Joshua J Joseph1, Justin B Echouffo-Tcheugui2, Sameera A Talegawkar3, Valery S Effoe4, Victoria Okhomina5, Mercedes R Carnethon6, Willa A Hsueh7, Sherita H Golden8. 1. Department of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio; Johns Hopkins University, School of Medicine, Baltimore, Maryland. Electronic address: joseph.117@osu.edu. 2. Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Rollins School of Public Health, Emory University, Atlanta, Georgia. 3. Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health at the George Washington University, Washington, District of Columbia. 4. Division of Public Health Sciences, Wake Forest University, School of Medicine, Winston-Salem, North Carolina. 5. University of Mississippi Medical Center, Jackson, Mississippi. 6. Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. 7. Department of Medicine, The Ohio State University, Wexner Medical Center, Columbus, Ohio. 8. Johns Hopkins University, School of Medicine, Baltimore, Maryland.
Abstract
INTRODUCTION: The associations of modifiable lifestyle risk factors with incident diabetes are not well investigated in African Americans (AAs). This study investigated the association of modifiable lifestyle risk factors (exercise, diet, smoking, TV watching, and sleep-disordered breathing burden) with incident diabetes among AAs. METHODS: Modifiable lifestyle risk factors were characterized among 3,252 AAs in the Jackson Heart Study who were free of diabetes at baseline (2000-2004) using baseline questionnaires and combined into risk factor categories: poor (0-3 points), average (4-7 points), and optimal (8-11 points). Incidence rate ratios (IRR) for diabetes (fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes drugs, or glycosylated hemoglobin A1c ≥6.5%) were estimated using Poisson regression modeling adjusting for age, sex, education, occupation, systolic blood pressure, and BMI. Outcomes were collected 2005-2012 and data analyzed in 2016. RESULTS: Over 7.6 years, there were 560 incident diabetes cases (mean age=53.3 years, 64% female). An average or optimal compared to poor risk factor categorization was associated with a 21% (IRR=0.79, 95% CI=0.62, 0.99) and 31% (IRR=0.69, 95% CI=0.48, 1.01) lower risk of diabetes. Among participants with BMI <30, IRRs for average or optimal compared to poor categorization were 0.60 (95% CI=0.40, 0.91) and 0.53 (95% CI=0.29, 0.97) versus 0.90 (95% CI=0.67, 1.21) and 0.83 (95% CI=0.51, 1.34) among participants with BMI ≥30. CONCLUSIONS: A combination of modifiable lifestyle factors are associated with a lower risk of diabetes among AAs, particularly among those without obesity.
INTRODUCTION: The associations of modifiable lifestyle risk factors with incident diabetes are not well investigated in African Americans (AAs). This study investigated the association of modifiable lifestyle risk factors (exercise, diet, smoking, TV watching, and sleep-disordered breathing burden) with incident diabetes among AAs. METHODS: Modifiable lifestyle risk factors were characterized among 3,252 AAs in the Jackson Heart Study who were free of diabetes at baseline (2000-2004) using baseline questionnaires and combined into risk factor categories: poor (0-3 points), average (4-7 points), and optimal (8-11 points). Incidence rate ratios (IRR) for diabetes (fasting glucose ≥126 mg/dL, physician diagnosis, use of diabetes drugs, or glycosylated hemoglobin A1c ≥6.5%) were estimated using Poisson regression modeling adjusting for age, sex, education, occupation, systolic blood pressure, and BMI. Outcomes were collected 2005-2012 and data analyzed in 2016. RESULTS: Over 7.6 years, there were 560 incident diabetes cases (mean age=53.3 years, 64% female). An average or optimal compared to poor risk factor categorization was associated with a 21% (IRR=0.79, 95% CI=0.62, 0.99) and 31% (IRR=0.69, 95% CI=0.48, 1.01) lower risk of diabetes. Among participants with BMI <30, IRRs for average or optimal compared to poor categorization were 0.60 (95% CI=0.40, 0.91) and 0.53 (95% CI=0.29, 0.97) versus 0.90 (95% CI=0.67, 1.21) and 0.83 (95% CI=0.51, 1.34) among participants with BMI ≥30. CONCLUSIONS: A combination of modifiable lifestyle factors are associated with a lower risk of diabetes among AAs, particularly among those without obesity.
Authors: Myra A Carpenter; Richard Crow; Michael Steffes; William Rock; Jeffrey Heilbraun; Gregory Evans; Thomas Skelton; Robert Jensen; Daniel Sarpong Journal: Am J Med Sci Date: 2004-09 Impact factor: 2.378
Authors: Sherita Hill Golden; Arleen Brown; Jane A Cauley; Marshall H Chin; Tiffany L Gary-Webb; Catherine Kim; Julie Ann Sosa; Anne E Sumner; Blair Anton Journal: J Clin Endocrinol Metab Date: 2012-06-22 Impact factor: 5.958
Authors: Paul J Christine; Amy H Auchincloss; Alain G Bertoni; Mercedes R Carnethon; Brisa N Sánchez; Kari Moore; Sara D Adar; Tamara B Horwich; Karol E Watson; Ana V Diez Roux Journal: JAMA Intern Med Date: 2015-08 Impact factor: 21.873
Authors: Aurelian Bidulescu; Jiankang Liu; Solomon K Musani; Ervin R Fox; Tandaw E Samdarshi; Daniel F Sarpong; Viola Vaccarino; Peter W Wilson; Donna K Arnett; Rebecca Din-Dzietham; Herman A Taylor; Gary H Gibbons Journal: Circ Heart Fail Date: 2011-08-12 Impact factor: 8.790
Authors: Tibor Fülöp; DeMarc A Hickson; Sharon B Wyatt; Rajesh Bhagat; Michael Rack; Otis Gowdy; Michael F Flessner; Herman A Taylor Journal: Sleep Med Date: 2012-07-25 Impact factor: 3.492
Authors: Amy H Auchincloss; Ana V Diez Roux; Mahasin S Mujahid; Mingwu Shen; Alain G Bertoni; Mercedes R Carnethon Journal: Arch Intern Med Date: 2009-10-12
Authors: Amanda M Fretts; Barbara V Howard; Barbara McKnight; Glen E Duncan; Shirley A A Beresford; Mihriye Mete; Ying Zhang; David S Siscovick Journal: Diabetes Care Date: 2014-05-07 Impact factor: 19.112
Authors: Robin Ortiz; Bjoern Kluwe; James B Odei; Justin B Echouffo Tcheugui; Mario Sims; Rita R Kalyani; Alain G Bertoni; Sherita H Golden; Joshua J Joseph Journal: Psychoneuroendocrinology Date: 2018-12-27 Impact factor: 4.905
Authors: Peter T Katzmarzyk; Kenneth E Powell; John M Jakicic; Richard P Troiano; Katrina Piercy; Bethany Tennant Journal: Med Sci Sports Exerc Date: 2019-06 Impact factor: 5.411
Authors: Joshua J Joseph; Neal K Pohlman; Songzhu Zhao; David Kline; Guy Brock; Justin B Echouffo-Tcheugui; Mario Sims; Valery S Effoe; Wen-Chih Wu; Rita R Kalyani; Gary S Wand; Bjorn Kluwe; Willa A Hsueh; Marwah Abdalla; Daichi Shimbo; Sherita H Golden Journal: Circulation Date: 2021-02-19 Impact factor: 39.918
Authors: Bjorn Kluwe; Robin Ortiz; James B Odei; Songzhu Zhao; David Kline; Guy Brock; Justin B Echouffo-Tcheugui; Ju-Mi Lee; Sophie Lazarus; Teresa Seeman; Philip Greenland; Belinda Needham; Mercedes R Carnethon; Sherita H Golden; Joshua J Joseph Journal: Psychoneuroendocrinology Date: 2020-11-04 Impact factor: 4.905
Authors: Mercedes Sotos-Prieto; Songzhu Zhao; David Kline; Guy Brock; Holly Gooding; Josiemer Mattei; Fernando Rodriguez-Artalejo; Yuan-I Min; Eric B Rimm; Katherine L Tucker; Joshua J Joseph Journal: J Clin Med Date: 2021-05-22 Impact factor: 4.241