Relationship of Diet, Physical Activity, and Nutritional Status to the Risk of Diabetes Mellitus: Cross-Sectional Analysis
Keywords:
Diabetes mellitus, Dietary habit, Physical activity, Obesity, Risk factors, LifestyleAbstract
Diabetes mellitus is one of the metabolic diseases that continues to increase in prevalence worldwide, mainly due to unhealthy diet and sedentary lifestyle. This study aims to analyze the relationship between diet, physical activity, and major risk factors for the incidence of diabetes mellitus. This study used a cross-sectional research design with data collection through the Food Frequency Questionnaire (FFQ) to assess diet, the International Physical Activity Questionnaire (IPAQ) to measure physical activity levels, and blood sugar and HbA1c levels using calibrated laboratory equipment. In addition, anthropometric measurements were carried out to assess the nutritional status of respondents. The results showed that older age, obesity, excessive sugar consumption, and low physical activity were the main risk factors for diabetes mellitus. Respondents with a sugar consumption frequency of ≥3 times/week had a 2.67 times higher risk of developing diabetes mellitus compared to those who consumed lower amounts of sugar. Respondents with low levels of physical activity had a 3.12 times higher risk of developing diabetes compared to physically active individuals. In addition, obesity was also found to increase the risk of diabetes by 2.1 times. Multivariate analysis showed that excessive sugar consumption and lack of physical activity were the most influential factors on the incidence of diabetes mellitus. These findings suggest that lifestyle interventions based on healthy diet and increased physical activity are very important in efforts to prevent diabetes mellitus. Therefore, more effective education strategies and supportive health policies are needed to reduce sugar consumption and increase physical activity in the community. Further research with a longitudinal design is needed to evaluate the effectiveness of these interventions in the long term.
References
American Diabetes Association (ADA). (2023). Standards of Medical Care in Diabetes—2023. Diabetes Care, 46(Suppl 1), S1–S350. https://doi.org/10.2337/dc23-S001
Hu, F. B., Satija, A., & Manson, J. E. (2021). Curbing the Diabetes Pandemic: The Need for Global Prevention Strategies. JAMA, 326(7), 629–630. https://doi.org/10.1001/jama.2021.12117
Malik, V. S., Li, Y., Pan, A., De Koning, L., Schernhammer, E., Willett, W. C., & Hu, F. B. (2020). Long-term Consumption of Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Mortality in US Adults. Circulation, 141(17), 1372–1383. https://doi.org/10.1161/CIRCULATIONAHA.119.042900
Reynolds, A. N., Akerman, A. P., & Mann, J. (2019). Dietary fibre and whole grains in diabetes management: Systematic review and meta-analyses. PLoS Medicine, 16(3), e1002851. https://doi.org/10.1371/journal.pmed.1002851
Warburton, D. E. R., & Bredin, S. S. D. (2021). Health benefits of physical activity: A systematic review of current systematic reviews. Current Opinion in Cardiology, 36(5), 439–447. https://doi.org/10.1097/HCO.0000000000000870
Pan, X. F., Wang, L., & Pan, A. (2022). Prevention and management of type 2 diabetes: Dietary components and nutritional strategies. The Lancet Diabetes & Endocrinology, 10(2), 89–103. https://doi.org/10.1016/S2213-8587(21)00261-5
International Diabetes Federation (IDF). (2021). IDF Diabetes Atlas, 10th edition. Brussels, Belgium: International Diabetes Federation. https://diabetesatlas.org/
Ford, E. S., Bergmann, M. M., Kroger, J., Schienkiewitz, A., Weikert, C., & Boeing, H. (2019). Healthy lifestyle behaviors and all-cause mortality among adults with diabetes: The European Prospective Investigation Into Cancer and Nutrition (EPIC)-Potsdam Study. European Journal of Epidemiology, 34(9), 909–921. https://doi.org/10.1007/s10654-019-00546-2
Jakicic, J. M., Rogers, R. J., Davis, K. K., & Collins, K. A. (2018). Role of physical activity and exercise in treating patients with overweight and obesity. Clinical Chemistry, 64(1), 99–107. https://doi.org/10.1373/clinchem.2017.272443
Franks, P. W., & Pearson, E. R. (2021). Obesity, genetics, and the environmental determinants of type 2 diabetes. Diabetes Care, 44(5), 1173–1179. https://doi.org/10.2337/dc20-2722
Mozaffarian, D., Hao, T., Rimm, E. B., Willett, W. C., & Hu, F. B. (2018). Changes in diet and lifestyle and long-term weight gain in women and men. New England Journal of Medicine, 364(25), 2392–2404. https://doi.org/10.1056/NEJMoa1014296
Ley, S. H., Hamdy, O., Mohan, V., & Hu, F. B. (2018). Prevention and management of type 2 diabetes: Dietary components and nutritional strategies. The Lancet, 383(9933), 1999–2007. https://doi.org/10.1016/S0140-6736(14)60613-9
Guthold, R., Stevens, G. A., Riley, L. M., & Bull, F. C. (2020). Worldwide trends in insufficient physical activity from 2001 to 2016: A pooled analysis of 358 population-based surveys with 1.9 million participants. The Lancet Global Health, 6(10), e1077-e1086. https://doi.org/10.1016/S2214-109X(18)30357-7
Schwingshackl, L., Schwedhelm, C., Hoffmann, G., Knüppel, S., Preterre, A., Iqbal, K., ... & Boeing, H. (2018). Food groups and risk of type 2 diabetes mellitus: A systematic review and meta-analysis of prospective studies. European Journal of Epidemiology, 33(2), 125–147. https://doi.org/10.1007/s10654-018-0347-4
Ekelund, U., Tarp, J., Fagerland, M. W., Johannessen, J. S., Hansen, B. H., Jefferis, B. J., ... & Lee, I. M. (2019). Joint associations of accelometer-measured physical activity and sedentary time with all-cause mortality: A harmonized meta-analysis in more than 44,000 middle-aged and older individuals. British Journal of Sports Medicine, 53(12), 1019–1026. https://doi.org/10.1136/bjsports-2019-100765
