title: Influence of familial risk on diabetes risk-reducing behaviors among U.S. adults without diabetes.
abstract: OBJECTIVE
  To test the association of family history of diabetes with the adoption of diabetes risk-reducing behaviors and whether this association is strengthened by physician advice or commonly known factors associated with diabetes risk.
  
  
  METHODS
  We used cross-sectional data from the 2005-2008 National Health and Nutrition Examination Survey (NHANES) to examine the effects of family history of diabetes on the adoption of selected risk-reducing behaviors in 8,598 adults (aged ≥20 years) without diabetes. We used multiple logistic regression to model three risk reduction behaviors (controlling or losing weight, increasing physical activity, and reducing the amount of dietary fat or calories) with family history of diabetes.
  
  
  RESULTS
  Overall, 36.2% of U.S. adults without diabetes had a family history of diabetes. Among them, ~39.8% reported receiving advice from a physician during the past year regarding any of the three selected behaviors compared with 29.2% of participants with no family history (P < 0.01). In univariate analysis, adults with a family history of diabetes were more likely to perform these risk-reducing behaviors compared with adults without a family history. Physician advice was strongly associated with each of the behavioral changes (P < 0.01), and this did not differ by family history of diabetes.
  
  
  CONCLUSIONS
  Familial risk for diabetes and physician advice both independently influence the adoption of diabetes risk-reducing behaviors. However, fewer than half of participants with familial risk reported receiving physician advice for adopting these behaviors.
authors.affiliation: Ofﬁce of Public Health Genomics, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. mdc9@cdc.gov
authors.forename: Man-Huei
authors.initials: MH
authors.lastname: Chang
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Valdez
authors.forename: Renée M
authors.initials: RM
authors.lastname: Ned
authors.forename: Tiebin
authors.initials: T
authors.lastname: Liu
authors.forename: Quanhe
authors.initials: Q
authors.lastname: Yang
authors.forename: Ajay
authors.initials: A
authors.lastname: Yesupriya
authors.forename: Nicole F
authors.initials: NF
authors.lastname: Dowling
authors.forename: James B
authors.initials: JB
authors.lastname: Meigs
authors.forename: Michael S
authors.initials: MS
authors.lastname: Bowen
authors.forename: Muin J
authors.initials: MJ
authors.lastname: Khoury
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000235:genetics / Q000517:prevention & control*; D005260:Female; D020022:Genetic Predisposition to Disease; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology