Joint impact of BMI, physical activity and diet on type 2 diabetes: Findings from two population-based cohorts in China

Global burden of Type 2 Diabetes Mellitus attributable to dietary risks in elderly adults: insights from the Global Burden of Disease study 2021

Background

Type 2 Diabetes Mellitus (T2DM) poses a significant global health challenge, particularly among elderly adults. Dietary risk factors, such as high consumption of processed meats and sugar-sweetened beverages and low intake of whole grains and fruits, play a critical role in the burden of T2DM. This study aims to comprehensively quantify the global burden of T2DM attributable to dietary risks among elderly adults, identify significant dietary risk factors driving disease burden, and evaluate temporal, regional, and demographic variations to inform targeted public health strategies and interventions for reducing the impact of T2DM.

Methods

This study utilized data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to assess T2DM burden attributable to dietary risks among adults aged 65 years and older across 204 countries and territories. Metrics included age-standardized mortality rates (ASMR) and disability-adjusted life-year rates (ASDR). Dietary risk factors analyzed included low intake of whole grains, fruits, vegetables, and fiber, as well as high intake of processed meat, red meat, and sugar-sweetened beverages. Joinpoint regression and decomposition analyses were performed to examine temporal trends and drivers of changes by region, SDI level, sex, and age.

Results

In 2021, dietary risks accounted for 23.61% of T2DM-related deaths and 24.85% of DALYs among elderly adults. ASMR showed a slight decline globally (AAPC: -0.08), while ASDR exhibited a significant upward trend (AAPC: +0.7) from 1990 to 2021. High SDI regions demonstrated decreasing ASMR but persistent DALYs due to prolonged survival with complications. Conversely, low and middle SDI regions exhibited rapid increases in ASMR and ASDR, driven by dietary transitions and limited healthcare resources. Males consistently bore a higher burden than females, with pronounced disparities in low and middle SDI regions. Aging and population growth were the primary drivers of the increasing burden globally.

Conclusion

This study underscores the substantial burden of T2DM attributable to dietary risks among elderly adults and highlights significant regional and demographic disparities. Targeted public health interventions, personalized nutritional strategies, and improved healthcare access are essential to mitigate this burden. Future research should explore the impact of emerging dietary trends and precision nutrition on T2DM prevention and management.

Joint Effects of Physical Activity and Body Mass Index on Prevalent Diabetes in a Nationally Representative Sample of 1.9 Million US Adults

Aim: To investigate the joint effects of physical activity (PA) and body mass index (BMI) on prevalent diabetes mellitus in a nationally representative sample of US adults. Materials and Methods: Data were pooled from five US Behavioral Risk Factor Surveillance System (BRFSS) surveys from 2011 to 2019. Cross-sectional associations between independent and combined PA and BMI status and diabetes were analysed using Poisson's log-linear regression with a robust-error variance, reported by adjusted prevalence ratios (APRs). These models were adjusted for relevant sociodemographic, behavioral, and health-related factors. Results: Data was available for 1,913,732 individuals (≥ 18 years). Considering individuals highly active and with normal weight as the reference group, there was an association between decreasing levels of PA and increasing BMI and diabetes prevalence. APRs ranged from APR = 1.09 (nonactive, normal weight group; 95% CI = 1.09-1.09), 1.67 (nonactive, overweight group; 95% CI = 1.67-1.67), 2.23 (nonactive, Class I obesity group; 95% CI = 2.23-2.23), 2.71 (nonactive, Class II obesity group; 95% CI = 2.71-2.71), and 3.17 (nonactive, Class III obesity group; 95% CI = 3.16-3.17). Conclusions: BMI appears to be a substantially larger predictor of diabetes compared to PA in a large population-level sample of US adults. PA provided modest reductions in the prevalence of diabetes but did not attenuate the detrimental impact of overweight and increasing levels of obesity on diabetes prevalence.

Protein-enriched and anti-inflammatory dietary patterns, healthy lifestyle index and depressive symptoms: A cross-sectional study of 287,945 adults in China

OBJECTIVES

Depressive symptoms have a considerable negative impact on mental health. This study aimed to understand the relationship between the protein-enriched and anti-inflammatory dietary index scores, modified healthy lifestyle index scores (Modified HLIS), and depressive symptoms.

METHODS

This study used convenience sampling to conduct a single-center cross-sectional survey. From January 1, 2015 to December 31, 2020, a total of 287,945 Chinese adults from a health management center of a general hospital completed an online self-reported health questionnaire, which included demographic characteristics, the Dietary Diversity Scale, the Modified Healthy Lifestyle Index Scores and the Patient Health Questionnaire-9.

RESULTS

The higher anti-inflammatory dietary index scores (POR = 0.87; 95 % CI: 0.86-0.87; p < 0.001), moderate modified healthy lifestyle index scores (POR = 0.76; 95 % CI: 0.75-0.78; p < 0.001) and sufficient modified healthy lifestyle index scores (POR = 0.53; 95 % CI: 0.52-0.54; p < 0.001) were negatively associated with depressive symptoms, while the higher protein-enriched dietary index scores (POR = 1.01; 95 % CI: 1.01-1.02; p < 0.001) was positively correlated with depressive symptoms.

CONCLUSIONS

This study demonstrated that protein-enriched and anti-inflammatory dietary index scores, and multiple healthy lifestyles are associated depressive symptoms in adults.