Lifestyle Choices
Lifestyle Risk Factors are Related to New-onset Diabetes Mellitus in Older Adults
Bottom Line: Unhealthy lifestyle choices causes or contributes to the earlier onset of new diabetes in older adults.Indeed, it appears that unhealthy lifestyle choices "could be responsible for nine out of ten new cases of diabetes mellitus among older adults. Lifestyle advice seems to be just as important for older people as it is for anyone else, say the researchers. If the associations reported here are causal, even modest changes in lifestyle could have a big effect on the incidence of diabetes among the fastest growing sector of the US population."
Method: A cohort study tracked 4883 men and women aged 65 or more years old for ten years. These participants were randomly selected from lists of adults who were eligible for state funded health care (Medicare), and the mean age at baseline was 72 years
Results: The study suggests, "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 insulin or other diabetes medication dependent diabetes in this age group would decline 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%)."
Mozaffarian D, Kamineni A, Carnethon M, Djoussé L, Mukamal KJ, Siscovick D. "Lifestyle risk factors and new-onset diabetes mellitus in older adults: the cardiovascular health study," Arch Intern Med 2009;169:798-807 [PubMed Abstract]
Want to Loose Weight? Burn More Calories Than You Eat
Portion Size and the Caloric Content (Density) of Foods Matter in Weight Loss
quote:
Background
When the portion size and energy density (in kcal/g) of a food are varied simultaneously in a single meal, each influences energy intake independently.
Objective
We aimed to determine how the effects of portion size and energy density combine to influence energy intake and satiety over multiple meals for 2 d.
Design
In a crossover design, 24 young women were provided with meals and snacks for 2 consecutive days per week for 4 wk; all foods were consumed ad libitum. Across the 4 sessions, the subjects were served the same 2 daily menus, but all foods were varied in portion size and energy density between a standard level (100%) and a reduced level (75%).
Results
Reducing the portion size and energy density of all foods led to significant and independent decreases in energy intake over 2 d (P < 0.0001). A 25% decrease in portion size led to a 10% decrease in energy intake (231 kcal/d), and a 25% decrease in energy density led to a 24% decrease in energy intake (575 kcal/d). The effects on energy intake were additive and were sustained from meal to meal. Despite the large variation in energy intake, there were no significant differences in the ratings of hunger and fullness across conditions over the 2 d.
Conclusions
Reductions in portion size and energy density independently decreased ad libitum energy intake in women when commonly consumed foods were served over 2 d. Reductions in both portion size and energy density can help to moderate energy intake without increased hunger.
Key Words: Portion size • energy density • energy intake • obesity prevention and control • satiety • humans • adult • clinical trial • crossover studies.
Rolls BJ, Roe LS, Meengs JS. "Reductions in portion size and energy density of foods are additive and lead to sustained decreases in energy intake." American Journal of Clinical Nutrition. January 2006;83(1):11-17.