The long term effect of dietary habits and physical activity on type 2 diabetes incidence: 10-year follow up of the ATTICA study (2002-2012)

Efi Koloverou, Demosthenes B Panagiotakos, Christos Pitsavos, Christina Chrysohoou, Ekavi N Georgousopoulou, Dimitris Toussoulis, Christodoulos Stefanadis



Aim: to record the 10-year diabetes incidence and investigate the effect of dietary habits and physical activity on its development.
Material and methods: from May 2001 to December 2002, 1514 men and 1528 women (>18 years) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, were enrolled in ATTICA study. Socio-demographic, clinical, lifestyle and biochemical characteristics were evaluated. Dietary habits were assessed through a validated semi-quantitative, food frequency questionnaire and physical activity through a translated, validated, version of International Physical Activity Questionnaire (IPAQ). Diabetes diagnosis was defined as glucose>125mg/dL or use of antidiabetic medication. In 2011-2012, the 10-year follow-up was performed.
Results: 191 incident cases of diabetes were documented, yielding an incidence of 12.9%. Medium and high adherence to the Mediterranean diet decreased 10-year diabetes risk by 49% (OR= 0.51, 95%CI: 0.30, 0.88) and 62% (OR=0.38, 95%CI: 0.16, 0.88) respectively. Moderate coffee consumption (≥250mL/day, adjusted for 28% caffeine containment) and low alcohol consumption (<1 glass/day) also decreased risk by 54% (OR=0.46, 95%CI: 0.24, 0.90) and 53% (OR=0.47, 95%CI: 0.26, 0.83), compared to abstention. Finally, moderate level of physical (331-1484 vs. <150 MET minutes/ week) led to a risk reduction of 44% (OR=0.56, 95% CI: 0.34, 0.92).
Conclusions: The present work reported the importance of non-pharmacological interventions in the primary prevention of diabetes. Mediterranean diet, moderate coffee consumption, low alcohol consumption, and moderate level of physical activity exert a beneficial effect against diabetes onset.

Keywords: incidence, Mediterranean diet, alcohol, coffee, physical activity