Diet and physical activity in relation to overall mortality amongst adult diabetics in a general population cohort
- 24 March 2006
- journal article
- research article
- Published by Wiley in Journal of Internal Medicine
- Vol. 259 (6) , 583-591
- https://doi.org/10.1111/j.1365-2796.2006.01638.x
Abstract
To evaluate the effect on overall and cardiovascular mortality of diet and physical activity amongst diabetic persons. Population-based prospective investigation, from 1993 to mid-2004, in the Greek arm of the European Prospective Investigation into Cancer and Nutrition. Volunteers from the general adult Greek population. From an original sample of 28 572 volunteers, 1013 were taking at enrolment drugs for diabetes mellitus, had no missing information on the study variables and no comorbidity. Diet was assessed at baseline through a validated questionnaire. Proportional hazards regression was used to assess the relation of dietary factors and physical activity with mortality. None. Mortality ratios overall and from cardiovascular causes. During 4579 person-years, 80 deaths have occurred, 46 of which from cardiovascular causes. Physical activity was strongly inversely associated with mortality. Two nutritional variables were significantly associated with diabetic mortality, with hazard ratios for increases of daily intake by one standard deviation being 1.31 for eggs [95% confidence interval (95% CI) 1.07 to 1.60] and 1.82 for saturated lipids (95% CI, 1.14 to 2.90). These two associations were considerably stronger for cardiovascular mortality. Waist-to-height ratio was positively, whereas hip circumference inversely associated with mortality. No significant interactions with gender for any of the study variables were evident. Amongst confirmed diabetic persons, increased physical activity is associated with significant reduction of mortality, whereas increased consumption of eggs and saturated fats is associated with significant increase of mortality. Monounsaturated lipids are preferable for diabetic persons.Keywords
This publication has 33 references indexed in Scilit:
- Diet and cancer — the European Prospective Investigation into Cancer and NutritionNature Reviews Cancer, 2004
- Nutrition Principles and Recommendations in DiabetesDiabetes Care, 2004
- European Prospective Investigation into Cancer and Nutrition (EPIC): study populations and data collectionPublic Health Nutrition, 2002
- A Prospective Study of Obesity and Risk of Coronary Heart Disease Among Diabetic WomenDiabetes Care, 2002
- Body Mass Index in Relation to Energy Intake and Expenditure among Adults in GreeceEpidemiology, 2000
- Is obesity related to microvascular and macrovascular complications in diabetes? The Wisconsin Epidemiologic Study of Diabetic RetinopathyArchives of internal medicine (1960), 1997
- Reproducibility and relative validity of an extensive semi-quantitative food frequency questionnaire using dietary records and biochemical markers among Greek schoolteachersInternational Journal of Epidemiology, 1997
- Mortality Risk by Body Weight and Weight Change in People with NIDDM: The WHO Multinational Study of Vascular Disease in DiabetesDiabetes Care, 1995
- Compendium of Physical Activities: classification of energy costs of human physical activitiesMedicine & Science in Sports & Exercise, 1993
- The Whitehall Study: Ten Year Follow‐up Report on Men With Impaired Glucose Tolerance With Reference to Worsening to Diabetes and Predictors of DeathDiabetic Medicine, 1984