CPH Faculty Author Article on Type 2 Diabetes
Dr. Ying Liu, Assistant Professor in the Department of Biostatistics and Epidemiology of the East Tennessee State University College of Public Health, is lead author of an article published in the Journal of Diabetes. The article, “Associations of lifestyle factors (smoking, alcohol consumption, diet and physical activity) with type 2 diabetes among American adults from National Health and Nutrition Examination Survey (NHANES) 2005–2014,” highlights unhealthy lifestyles that can lead to many health problems, especially type 2 diabetes.
Drs. Kesheng Wang and Shimin Zheng, Associate Professors, along with Drs. Mildred Maisonet and Liang Wang, Assistant Professors in the Department of Biostatistics and Epidemiology, are co-authors.
The article examined various lifestyle factors, including smoking, alcohol consumption, physical activity, and diet, to determine their association with type 2 diabetes in American adults. Data for 12,987 American adults participating in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2014 were evaluated. Participants were classified as having type 2 diabetes when they answered "yes" to the question “Other than during pregnancy, have you ever been told by a doctor or other health professional that you had diabetes or an elevated blood sugar level?”
Dr. Liu states, “Using up-to-date NHANES survey data, we report on the latest 10-year prevalence trends for type 2 diabetes among American adults.”
The study found that, over time, there was a significant increasing prevalence trend for type 2 diabetes among American adults. Smokers and individuals consuming more than 12 alcoholic drinks in the past year were less likely to report having type 2 diabetes than non-smokers and those consuming less than 12 alcoholic drinks. Participants with light physical activity have a greater likelihood of having type 2 diabetes than those engaging in vigorous physical activity. Individuals consuming a poor diet were more likely to report having type 2 diabetes than those eating an excellent diet. All these relationships remained significant after adjustment for demographics and socioeconomic status.
Dr. Liu explains, "The reasons for the lack of the expected positive association between type 2 diabetes and both smoking and alcohol consumption in the present study are not clear. However, we can speculate on some possible explanations. It is well known that smoking and excessive alcohol consumption are significant modifiable risk factors for cardiovascular disease and other chronic diseases, such as type 2 diabetes. Naturally, diabetic patients tend to pay more attention to their lifestyle than non-diabetics."
She continues, "Over the duration of type 2 diabetes treatment, there is a high probability that patients will quit or reduce smoking or alcohol consumption to comply with physicians’ recommendations. Therefore, it is not surprising that a smaller percentage of diabetic individuals were smokers and drank a lot of alcoholic beverages in the present study. These findings may indicate the success of campaigns to reduce alcohol consumption and tobacco smoking among diabetics.”
The researchers conclude all four lifestyle factors were significantly associated with type 2 diabetes among American adults. The findings of the present study provide useful information for healthcare providers that may help them promote specific lifestyle modifications.
“The results indicated that diet quality, the intensity of physical activity, smoking status, and alcohol consumption are significantly associated with type 2 diabetes, with different directions among US adults,” continues Dr. Liu. “This finding can provide guidance for campaigns to reduce the number of patients with type 2 diabetes.”