, CAD PRS hazard ratio (HR) 2.61 (2.02-3.36)] and T2DM PRS [HR 2.08 (1.58-2.73)], respectively. These relationships remained significant even after an adjustment for a comprehensive range of demographic and clinical factors. In the very high genetic risk group, adherence to an unfavorable lifestyle was further associated with a substantially increased risk of CV mortality [favorable vs. unfavorable lifestyle with very high genetic risk for CAD PRS, HR 8.31 (5.12-13.49); T2DM PRS, HR 5.84 (3.39-10.04)]. Across all genetic risk groups, 32.1% of CV mortality was attributable to lifestyle behavior [population attributable fraction (PAF) 32.1% (95% CI 28.8-35.3%)] and 14.1% was attributable to smoking [PAF 14.1% (95% CI 12.4-15.7%)]. There was no evidence of significant interaction between PRSs and age, sex, or lifestyle behavior in predicting the risk of CV mortality.ConclusionPRSs for CAD or T2DM and lifestyle behaviors are the independent predictive factors for future CV mortality in the white, middle-aged population. PRS-based risk assessment could be useful to identify the individuals who need intensive behavioral or therapeutic interventions to reduce the risk of CV mortality.

Project description:BackgroundThis study explored whether the prospective associations between muscle strength and incident type 2 diabetes (T2D) differ by varying levels of genetic susceptibility to T2D.MethodsThis study included 141,848 white British individuals from the UK Biobank. Muscle strength was expressed as the relative value of grip strength (measured by a hand dynamometer) divided by fat-free mass (measured via bioelectrical impedance analysis). Three categories of muscle strength (low, medium and high) were generated based on the sex- and age-specific tertiles. Genetic risk of T2D was estimated using a weighted polygenic risk score based on 138 independent single-nucleotide polymorphisms for T2D. During a median 7.4-year follow-up, 4,743 incident T2D cases were accrued. Cox regression with age as the underlying timescale was fit.ResultsHigh muscle strength was associated with a 44% lower hazard of T2D (HR:0.56, 95%CI:0.52-0.60), compared with low muscle strength, after adjustment for genetic risk of T2D. The inverse association between muscle strength and incident T2D was weaker in individuals with high genetic susceptibility. There was evidence of interaction between muscle strength and genetic susceptibility to T2D (p-additive = 0.010, p-multiplicative = 0.046). The estimated 8-year absolute risk of T2D was lower for high genetic risk-high muscle strength (2.47%), compared with low (2.89%) or medium (4.00%) genetic risk combined with low muscle strength.ConclusionsHigher muscle strength was associated with lower relative risk of developing T2D, irrespective of genetic susceptibility to T2D, while such association was weaker in the high genetic risk group. Individuals at high genetic risk of T2D but with high muscle strength may have a lower 8-year absolute risk of developing T2D, compared with those at low or medium genetic risk but with low muscle strength. Our findings inform future clinical trials to prevent or delay the onset of T2D by implementing muscle-strengthening interventions among individuals of varying levels of genetic susceptibility to T2D, including those with high genetic risk.

Dataset Information

Association between a mediterranean lifestyle and Type 2 diabetes incidence: a prospective UK biobank study.

Background

Methods

Results

Conclusions

Publications

Association between a mediterranean lifestyle and Type 2 diabetes incidence: a prospective UK biobank study.

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