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BMJ 2009; 338 doi: (Published 05 May 2009) Cite this as: BMJ 2009;338:b1826

Unhealthy lifestyles blamed for most new diabetes in older adults

Unhealthy lifestyles could be responsible for nine out of ten new cases of diabetes mellitus among older US adults, say researchers. A cohort study that tracked 4883 men and women aged 65 or over for ten years suggested that if all older people exercised more, stopped smoking (or never started), ate a healthy diet, drank moderately, and had a body mass index of less than 25, the incidence of drug dependent diabetes in this age group would fall by 89% (95% CI 23% to 99%). The analysis found a clear dose-response effect. Risk of diabetes fell in a stepwise fashion with each extra healthy lifestyle factor.

All five factors were linked to incident diabetes independently of each other and of age, sex, ethnic background, education, and income. Even without body mass index, which is hard to modify, the population attributable risk of the other four factors combined was 81% (95% CI 42% to 94%).

The participants were randomly selected from lists of adults who were eligible for state funded health care (Medicare), and the mean …

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