No Difference in Diet and Lifestyle Advice for Individuals with and without Diabetes

The results of a large-scale longitudinal observational study suggest that people with diabetes do not require different dietary and lifestyle recommendations than the general public. According to these new study data, they benefit even more from the usual recommendations than nondiabetic individuals. Diewertje Sluik, who conducted the research in the Department of Epidemiology of the German Institute of Human Nutrition (DifE), a partner in the DZD, reported her results together with her colleagues in the journal "Diabetologia".

In the new study the scientists investigated whether the associations between lifestyle factors and mortality risk differ between individuals with and without type 2 diabetes.
The analysis was based on data of the European Prospective Investigation into Cancer and Nutrition (EPIC), one of the largest European dietary studies, which since 1992 has been investigating the associations between lifestyle and the emergence of chronic diseases. The scientists analyzed the data of a cohort of 6,384 persons with diabetes and 258,911 EPIC participants without known diabetes.
In both groups – individuals with and without diabetes – the epidemiologists quantified the associations between mortality risk and BMI, waist/height ratio, 26 food groups, alcohol consumption, physical activity and smoking.
Compared to people without diabetes, the scientists found that in general, people with diabetes had a 62% higher mortality risk. However, in both groups the mortality risk was influenced by nearly the same factors. Smoking, little physical activity, high alcohol consumption, excess weight and a diet rich in fat and meat but with low fruit and vegetable content were associated with increased mortality risk. The two groups’ individual risk factors differed in strength but not in the direction of the observed associations. For individuals with diabetes it was noted that the consumption of fruit, legumes, nuts, pasta, poultry and vegetable oil had a particularly positive impact on the mortality risk.
“This study is an indication that recommendations for a healthy lifestyle should be the same for people both with and without diabetes,” said Diewertje Sluik, lead author of the study. However, the study also suggests that people with diabetes should pay more attention to their diets, since the mortality risk is greater for them than for people without the disease. Moreover, a diet with certain food groups has a particularly beneficial effect on people with diabetes. “This study provides further evidence that a healthy lifestyle and diet have many different positive effects and that this insight also applies to those who already have the condition,” said Heiner Boeing, head of the Department of Epidemiology at the DIfE and director of the Potsdam EPIC study.
Background information:
The EPIC study is a prospective study of the associations between diet, cancer and other chronic diseases such as type 2 diabetes. A total of 519,000 adult participants are enrolled in the EPIC study in 23 administrative centers in ten European countries. More than 27,000 participants are enrolled in the Potsdam EPIC study, which is a part of the overall EPIC study.
Original publication:
Sluik, D. et al. 2013; DOI 10.1007/s00125-013-3074-y