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Both birth weight and adult lifestyle raise diabetes risk

Joint effect of early and later life makes diabetes even more likely

Adrian O'Dowd

Thursday, 23 July 2015

Peoples’ risk of developing diabetes is even higher if they have both low birth weight and an unhealthy lifestyle in adulthood, concludes a new study* published in The BMJ.

US researchers found that people’s chances of developing diabetes were at their highest when both factors were present.

There are an estimated 387 million people living with diabetes globally and 4.9 million deaths were attributed to the condition in 2014.

Both unhealthy lifestyles and early life development problems have been linked to the rise of type 2 diabetes.

Previous studies have suggested that the relation between early life exposures and later life risk of type 2 diabetes may be modified by lifestyle in adulthood.

However, few studies have explored their joint effect on diabetes risk.

A US research team led by Dr Lu Qi, associate professor of nutrition and epidemiology at Harvard School of Public Health in Boston and associate professor at Harvard Medical School, therefore, set out to assess the joint association of birth weight and established lifestyle risk factors in adulthood with type 2 diabetes.

They used data from three large ongoing trials and tracked 149,794 healthy men and women for 20-30 years.

These people’s birth weight was recorded and detailed information on lifestyle habits and medical history was collected every two years.

Five lifestyle factors - diet, smoking, physical activity, alcohol consumption, and body mass index (BMI) - were used to calculate an unhealthy lifestyle score.

During the period of the study, the researchers documented 11,709 new cases of type 2 diabetes.

They found consistent associations between low birth weight and risk of type 2 diabetes and a similar association with unhealthy lifestyle.

However, they also found there was a significant combined link between birth weight and unhealthy lifestyle on risk of type 2 diabetes.

Their findings showed the attributable proportions of joint effect were 22% for lower birth weight alone, 59% to unhealthy lifestyle alone, and 17% to their interaction.

This means that 17% of diabetes cases would occur if both lower birth weight and unhealthier lifestyle were present, but not if only one was present.

The researchers said their findings emphasise the importance of adopting a healthy lifestyle to prevent the majority of type 2 diabetes cases.

They concluded: “The findings suggest that most cases of type 2 diabetes cases could be prevented by the adoption of a healthier lifestyle, but simultaneous improvement of both prenatal and postnatal factors could further prevent additional cases.”

* Yanping Li, et al. Birth weight and later life adherence to unhealthy lifestyles in predicting type 2 diabetes: prospective cohort study. BMJ 2015;351:h3672. DOI: 10.1136/bmj.h3672

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