Reducing obesity can prevent up to half of new cases of type 2 diabetes

Reducing the prevalence of obesity could prevent up to half of new cases of type 2 diabetes in the United States, according to a new study published today in the Journal of the American Heart Association, an open access journal of the American Heart Association. Obesity is a major contributor to diabetes, and the new study suggests more tailored efforts are needed to reduce the incidence of obesity-linked diabetes.

Type 2 diabetes is the most common form of diabetes, affecting more than 31 million Americans, according to the United States Centers for Disease Control and Prevention. Risk factors for type 2 diabetes include being overweight or obese; be over 45 years old; have an immediate family member diagnosed with type 2 diabetes; be physically active less than 3 times a week; or a history of gestational diabetes (diabetes during pregnancy). Type 2 diabetes is more common in black, Hispanic or Latin American, Native American, Alaska, Pacific Islander, or Asian Americans.

The number of deaths from type 2 diabetes in people under 65 is increasing alongside serious complications of the disease, including amputations and hospitalizations. In addition, type 2 diabetes has an impact on heart disease and the risk of stroke: adults with type 2 diabetes are twice as likely to have a heart attack or stroke as adults. people without diabetes.

Type 2 diabetes can be prevented or delayed with healthy lifestyle changes, such as losing weight, eating healthy foods, and being physically active. According to the National Diabetes Prevention Program, behavior changes have been shown to help people with prediabetes lose 5-7% of their body weight and reduce their risk of developing type 2 diabetes by 58% ( 71% for people over 60). . Researchers looked at the prevalence and excessive risk of type 2 diabetes associated with obesity.

Our study highlights the significant impact that reducing obesity could have on the prevention of type 2 diabetes in the United States. Reducing obesity must be a priority. Public health efforts that support healthy lifestyles, such as improving access to nutritious food, promoting physical activity, and developing community-based programs to prevent obesity, could significantly reduce new type 2 diabetes. “

Natalie A. Cameron, MD, first author of the study, medical resident in internal medicine, McGaw Medical Center, Northwestern University, Chicago

The researchers used information from the Multi-Ethnic Atherosclerosis Study (MESA) and four pooled cycles (2001-2016) from the National Health and Nutrition Survey (NHANES). MESA is an ongoing longitudinal study of 45 to 84 year olds who did not have cardiovascular disease at the time of recruitment. The MESA data included in this study was collected during five visits from 2000 to 2017 at six centers in the U.S. NHANES is a cross-sectional study of the U.S. population that takes place every two years using patient questionnaires. and examination data.

For this analysis, the authors limited the data to participants aged 45 to 79. They included only those who were non-Hispanic white, non-Hispanic black, or Mexican Americans and who did not have type 1 or type 2 diabetes at the start of the study. The researchers calculated both the prevalence of obesity and the excessive risk of type 2 diabetes associated with obesity.

The results of the study include:

• Among NHANES participants, the overall prevalence of obesity increased from 34% to 41% and was consistently higher in adults with type 2 diabetes.
• Among MESA participants
  • about 1 in 10 people (11.6%) developed type 2 diabetes after nine years.
  • Obese people were almost three times more likely to develop type 2 diabetes than non-obese people (20% vs. 7.3%, respectively).
• In the two MESA and NHANES groups:
  • Obesity was linked to the development of type 2 diabetes in 30 to 53% of cases.
  • a greater proportion of obese participants had an annual family income of less than $ 50,000, and they were more likely to be non-Hispanic black or Mexican Americans.
  • The prevalence of obesity was lowest among non-Hispanic white women, but this group had the highest obesity-linked type 2 diabetes.

“Our study confirms that there is a higher prevalence of obesity in non-Hispanic black adults and Mexican-American adults compared to non-Hispanic white adults. We believe these differences could indicate important social determinants of health factors that are contributing to new cases of type 2 diabetes in addition to obesity, ”says Cameron.

“In addition, the obesity epidemic has collided with the COVID-19 pandemic,” says Sadiya S. Khan, MD, M.Sc., lead author of the study and assistant professor of medicine and preventive medicine at the Feinberg School of Medicine at Northwestern University. “The greater severity of COVID-19 infection among obese people is of concern due to the increasing burden of adverse health consequences they may experience in the years to come; therefore, more efforts are needed to help more adults adopt healthier lifestyles and hopefully reduce the prevalence. of obesity. “

This analysis only included middle-aged to older adults without cardiovascular disease who were non-Hispanic white, non-Hispanic black, or Mexican-American, so the results may not be generalizable to the entire U.S. population. . Future research is needed to assess the burden of obesity on new cases of type 2 diabetes in other age groups and racial and ethnic groups.