23 January 2015 In Diabetes

This observational study examined the association between modifiable lifestyle and social factors on the incidence and progression of early chronic kidney disease (CKD) among those with type 2 diabetes. All 6972 people from the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET) with diabetes but without macroalbuminuria were studied. CKD progression was defined as decline in GFR of more than 5% per year, progression to end-stage renal disease, microalbuminuria, or macroalbuminuria at 5.5 years. Lifestyle/social factors included tobacco and alcohol use, physical activity, stress, financial worries, the size of the social network and education. Adjustments were made for known risks such as age, diabetes duration, GFR, albuminuria, gender, body mass index, blood pressure, fasting plasma glucose, and angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers use. Competing risk of death was considered. At study end, 31% developed CKD and 15% had died. The social network score (SNS) was a significant independent risk factor of CKD and death, reducing the risk by 11 and 22% when comparing the third to the first tertile of the SNS (odds ratios of CKD 0.89 and death 0.78). Education showed a significant association with CKD but stress and financial worries did not. Those with moderate alcohol consumption had a significantly decreased CKD risk compared with nonusers. Regular physical activity significantly decreased the risk of CKD. Thus, lifestyle is a determinant of kidney health in people at high cardiovascular risk with diabetes.

04 December 2014 In Diabetes

OBJECTIVE: Light-to-moderate alcohol drinking has been shown to reduce the risk of type 2 diabetes, for which obesity is a primary risk factor. The aim of this study was to determine whether drinking alcohol influences the relationship between obesity and hyperglycemia.

METHOD: The relationships of adiposity indices with hyperglycemia were compared among middle-aged Japanese men (N = 12,627) who were non-, light-to-moderate (/=22 and /=44 g ethanol/day) drinkers.

RESULTS: There were significant positive correlations of hemoglobin A1c with body mass index (BMI) and waist-to-height ratio (WHtR), which were significantly weaker in light-to-moderate and heavy drinkers than in nondrinkers but were not significantly different in very heavy drinkers compared with nondrinkers. Odds ratios (ORs) for hyperglycemia in subjects with versus those without high BMI or WHtR were significantly higher than reference level of 1.00 in all the drinker groups and significantly lower in light-to-moderate and heavy drinkers compared with nondrinkers; however they were not significantly different in very heavy drinkers compared with nondrinkers. ORs of the interaction term consisting of alcohol drinking and high adiposity index were significantly lower than the reference level in the light-to-moderate and heavy drinkers (OR with 95% confidence interval: high BMI, 0.61 [0.41, 0.91] in light-to-moderate drinkers and 0.64 [0.48, 0.85] in heavy drinkers; high WHtR, 0.57 [0.38, 0.85] in light-to-moderate drinkers and 0.66 [0.50, 0.88] in heavy drinkers) but were not significantly different from the reference level in very heavy drinkers (high BMI, 0.90 [0.65, 1.25]; high WHtR, 1.04 [0.74, 1.46]).

CONCLUSIONS: The associations between obesity and hyperglycemia were weaker in light-to-moderate drinkers than in nondrinkers. Thus, light-to-moderate drinking may reduce the impact of obesity on the risk for diabetes.

(J. Stud. Alcohol Drugs, 75, 1032-1038, 2014)

06 May 2014 In General Health




BACKGROUND: The obesity epidemic is a major health problem in the United States. Alcohol consumption is a source of energy intake that may contribute to body weight gain and development of obesity. However, previous studies of this relationship have been limited, with inconsistent results. METHODS: We conducted a prospective cohort study among 19 220 US women aged 38.9 years or older who were free of cardiovascular disease, cancer, and diabetes mellitus and had a baseline body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) within the normal range of 18.5 to less than 25. Alcoholic beverage consumption was reported on a baseline questionnaire. Body weight was self-reported on baseline and 8 annual follow-up questionnaires. RESULTS: There was an inverse association between amount of alcohol consumed at baseline and weight gained during 12.9 years of follow-up. A total of 7942 (41.3%) initially normal-weight women became overweight or obese (BMI > or =25) and 732 (3.8%) became obese (BMI > or =30). After adjusting for age, baseline BMI, smoking status, nonalcohol energy intake, physical activity level, and other lifestyle and dietary factors, the relative risks of becoming overweight or obese across total alcohol intake of 0, more than 0 to less than 5, 5 to less than 15, 15 to less than 30, and 30 g/d or more were 1.00, 0.96, 0.86, 0.70, and 0.73, respectively (P( )for trend( )<.001). The corresponding relative risks of becoming obese were 1.00, 0.75, 0.43, 0.39, and 0.29 (P( )for trend( )<.001). The associations were similar by subgroups of age, smoking status, physical activity level, and baseline BMI. CONCLUSION: Compared with nondrinkers, initially normal-weight women who consumed a light to moderate amount of alcohol gained less weight and had a lower risk of becoming overweight and/or obese during 12.9 years of follow-up.




06 May 2014 In General Health




OBJECTIVE: To investigate the relative importance of the individual components of the Mediterranean diet in generating the inverse association of increased adherence to this diet and overall mortality. DESIGN: Prospective cohort study. SETTING: Greek segment of the European Prospective Investigation into Cancer and nutrition (EPIC). PARTICIPANTS: 23 349 men and women, not previously diagnosed with cancer, coronary heart disease, or diabetes, with documented survival status until June 2008 and complete information on nutritional variables and important covariates at enrolment. MAIN OUTCOME MEASURE: All cause mortality. RESULTS: After a mean follow-up of 8.5 years, 652 deaths from any cause had occurred among 12 694 participants with Mediterranean diet scores 0-4 and 423 among 10 655 participants with scores of 5 or more. Controlling for potential confounders, higher adherence to a Mediterranean diet was associated with a statistically significant reduction in total mortality (adjusted mortality ratio per two unit increase in score 0.864, 95% confidence interval 0.802 to 0.932). The contributions of the individual components of the Mediterranean diet to this association were moderate ethanol consumption 23.5%, low consumption of meat and meat products 16.6%, high vegetable consumption 16.2%, high fruit and nut consumption 11.2%, high monounsaturated to saturated lipid ratio 10.6%, and high legume consumption 9.7%. The contributions of high cereal consumption and low dairy consumption were minimal, whereas high fish and seafood consumption was associated with a non-significant increase in mortality ratio. CONCLUSION: The dominant components of the Mediterranean diet score as a predictor of lower mortality are moderate consumption of ethanol, low consumption of meat and meat products, and high consumption of vegetables, fruits and nuts, olive oil, and legumes. Minimal contributions were found for cereals and dairy products, possibly because they are heterogeneous categories of foods with differential health effects, and for fish and seafood, the intake of which is low in this Population.




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