The DOI matches its Crossref record; 44 of the 44 references it cites were found in a registry or an index.
Lifestyle Risk Factors and New-Onset Diabetes Mellitus in Older Adults: The Cardiovascular Health Study
Open accessAbstract
BACKGROUND: The combined impact of lifestyle factors on incidence of diabetes mellitus later in life is not well established. The objective of this study was to determine how lifestyle factors, assessed in combination, relate to new-onset diabetes in a broad and relatively unselected population of older adults. METHODS: We prospectively examined associations of lifestyle factors, measured using repeated assessments later in life, with incident diabetes mellitus during a 10-year period (1989-1998) among 4883 men and women 65 years or older (mean [SD] age at baseline, 73 [6] years) enrolled in the Cardiovascular Health Study. Low-risk lifestyle groups were defined by physical activity level (leisure-time activity and walking pace) above the median; dietary score (higher fiber intake and polyunsaturated to saturated fat ratio, lower trans-fat intake and lower mean glycemic index) in the top 2 quintiles; never smoked or former smoker more than 20 years ago or for fewer than 5 pack-years; alcohol use (predominantly light or moderate); body mass index less than 25 (calculated as weight in kilograms divided by height in meters squared); and waist circumference of 88 cm for women or 92 cm for men. The main outcome measure was incident diabetes defined annually by new use of insulin or oral hypoglycemic medications. We also evaluated fasting and 2-hour postchallenge glucose levels. RESULTS: During 34,539 person-years, 337 new cases of drug-treated diabetes mellitus occurred (9.8 per 1000 person-years). After adjustment for age, sex, race, educational level, and annual income, each lifestyle factor was independently associated with incident diabetes. Overall, the rate of incident diabetes was 35% lower (relative risk, 0.65; 95% confidence interval, 0.59-0.71) for each 1 additional lifestyle factor in the low-risk group. Participants whose physical activity level and dietary, smoking, and alcohol habits were all in the low-risk group had an 82% lower incidence of diabetes (relative risk, 0.18; 95% confidence interval, 0.06-0.56) compared with all other participants. When absence of adiposity (either body mass index <25 or waist circumference < or =88/92 cm for women/men) was added to the other 4 low-risk lifestyle factors, incidence of diabetes was 89% lower (relative risk, 0.11; 95% confidence interval, 0.01-0.76). Overall, 9 of 10 new cases of diabetes appeared to be attributable to these 5 lifestyle factors. Associations were slightly attenuated, but still highly significant, for incident diabetes defined by medication use or glucose level. CONCLUSION: Even later in life, combined lifestyle factors are associated with a markedly lower incidence of new-onset diabetes mellitus.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“A cohort study found that alcohol and smoking also increased the risk of T2D, even in individuals who were classified as having low-risk diet and physical activity profiles.78”
From A review of current trends with type 2 diabetes epidemiology, aetiology, pathogenesis, treatments and future perspectives (2021) · cites this paper as [78]
In the citing paper
“Most of these burdens are preventable and are occurring at unnecessarily younger ages, largely owing to suboptimal lifestyle, which includes poor diet quality, excess caloric intake, physical inactivity, and smoking.2–5”
From Components of a Cardioprotective Diet: New Insights (2011) · cites this paper as [5]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011
Grundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., Gordon, D. J., Krauss, R. M., Savage, P. J., Smith, S. C., et al. (2005) · Circulation · doi:10.1161/circulationaha.105.169404 · Cited by 11,961
Tuomilehto, J., Lindström, J., Eriksson, J. G., Valle, T. T., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louheranta, A., Rastas, M., et al. (2001) · New England Journal of Medicine · doi:10.1056/nejm200105033441801 · Cited by 10,873
The Cardiovascular Health Study: design and rationale.
Fried, L. P., Borhani, N. O., Enright, P., Furberg, C. D., Gardin, J. M., Kronmal, R. A., Kuller, L. H., Manolio, T. A., Mittelmark, M. B., Newman, A., et al. (1991) · Annals of Epidemiology · doi:10.1016/1047-2797(91)90005-w · Cited by 3,652
Diet, lifestyle, and the risk of type 2 diabetes mellitus in women.
Hu, F. B., Manson, J. E., Stampfer, M. J., Colditz, G., Liu, S., Solomon, C. G., & Willett, W. C. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa010492 · Cited by 2,901
Rimm, E. B., Giovannucci, E. L., Stampfer, M. J., Colditz, G. A., Litin, L. B., & Willett, W. C. (1992) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a116211 · Cited by 2,104
Primary Prevention of Coronary Heart Disease in Women through Diet and Lifestyle
Stampfer, M. J., Hu, F. B., Manson, J. E., Rimm, E. B., & Willett, W. C. (2000) · New England Journal of Medicine · doi:10.1056/nejm200007063430103 · Cited by 1,794
Physical activity and reduced occurrence of non–insulin-dependent diabetes mellitus
Helmrich, S. P., Ragland, D. R., Leung, R. W., & Paffenbarger, R. S. (1991) · New England Journal of Medicine · doi:10.1056/nejm199107183250302 · Cited by 1,634
Rimm, E. B., Williams, P., Fosher, K., Criqui, M., & Stampfer, M. J. (1999) · BMJ · doi:10.1136/bmj.319.7224.1523 · Cited by 1,360
Active Smoking and the Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis
Willi, C., Bodenmann, P., Ghali, W. A., Faris, P. D., & Cornuz, J. (2007) · JAMA · doi:10.1001/jama.298.22.2654 · Cited by 1,268
Wang, Y., Rimm, E. B., Stampfer, M. J., Willett, W. C., & Hu, F. B. (2005) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/81.3.555 · Cited by 1,127
Feskanich, D., Rimm, E. B., Giovannucci, E. L., Colditz, G. A., Stampfer, M. J., Litin, L. B., & Willett, W. C. (1993) · Journal of the American Dietetic Association · doi:10.1016/0002-8223(93)91754-e · Cited by 1,070
Physical Activity and Cardiovascular Health
(1996) · JAMA · doi:10.1001/jama.276.3.241 · Cited by 1,007
Hu, F. B., Sigal, R. J., Rich-Edwards, J. W., Colditz, G. A., Solomon, C. G., Willett, W. C., Speizer, F. E., & Manson, J. E. (1999) · JAMA · doi:10.1001/jama.282.15.1433 · Cited by 914
Carey, V. J., Walters, E. E., Colditz, G. A., Solomon, C. G., Willet, W. C., Rosner, B. A., Speizer, F. E., & Manson, J. E. (1997) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009158 · Cited by 827
Dietary fat intake and risk of type 2 diabetes in women
Salmerón, J., Hu, F. B., Manson, J. E., Stampfer, M. J., Colditz, G. A., Rimm, E. B., & Willett, W. C. (2001) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/73.6.1019 · Cited by 818
Bassuk, S. S., & Manson, J. E. (2005) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00160.2005 · Cited by 744
WEIGHT AS A RISK FACTOR FOR CLINICAL DIABETES IN WOMEN
Colditz, G. A., Willett, W. C., Stampfer, M. J., Manson, J. E., Hennekens, C. H., Arky, R. A., & Speizer, F. E. (1990) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115686 · Cited by 733
Surveillance and ascertainment of cardiovascular events
Ives, D. G., Fitzpatrick, A. L., Bild, D. E., Psaty, B. M., Kuller, L. H., Crowley, P. M., Cruise, R. G., & Theroux, S. (1995) · Annals of Epidemiology · doi:10.1016/1047-2797(94)00093-9 · Cited by 688
Moderate Alcohol Consumption Lowers the Risk of Type 2 Diabetes
Koppes, L. L. J., Dekker, J. M., Hendriks, H. F. J., Bouter, L. M., & Heine, R. J. (2005) · Diabetes Care · doi:10.2337/diacare.28.3.719 · Cited by 671
Association between Physical Activity and Markers of Inflammation in a Healthy Elderly Population
Geffken, D. F., Cushman, M., Burke, G. L., Polak, J. F., Sakkinen, P. A., & Tracy, R. P. (2001) · American Journal of Epidemiology · doi:10.1093/aje/153.3.242 · Cited by 599
The Diabetes Prevention Program Research Group (2005) · Diabetes Care · doi:10.2337/diacare.28.4.888 · Cited by 572
Recruitment of adults 65 years and older as participants in the cardiovascular health study
Tell, G. S., Fried, L. P., Hermanson, B., Manolio, T. A., Newman, A. B., & Borhani, N. O. (1993) · Annals of Epidemiology · doi:10.1016/1047-2797(93)90062-9 · Cited by 558
Methods of assessing prevalent cardiovascular disease in the Cardiovascular Health Study
Psaty, B. M., Kuller, L. H., Bild, D. E., Burke, G. L., Kittner, S. J., Mittelmark, M. B., Price, T. R., Rautaharju, P. M., & Robbins, J. B. (1995) · Annals of Epidemiology · doi:10.1016/1047-2797(94)00092-8 · Cited by 446
Newman, A. B., Lee, J. S., Visser, M., Goodpaster, B. H., Kritchevsky, S. B., Tylavsky, F. A., Nevitt, M., & Harris, T. B. (2005) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/82.4.872 · Cited by 445
Livesey, G., Taylor, R., Hulshof, T., & Howlett, J. (2008) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/87.1.258s · Cited by 439
Studies in the Distribution of Body Fat
Shimokata, H. (1989) · JAMA · doi:10.1001/jama.261.8.1169 · Cited by 426
Lynch, J. (1996) · Archives of Internal Medicine · doi:10.1001/archinte.1996.00440110073010 · Cited by 366
Smoking induces insulin resistance—a potential link with the insulin resistance syndrome
ATTVALL, S., FOWELIN, J., LAGER, I., VON SCHENCK, H., & SMITH, U. (1993) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.1993.tb00680.x · Cited by 363
Anderson, J. W., Randles, K. M., Kendall, C. W. C., & Jenkins, D. J. A. (2004) · Journal of the American College of Nutrition · doi:10.1080/07315724.2004.10719338 · Cited by 350
Psaty, B. M. (1992) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(92)90143-b · Cited by 317
The Diabetes Prevention Program Research Group [Prepared by Jill Crandall, D. S. (2006) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/61.10.1075 · Cited by 254
Carlsson, S., Hammar, N., & Grill, V. (2005) · Diabetologia · doi:10.1007/s00125-005-1768-5 · Cited by 239
Carnethon, M. R., Prineas, R. J., Temprosa, M., Zhang, Z.-M., Uwaifo, G., Molitch, M. E., & for the Diabetes Prevention Program Research Group (2006) · Diabetes Care · doi:10.2337/diacare.29.04.06.dc05-1729 · Cited by 220
Self-citationAcute Effect of Cigarette Smoking on Glucose Tolerance and Other Cardiovascular Risk Factors
Frati, A. C., Iniestra, F., & Ariza, C. R. (1996) · Diabetes Care · doi:10.2337/diacare.19.2.112 · Cited by 206
Cigarette Smoking and Increased Central Adiposity
Barrett-Connor, E. L., & Khaw, K. (1989) · Annals of Internal Medicine · doi:10.7326/0003-4819-111-10-783 · Cited by 201
Siscovick, D. S., Fried, L. P., Mittelmark, M. B., Rutan, G. H., Bild, D. E., & O’Leary, D. H. (1997) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a009066 · Cited by 163
Self-citationSmoking cessation improves insulin sensitivity in healthy middle‐aged men
Eliasson, B., Attvall, S., Taskinen, M., & Smith, U. (1997) · European Journal of Clinical Investigation · doi:10.1046/j.1365-2362.1997.1330680.x · Cited by 151
Glycemic Effects of Moderate Alcohol Intake Among Patients With Type 2 Diabetes
Shai, I., Wainstein, J., Harman-Boehm, I., Raz, I., Fraser, D., Rudich, A., & Stampfer, M. J. (2007) · Diabetes Care · doi:10.2337/dc07-1103 · Cited by 134 · cited 5×
“76) 40 (20-56) Physical activity level medianb Dietary score upper 2 quintilesc 3 Low-risk lifestyle factors 12.”
InfluentialDietary assessment using a picture-sort approach
Kumanyika, S., Tell, G. S., Shemanski, L. R., Martel, J., & Chinchilli, V. (1997) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/65.4.1123s · Cited by 108
Vasdev, S., Gill, V. D., & Singal, P. K. (2006) · Vascular Health and Risk Management · doi:10.2147/vhrm.2006.2.3.263 · Cited by 70
Eating patterns of community-dwelling older adults: The cardiovascular health study
Kumanyika, S., Tell, G. S., Shemanski, L. R., Polak, J. F., & Savage, P. J. (1994) · Annals of Epidemiology · doi:10.1016/1047-2797(94)90076-0 · Cited by 39
Dietrich, T., García, R. I., de Pablo, P., Schulze, P. C., & Hoffmann, K. (2007) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/hjr.0b013e328270b913 · Cited by 36
Past and Current Smoking in Relation to Body Fat Distribution in Older Men and Women
Visser, M., Launer, L. J., Deurenberg, P., & Deeg, D. J. H. (1999) · The Journals of Gerontology Series A · doi:10.1093/gerona/54.6.m293 · Cited by 27
Flagged first, then by citations
Research works printed but not linked: 1
- [34]Levitzky YS Guo CY Rong J Relation of smoking status to a panel of inflammatory markers: the Framingham offspring [published online ahead of print] Atherosclerosis 2008 PMC2783981 18289552
Cited by
Sorted by citations
Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association
Benjamin, E. J., Blaha, M. J., Chiuve, S. E., Cushman, M., Das, S. R., Deo, R., de Ferranti, S. D., Floyd, J., Fornage, M., Gillespie, C., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000485 · Cited by 12,591
Self-citationHeart Disease and Stroke Statistics—2012 Update: A Report From the American Heart Association
Writing Group Members, Roger, V. L., Go, A. S., Lloyd-Jones, D. M., Benjamin, E. J., Berry, J. D., Borden, W. B., Bravata, D. M., Dai, S., Ford, E. S., et al. (2012) · Circulation · doi:10.1161/cir.0b013e31823ac046 · Cited by 7,333
Self-citationHeart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., Das, S. R., de Ferranti, S., Després, J.-P., Fullerton, H. J., et al. (2016) · Circulation · doi:10.1161/cir.0000000000000350 · Cited by 6,596
Self-citationHeart Disease and Stroke Statistics—2011 Update: A Report From the American Heart Association
Roger, V. L., Go, A. S., Lloyd-Jones, D. M., Adams, R. J., Berry, J. D., Brown, T. M., Carnethon, M. R., Dai, S., de Simone, G., Ford, E. S., et al. (2011) · Circulation · doi:10.1161/cir.0b013e3182009701 · Cited by 6,149
Self-citationHeart Disease and Stroke Statistics—2015 Update: A Report From the American Heart Association
Mozaffarian, D., Benjamin, E. J., Go, A. S., Arnett, D. K., Blaha, M. J., Cushman, M., de Ferranti, S., Després, J.-P., Fullerton, H. J., Howard, V. J., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000152 · Cited by 5,797
Self-citation
Metadata
- Authors
- Mozaffarian, D., Kamineni, A., Carnethon, M., Djoussé, L., Mukamal, K. J., & Siscovick, D.
- Affiliations
- Brigham and Women's Hospital (US)
- Northwestern University (US)
- ORCID
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2009-04-27
- Volume
- 169
- Issue
- 8
- Pages
- 798
- ISSN
- 0003-9926 (ISSN-L)
- PMC
- PMC2828342
- OpenAlex
- W2017242961
- Cited by
- 358
- References
- 44
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 12 · 2023: 12 · 2022: 17 · 2021: 22 · 2020: 17 · 2019: 13 · 2018: 16 · 2017: 23 · 2016: 19 · 2015: 23 · 2014: 41 · 2013: 27 · 2012: 32
- FWCI
- 24.44
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01hc085082-026, n01hc085081-021, n01hc045133-001, n01hc085079-024, n01hc015103-009, n01hc085084-005, n01hc085085-011, n01hc085083-027, n01hc085080-026, n01hc085086-022, n01hc55222-0-0-0, n01hc075150-004, n01hc035129-010, 1k08hl075628-01)
- National Heart, Lung, and Blood Institute (N01-HC-85081, N01HC85085, N01 HC085086, N01HC-85083, K01HL070444, K08-HL-075628, N01 HC085079, N01HC85082, N01HC‐75150, N01 HC85086, N01 HC035129, N01HC85080, N01 HC015103, N01 HC55222, U01HL080295, N01 HC055222, K01 HL-70444, N01 HC075150, N01 HC045133, N01-HC85079, N01-HC85084)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Keywords
- new-onset diabetes, lifestyle risk factors, older adults, physical activity, dietary fiber, dietary fat, smoking, alcohol consumption, body mass index, waist circumference, adiposity, diabetes incidence, Cardiovascular Health Study, weight loss
- MeSH terms
- Aged, Aged, 80 and over, Diabetes Mellitus, Type 2, Female, Humans, Life Style, Male, Prospective Studies, Risk Factors, United States, Incidence, Age of Onset, National Heart, Lung, and Blood Institute (U.S.)
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
