title: Role of adiposity and lifestyle in the relationship between family history of diabetes and 20-year incidence of type 2 diabetes in U.S. women.
abstract: OBJECTIVE
  To evaluate to what extent the association between family history of diabetes and risk of type 2 diabetes can be explained by excess adiposity and lifestyle risk factors.
  
  
  METHODS
  We analyzed data from 73,227 women who participated in the Nurses' Health Study cohort. A family history of diabetes was defined as having at least one first-degree family member with diabetes. Lifestyle factors, weight, and height were assessed by using validated questionnaires, and BMI was calculated. The relative risk of type 2 diabetes was estimated using Cox proportional hazards analysis.
  
  
  RESULTS
  We documented 5,101 cases of type 2 diabetes during 20 years of follow-up. The age-adjusted relative risk of type 2 diabetes in participants with a family history was 2.27 (95% CI 2.14-2.40) compared with the risk in those without a family history of diabetes. Participants with a family history of diabetes had a higher BMI and were more likely to have a parental history of obesity. BMI explained 21.1% (19.4-22.9) of the association between family history of diabetes and risk of type 2 diabetes. Intakes of red meat, alcohol, and sugar-sweetened beverages explained 1.1% (0.8-1.3), 4.8% (4.3-5.3), and 2.8% (2.4-3.2) of this association, respectively.
  
  
  CONCLUSIONS
  These results suggest that excess adiposity and, to a lesser extent, specific dietary habits can explain a substantial part of the association between having a family history of diabetes and risk of type 2 diabetes.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA. e.vantriet@vumc.nl
authors.forename: Esther
authors.initials: E
authors.lastname: van 't Riet
authors.forename: Jacqueline M
authors.initials: JM
authors.lastname: Dekker
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.forename: Giel
authors.initials: G
authors.lastname: Nijpels
authors.forename: Frank B
authors.initials: FB
authors.lastname: Hu
authors.forename: Rob M
authors.initials: RM
authors.lastname: van Dam
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D049628:Body Size / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D014481:United States / Q000453:epidemiology