I don't know if I have two or three of the healthy-lifestyle factors. Don't smoke, BMI good, but how to interpret the drinking quota? Does "one drink a day" mean ever, any day? Or does it mean kind of on average? The latter seems more reasonable, like asking if you're a very moderate drinker (I am). But the individual day may really be the important thing, since that is what triggers an insulin response. When I drink, I may well have two glasses of wine, not one. Does that prevent the third good mark?

Gosh, I don't know. I drink seldom, but, shall we say, deeply. Perhaps I was as low as 1 healthy factor out of 5. Urp.

Anyway, I realized the WSJ site I linked isn't fully accessible, so here is a link to the abstract of the study.

If I am reading the abstract correctly, this is what it says:
- men who had 1 healthy lifestye factor had a 31% lower probability of developing diabetes than men with none, women had 39% lower.
- men who had the 4 healthy factors of diet, smoking, drinking, and exercise had 39% lower, women had 57% lower.
- men who had all 5 healthy factors, i.e. weight as well, had 72% lower, women had 84% lower.
- the study group was almost 200,000 men and women, aged 50-71 in 1995-1996, which is when their lifestyle factors were assessed. They had no diabetes, cancer or cardiac diseases at that time. Their diabetes status was assessed a decade later, 2004-2006.
- of the total group, 9.6% of the men developed diabetes and 7.5% of the women. The abstract doesn't say the rates for each of the subgroups.

This kind of study has limitations, but I still think it is thought-provoking, especially as (some of us) approach the blessed state of middle age.

Here is a link that might be useful: Link To Abstract

OK, so does wzalking half a mile to work and then back home twice daily (I walk home for lunch) count as exercise? How about if I walk two miles of fence on the weekend? If so, I have that one. I don't smoke and never have. That's two. I don't drink because I just don't like it. That's three. I et a LOT of vegetables but nearly no fruit, so how does that factor in? I eat easily 6 or 7 servings of vegetables, maybe one of fruit, so am I good to go on that? If so, I'm at four. I need to lose that 20 pounds I gained, though, so I havne't gotten all five.

Doesn't keep my cholesterol or my blood pressure down, though my glucose tests have always been good....

Approach middle age? Hmmmm. I'm 56, so I might be getting a bit past that, but I can still outrun my grandson. Not the Princess, she runs like a deer!

Annie

50 is the new 40 and so on.

Really. People can be so much more active, healthy, full of energy, etc as they age, today. We have the potential to be better-nourished, have better medical care, less grinding jobs, and social norms are more supportive. It is in part a choice, of course, but some make it and, Annie, I expect you've made that choice.

Until about 18 months ago, I wasn't making that choice. I've taken some steps in the right direction, and this study made me think about the additional steps I need to take.

I don't have diabetes, don't think I am close to having diabetes, but there was a time when I was anxiously examining my blood work and realized that I was worried about it for potentially good reason.

Sorry, not meaning to be preachy. I'm the last person who would have the right to be.

I know this is about lifestyle factors, but I'd really like to see that compared to genetics.

The rate of diabetes in the US has almost tripled in the last few decades, too short a time for our genetics to change much. I think that means the large majority of the disease in this country is lifestyle related.

I do think that there is a small core rate of the disease that is truly genetic, meaning you are likely to get it despite a healthy ''lifestyle''. Type 1 and some type 2. Pretty small, though.

Here is a link that might be useful: CDC link

The CDC graph climbs just when the diagnostic criteria were redefined. (There are other problems with their estimates too, but that glaring one isn't mentioned at all in the "methods and limitations" window.)

Here's a 1998 AAFP journal article that outlines the changes. Quoting:

Impact of the New Diagnostic Criteria

Physicians may be concerned that the new diagnostic criteria for diabetes mellitus, including the lower cutoff for fasting plasma glucose levels, may greatly increase the number of people who are diagnosed with diabetes mellitus in their practices. Concerns about overdiagnosis include the harm created by anxiety, the risks and costs of unnecessary treatment, and possible insurance discrimination, especially if the condition that is being diagnosed is relatively benign or if no effective treatment is available. On the other hand, underdiagnosing a condition is harmful if early treatment can make a difference in patient outcome, especially if the treatment is relatively benign and inexpensive.

It is true that a rigorous screening program will increase the number of persons who are diagnosed with diabetes mellitus. However, currently one half of the people who have diabetes mellitus according to the old criteria have not been diagnosed and may remain undiagnosed for up to 10 years.

Here is a link that might be useful: Diagnosis of Diabetes - new criteria (1998 article)

Wouldn't a change in the diagnostic criteria for a disease result in a one-time jump in the reported rate of the disease (maybe over a few years), rather than a steady increase over multiple decades?

For diabetes specifically, we know the average weight of Americans has increased considerably in the past decades.

'' average height of a man aged 20-74 years increased from just over 5'8' in 1960 to 5'9�' in 2002, while the average height of a woman the same age increased from slightly over 5'3' 1960 to 5'4' in 2002.

Meanwhile, the average weight for men aged 20-74 years rose dramatically from 166.3 pounds in 1960 to 191 pounds in 2002, while the average weight for women the same age increased from 140.2 pounds in 1960 to 164.3 pounds in 2002.

Though the average weight for men aged 20-39 years increased by nearly 20 pounds over the last four decades, the increase was greater among older men:

Men between the ages of 40 and 49 were nearly 27 pounds heavier on average in 2002 compared to 1960.

Men between the ages of 50 and 59 were nearly 28 pounds heavier on average in 2002 compared to 1960.

Men between the ages of 60 and 74 were almost 33 pounds heavier on average in 2002 compared to 1960.''

Granted, taller people tend to weigh more, but when I look at some height-to-weight charts, a 1 inch height difference for a man translates to only about 5-6 lb.

Here is a link that might be useful: Weight 1960-2002

I am with coconut-nj. I think genetics is one of the most important factor. In addition, I think age, sex, and race should be included.

"------ The rate of diabetes in the US has almost tripled in the last few decades, too short a time for our genetics to change much. I think that means the large majority of the disease in this country is lifestyle related------"

Possible, possibly not.

When it comes to genetics, we are extremely critical for dogs, cats, horses, cows, tomatoes, corns, roses, hostas ---etc.

Over a few million years, nature has perfected a system of natural selection. All life forms have their ways of proven mating strategies to produce the fittest next generations.

But when it comes to humans, we feel that we are not part of that system. We have totally messed up our mating strategies to produce the best progenies.

Mating practices have been perverted into entertainment, social formalities, and commerce.

What do females' three measurements have to do with fitness of our offspring?

It takes only one generation to mess up your genetics.

dcarch

Johnliu said: Wouldn't a change in the diagnostic criteria for a disease result in a one-time jump in the reported rate of the disease (maybe over a few years), rather than a steady increase over multiple decades?

I think not. It takes time for a change in practice to spread. Notice that article I quoted is anticipating resistance.
I'm not saying there wasn't an increase, just that the slope of the curve may be very much exaggerated. Diabetes may have been way underdiagnosed under the old criteria.
Also, what the CDC did is extrapolate for the whole population from surveys. Self-reporting is a pretty unreliable way to find out what percentage of a population is diabetic, I think. DH's grandfather was said by everyone in the family to be diabetic. Despite the fact that he ate whatever he wanted, never used insulin, and lived to be 91.

''We have totally messed up our mating strategies to produce the best progenies.

Mating practices have been perverted into entertainment, social formalities, and commerce.''

Definitely, but this is hardly an invention of the past few decades.

"---Definitely, but this is hardly an invention of the past few decades. -----"

Mostly recently since internet.

Which kid has not spent a ton of time viewing free porn recently?

Looking sexy for little girls is a fairly recent thing.

dcarch

It's absolutely genetic to be diabetic or not. That is, if you are genetically predisoposed to be diabetic, it doens't matter if you avoid all sugar and exercise. If you are not, eating a bunch of sugar will not trigger it. Higher weight will help the disease along more than sugar, though. That much is known.