Lifestyle factors associated with glycaemic control and body mass index in older adults with diabetes.
OBJECTIVE
To investigate the relations between lifestyle factors (diet and exercise), glycated haemoglobin (HbA(1c)) and body mass index (BMI) in older adults with diabetes.


METHODS
A community hospital-based cross-sectional study of 150 noninstitutionalized, ambulatory adults (>/=65 y) with diabetes, residing within New Zealand's Kapiti region.


METHODS
Patients were recruited from all general practices; two diabetes clinics; local diabetes society and through advertisements in community newspapers. A total of 211 eligible people were identified, but 60 refused to participate and one withdrew. In all, 150 people completed the study (71% participation rate).


METHODS
Nutrient intakes were calculated by a food-frequency questionnaire. Physical activity was assessed by interview using a validated questionnaire. Medical history and demographic data were obtained by interview or self-completed questionnaires; height, weight and HbA(1c) were measured. Multivariate models using bootstrapping and stepwise linear regression were used to select factors associated with HbA(1c) and BMI.


RESULTS
Each five-unit increase in energy from dietary saturated fat and five-unit increase in BMI were associated with 6% (95% confidence interval=2-10%; P=0.004) and 4% (0.3-7%; P=0.031) increases in HbA(1c), respectively. For females with moderate, compared with low overall activity, there was a 14% (7-20%; P=0.000) reduction in BMI while for males the reduction was only 5% (-1-11%; P=0.116). BMI decreased 5% (2-9%; P=0.004) with each 10-y increase in age, while a five-unit increment in energy from dietary sucrose was associated with a 6% (1-11%; P=0.025) increase in BMI.


CONCLUSIONS
Reducing dietary saturated fat and excess body weight may be useful means of improving glycaemic control in older adults with diabetes. Increasing physical activity and reducing energy from dietary sucrose may assist weight control, the former particularly in women.
Paraparaumu Hospital, Capital and Coast Health, Private Bag, Wellington, New Zealand. grylls@compuserve.com
W K
WK
Grylls
J E
JE
McKenzie
C C
CC
Horwath
J I
JI
Mann
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology / Q000378:metabolism*; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D002149:Energy Intake / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008019:Life Style; D016014:Linear Models; D008297:Male; D012737:Sex Factors; D011795:Surveys and Questionnaires; D015431:Weight Loss / Q000502:physiology
D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D006442:Glycated Hemoglobin