Lifestyle factors associated with glycaemic control and body mass index in older adults with diabetes

Abstract

Objective: To investigate the relations between lifestyle factors (diet and exercise), glycated haemoglobin (HbA 1c ) and body mass index (BMI) in older adults with diabetes. Design and setting: A community hospital-based cross-sectional study of 150 noninstitutionalized, ambulatory adults (Z65 y) with diabetes, residing within New Zealand's Kapiti region. Subjects: Patients were recruited from all general practices; two diabetes clinics; local diabetes society and through advertisements in community newspapers. A total of 211 eligible people were identified, but 60 refused to participate and one withdrew. In all, 150 people completed the study (71% participation rate). Methods: Nutrient intakes were calculated by a food-frequency questionnaire. Physical activity was assessed by interview using a validated questionnaire. Medical history and demographic data were obtained by interview or self-completed questionnaires; height, weight and HbA 1c were measured. Multivariate models using bootstrapping and stepwise linear regression were used to select factors associated with HbA 1c and BMI. Results: Each five-unit increase in energy from dietary saturated fat and five-unit increase in BMI were associated with 6% (95% confidence interval ¼ 2-10%; P ¼ 0.004) and 4% (0.3-7%; P ¼ 0.031) increases in HbA 1c , respectively. For females with moderate, compared with low overall activity, there was a 14% (7-20%; P ¼ 0.000) reduction in BMI while for males the reduction was only 5% (À1-11%; P ¼ 0.116). BMI decreased 5% (2-9%; P ¼ 0.004) with each 10-y increase in age, while a fiveunit increment in energy from dietary sucrose was associated with a 6% (1-11%; P ¼ 0.025) increase in BMI. Conclusions: Reducing dietary saturated fat and excess body weight may be useful means of improving glycaemic control in older adults with diabetes. Increasing physical activity and reducing energy from dietary sucrose may assist weight control, the former particularly in women.

Association between Nutrient Intake and Obesity in Type 2 Diabetic Patients from the Korean National Diabetes Program: A Cross-Sectional Study

“…Only 10.6% had a carbohydrate intake of less than 50% of total energy intake. High saturated fat intake has been reported to be associated with higher BMI in older adults with diabetes (26) but there was no association between saturated fat and obesity in the present study. This seems to be due to a lower saturated fat intake in the present study.…”

“…Higher carbohydrate intake was associated with a lower risk of obesity in several studies. Consuming a low-carbohydrate (approximately <47% energy) diet was associated with greater likelihood of being overweight or obese among healthy Canadian adults (26). In elderly people of the Mediterranean islands, increase in carbohydrate and protein consumption was associated with a lower likelihood of being obese (5).…”

Total Energy Intake May Be More Associated with Glycemic Control Compared to Each Proportion of Macronutrients in the Korean Diabetic Population

“…An association between macronutrient intake and glycemic control in Western countries has been conclusively established [11-23]. Total energy intake and total fat intake are closely related with glycemic control [11,12,22,23]. However, the association between carbohydrate intake and glycemic control is unclear [13-21].…”

The evolution of the nutritional management of diabetes

“…Individuals with diabetes should be encouraged to take regular physical exercise (Grylls et al 2003). Exercise improves cardiovascular fitness and reduces insulin resistance (Boule et al 2001).…”