The association of a healthy lifestyle index and imaging-based body fat distribution with glycemic status and Type 2 diabetes in the Multi Ethnic Cohort: a cross-sectional analysis

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Item Type:	Article
Title:	The association of a healthy lifestyle index and imaging-based body fat distribution with glycemic status and Type 2 diabetes in the Multi Ethnic Cohort: a cross-sectional analysis
Creators Name:	Klapp, R., Nimptsch, K., Pischon, T., Wilkens, L.R., Lim, U., Guillermo, C., Setiawan, V.W., Shepherd, J.A, Le Marchand, L. and Maskarinec, G.
Abstract:	INTRODUCTION: As several behaviors captured by the Lifestyle Risk Factor Index (LSRI) are protective against Type 2 diabetes (T2D) and may affect body fat distribution, we examined its relation with both outcomes. METHODS: In a subset of the Multiethnic Cohort, participants from five ethnic groups (60-77 years) were assigned LSRI scores (one point each for consuming <1 (women)/<2 (men) alcoholic drinks/day, ≥1.5 physical activity hours/week, not smoking, and adhering to ≥3/7 dietary recommendations). All participants completed an extensive Quantitative Food Frequency Questionnaire to allow estimation of adherence to intake recommendations for fruits, vegetables, refined and whole grains, fish, processed and non-processed meat. Glycemic/T2D status was classified according to self-reports and fasting glucose. We estimated prevalence odds ratios (POR) of LSRI with glycemic/T2D status and DXA- and MRI-based body fat distribution using logistic regression. RESULTS: Of 1713 participants, 43% had normoglycemia, 30% Pre-T2D, 9% Undiagnosed T2D, and 18% T2D. Overall, 39% scored 0-2, 49% 3, and 12% 4 LSRI points. T2D prevalence was 55% (POR 0.45; 95% confidence intervals 0.27, 0.76) lower for 4 vs. 0-2 LSRI points with weaker associations for abnormal glycemic status. Despite the low adherence to dietary recommendations (22%), this was the only component related to lower T2D prevalence. The inverse LSRI-T2D association was only observed among Latinos and Japanese Americans in ethnic-specific models. Visceral fat measures were higher in T2D patients and attenuated the LSRI-T2D association. CONCLUSION: These findings support the role of a healthy lifestyle, especially diet, in T2D prevention with differences across ethnicity.
Keywords:	Cross-Sectional Studies, Diet, Healthy Lifestyle, Risk Factors, Type 2 Diabetes Mellitus, Animals
Source:	European Journal of Clinical Nutrition
ISSN:	0954-3007
Publisher:	Nature Publishing Group
Volume:	78
Number:	3
Page Range:	236-242
Date:	March 2024
Additional Information:	Copyright © The Author(s), under exclusive licence to Springer Nature Limited 2023.
Official Publication:	https://doi.org/10.1038/s41430-023-01381-w
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