title: Adherence to healthy lifestyle factors and risk of death in men with diabetes mellitus: The Physicians' Health Study.
abstract: The relationship between healthy lifestyle factors and mortality in people with type 2 diabetes is unclear. The purpose of this study was to examine whether healthy lifestyle factors are associated with mortality in people with type 2 diabetes.
  
  
  
  We prospectively studied 1163 men with type 2 diabetes from the Physicians' Health Study. Lifestyle factors consisted of currently not smoking, moderate drinking (1-2 drinks/day), vigorous exercise (1+/week), BMI < 25 kg/m2, and being in the top 2 quintiles of the alternate healthy eating index-2010 (AHEI-2010). Multivariate Cox regression models were used to estimate hazard ratios (95% confidence intervals) of mortality.
  
  
  
  At baseline, average age was 69 years and mean follow up was 9 years. About 22% of study participants had ≤1 healthy lifestyle factor, 37% had two, 29% had three, and 12% had four or more healthy lifestyle factors. An inverse relationship was found between the number of lifestyle factors and total mortality. Compared with participants who had ≤1 healthy lifestyle factor, the risk of death was 42% (95% CI; 19%-58%) lower for those with two healthy lifestyle factors, 41% (95% CI; 18%-58%) lower for those with three, and 44% (95% CI; 12%-64%) lower for those with 4 or more healthy lifestyle factors.
  
  
  
  Adherence to modifiable healthy lifestyle factors is associated with a lower risk of death among adult men with type 2 diabetes. Our study emphasizes the importance of educating individuals with diabetes to adhere to healthy lifestyle factors.
authors.affiliation: Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. Electronic address: dryashpatel21@gmail.com.
authors.forename: Yash R
authors.initials: YR
authors.lastname: Patel
authors.affiliation: Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Taraka V
authors.initials: TV
authors.lastname: Gadiraju
authors.affiliation: Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC) and Geriatric Research, Education, and Clinical Research Center (GRECC), Boston Veterans Affairs Healthcare System, Boston, MA, USA.
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
authors.affiliation: Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC) and Geriatric Research, Education, and Clinical Research Center (GRECC), Boston Veterans Affairs Healthcare System, Boston, MA, USA.
authors.forename: Luc
authors.initials: L
authors.lastname: Djoussé
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D000070497:Healthy Lifestyle; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors
keywords: Diabetes mellitus; Epidemiology; Lifestyle; Mortality