Association between a mediterranean lifestyle and Type 2 diabetes incidence: a prospective UK biobank study

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Abstract

Background

There is mounting evidence that the Mediterranean diet prevents type 2 diabetes, but little is known about the role of Mediterranean lifestyles other than diet and among non-Mediterranean populations. This work aimed to examine the association between a comprehensive Mediterranean-type lifestyle and type 2 diabetes incidence in a British adult population.

Methods

We used data from 112,493 individuals free of cardiovascular disease and type 2 diabetes mellitus, aged 40–69 years, from the UK Biobank cohort, who were followed from 2009 to 2010 to 2021. The Mediterranean lifestyle was assessed through the 25-item MEDLIFE index, which comprises three blocks: (a) “Mediterranean food consumption”, (b) “Mediterranean dietary habits”, (c) “Physical activity, rest, social habits, and conviviality”. Diabetes incidence was obtained from clinical records. Cox proportional-hazards regression models were used to analyze associations and adjusted for the main potential confounders.

Results

After a median follow-up of 9.4 years, 2,724 cases of type 2 diabetes were ascertained. Compared to the first quartile of MEDLIFE adherence, the hazard ratios (95% confidence interval) for increasing quartiles of adherence were 0.90 (0.82–0.99), 0.80 (0.72–0.89) and 0.70 (0.62–0.79) ( p-trend < 0.001). All three blocks of MEDLIFE were independently associated with lower risk of diabetes.

Conclusions

Higher adherence to the MEDLIFE index was associated with lower risk of type 2 diabetes in the UK Biobank. A Mediterranean-type lifestyle, culturally adapted to non-Mediterranean populations, could help prevent diabetes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12933-023-01999-x.

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Most cited references 53

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UK Biobank: An Open Access Resource for Identifying the Causes of a Wide Range of Complex Diseases of Middle and Old Age

Cathie Sudlow, John Gallacher, Naomi Allen … (2017)

Cathie Sudlow and colleagues describe the UK Biobank, a large population-based prospective study, established to allow investigation of the genetic and non-genetic determinants of the diseases of middle and old age.

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Global aetiology and epidemiology of type 2 diabetes mellitus and its complications

Sylvia Ley, Yan Zheng, Frank Hu (2017)

Globally, the number of people with diabetes mellitus has quadrupled in the past three decades, and diabetes mellitus is the ninth major cause of death. About 1 in 11 adults worldwide now have diabetes mellitus, 90% of whom have type 2 diabetes mellitus (T2DM). Asia is a major area of the rapidly emerging T2DM global epidemic, with China and India the top two epicentres. Although genetic predisposition partly determines individual susceptibility to T2DM, an unhealthy diet and a sedentary lifestyle are important drivers of the current global epidemic; early developmental factors (such as intrauterine exposures) also have a role in susceptibility to T2DM later in life. Many cases of T2DM could be prevented with lifestyle changes, including maintaining a healthy body weight, consuming a healthy diet, staying physically active, not smoking and drinking alcohol in moderation. Most patients with T2DM have at least one complication, and cardiovascular complications are the leading cause of morbidity and mortality in these patients. This Review provides an updated view of the global epidemiology of T2DM, as well as dietary, lifestyle and other risk factors for T2DM and its complications.

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Type 2 diabetes.

Melanie Davies, Sudesna Chatterjee, Kamlesh Khunti (2017)

415 million people live with diabetes worldwide, and an estimated 193 million people have undiagnosed diabetes. Type 2 diabetes accounts for more than 90% of patients with diabetes and leads to microvascular and macrovascular complications that cause profound psychological and physical distress to both patients and carers and put a huge burden on health-care systems. Despite increasing knowledge regarding risk factors for type 2 diabetes and evidence for successful prevention programmes, the incidence and prevalence of the disease continues to rise globally. Early detection through screening programmes and the availability of safe and effective therapies reduces morbidity and mortality by preventing or delaying complications. Increased understanding of specific diabetes phenotypes and genotypes might result in more specific and tailored management of patients with type 2 diabetes, as has been shown in patients with maturity onset diabetes of the young. In this Seminar, we describe recent developments in the diagnosis and management of type 2 diabetes, existing controversies, and future directions of care.

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Author and article information

Contributors

Mercedes Sotos-Prieto:

ORCID: http://orcid.org/0000-0001-9127-2586

mercedes.sotos@uam.es

Journal

Journal ID (nlm-ta): Cardiovasc Diabetol

Journal ID (iso-abbrev): Cardiovasc Diabetol

Title: Cardiovascular Diabetology

Publisher: BioMed Central (London )

ISSN (Electronic): 1475-2840

Publication date (Electronic): 4 October 2023

Publication date PMC-release: 4 October 2023

Publication date Collection: 2023

Volume: 22

Electronic Location Identifier: 271

Affiliations

[1 ]Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, ( https://ror.org/01cby8j38) Calle del Arzobispo Morcillo 4, Madrid, 28029 Spain

[2 ]GRID grid.466571.7, ISNI 0000 0004 1756 6246, CIBERESP (CIBER of Epidemiology and Public Health), ; Av. Monforte de Lemos, 3-5. 28029, Madrid, Spain

[3 ]Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet & Stockholm University, ( https://ror.org/056d84691) Stockholm, Sweden

[4 ]GRID grid.418921.7, ISNI 0000 0001 2348 8190, Foundation for Research and Biomedical Innovation of Primary Care of the Community of Madrid (FIIBAP), ; Av. de la Reina Victoria, 21, 6ª Planta, Madrid, 28003 Spain

[5 ]Hospital La Paz Institute for Health Research (IdIPAZ), ( https://ror.org/017bynh47) Paseo de la Castellana, 261, Madrid, 28046 Spain

[6 ]GRID grid.482878.9, ISNI 0000 0004 0500 5302, IMDEA-Food Institute. CEI UAM+CSIC, ; Ctra. de Canto Blanco 8, E. 28049, Madrid, Spain

[7 ]GRID grid.38142.3c, ISNI 000000041936754X, Department of Environmental Health, , Harvard T.H. Chan School of Public Health, ; 665 Huntington Avenue, Boston, MA 02115 USA

Author information

Mercedes Sotos-Prieto http://orcid.org/0000-0001-9127-2586

Article

Publisher ID: 1999

DOI: 10.1186/s12933-023-01999-x

PMC ID: 10552305

PubMed ID: 37794451

SO-VID: 44fc04c9-50ad-466e-85d4-0f5026896c46

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 23 May 2023

Date accepted : 19 September 2023

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100004593, Universidad Autónoma de Madrid;

Award ID: FPI contract

Funded by: FundRef http://dx.doi.org/10.13039/100014440, Ministerio de Ciencia, Innovación y Universidades;

Award ID: RYC 2018-02069I

Custom metadata

ScienceOpen disciplines: Endocrinology & Diabetes

Keywords: diet,physical activity,prevention,adult-onset diabetes,cohort,lifestyle medicine

Data availability:

ScienceOpen disciplines: Endocrinology & Diabetes

Keywords: diet, physical activity, prevention, adult-onset diabetes, cohort, lifestyle medicine

Association between a mediterranean lifestyle and Type 2 diabetes incidence: a prospective UK biobank study

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Abstract

Background

Methods

Results

Conclusions

Supplementary Information

Related collections

Journal of the ASEAN Federation of Endocrine Societies

Most cited references 53

UK Biobank: An Open Access Resource for Identifying the Causes of a Wide Range of Complex Diseases of Middle and Old Age

Global aetiology and epidemiology of type 2 diabetes mellitus and its complications

Type 2 diabetes.

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