title: Diagnosis of diabetes mellitus or cardiovascular disease and lifestyle changes - the Doetinchem cohort study.
abstract: OBJECTIVE
  To study whether being diagnosed with a cardiovascular disease (CVD) or diabetes mellitus (DM) is associated with improvements in lifestyles.
  
  
  METHODS
  We used data from the Doetinchem Cohort Study, a prospective study among 6386 Dutch men and women initially aged 20-59years who were examined four times over 15years (1987-2007). Logistic and linear regression models were used to assess the effect of a self-reported diagnosis of CVD (n=403) or DM (n=221) on smoking, alcohol consumption, weight, diet and physical activity.
  
  
  RESULTS
  Self-reported diagnosis of CVD increased rates of smoking cessation (OR=2.2, 95%CI 1.6 - 3.1). Adults reporting a diagnosis of DM (relatively) decreased weight (3.2%, 95%CI 2.2 - 4.2), (relatively) decreased energy intake (4.2%, 95%CI 0.7 - 7.7), decreased energy percentage from saturated fat (0.4%, 95%CI 0.0 - 0.9) and increased fish consumption (2.8 g/day, 95%CI 0.4 - 5.1). A self-reported diagnosis of CVD or DM was not associated with changes in physical activity.
  
  
  CONCLUSIONS
  A diagnosis of CVD or DM may act, along with possible effects of medical treatment, as a trigger to adopt a healthier lifestyle in terms of smoking cessation, healthier diet and weight loss.
authors.affiliation: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands; University of Utrecht, The Netherlands. Electronic address: A.manschot@online.nl.
authors.forename: A
authors.initials: A
authors.lastname: Manschot
authors.affiliation: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: Sandra.van.oostrom@rivm.nl.
authors.forename: S H
authors.initials: SH
authors.lastname: van Oostrom
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: H.A.Smit-3@umcutrecht.nl.
authors.forename: H A
authors.initials: HA
authors.lastname: Smit
authors.affiliation: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: Monique.verschuren@rivm.nl.
authors.forename: W M M
authors.initials: WM
authors.lastname: Verschuren
authors.affiliation: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: Susan.picavet@rivm.nl.
authors.forename: H S J
authors.initials: HS
authors.lastname: Picavet
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology; D002149:Energy Intake / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D010808:Physical Examination; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D012907:Smoking / Q000453:epidemiology*; D012923:Social Class; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Alcohol; BMI; Body Mass Index; CVD; Cardiovascular Disease; Cardiovascular disease; DCS; DM; Diabetes Mellitus; Diet; Doetinchem Cohort Study; GEE; Generalized estimating equations; Physical activity; Prospective cohort study; Smoking; Weight