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The Same, But Different

Quinn Phillips

October 23, 2013

People with diabetes often have to deal with other people’s misconceptions about their condition — for example, believing that it was caused by eating too much sugar, or that Type 1 and Type 2 diabetes are the same thing. Many people with diabetes relish the opportunity to explain that they can, in fact, eat anything someone without diabetes can. Now, a new study supports the idea that in diet and lifestyle, what’s good for someone with diabetes is the same as what’s good for most people — but when it comes to minimizing the risk of death, making good choices may be more important for people with diabetes.

The study, published last week by the journal Diabetologia, looked at participants in an enormous, previously completed European study on lifestyle, nutrition, and diseases. From this group, the researchers identified 6,384 participants with diabetes (type of diabetes was not identified) and 258,911 without diabetes. They built a statistical model that examined how participants’ risk of death was related to many factors identified in the study: body-mass index (BMI), intake of 26 different food groups, alcohol intake, physical activity level, and smoking status, among other factors. The researchers wanted to find out whether any of these factors affected the risk of death differently in people with or without diabetes.

As explained in an article on the study at Diabetes.co.uk, people with diabetes were 62% more likely than those without diabetes to die during the study’s 12-year follow-up period. Many lifestyle factors were found to be related to risk of death, but didn’t seem to affect people with and without diabetes any differently. Factors associated with a higher risk of death to a roughly equal degree in both groups included having a low or high BMI, drinking no alcohol or drinking in excess, having smoked or currently smoking, and getting less physical activity. When it came to dietary factors, though, certain foods that were associated with a higher or lower risk of death in people without diabetes had a more dramatic effect in people with diabetes. Foods in this category included fruits, legumes, nuts, seeds, pasta, poultry, and vegetable oil, all of which were associated with a reduced risk of death — with a deeper reduction seen in people with diabetes — and butter and margarine, which were associated with an increased risk of death, especially in people diabetes.

This study helps confirm the notion that there are no foods or lifestyle choices that are bad for people with diabetes but good for people without it, or vice versa. But its finding that certain foods lead to a greater benefit, or greater harm, in people with diabetes raises question of whether people with diabetes should receive different dietary advice — if receiving the same recommendations, but being told they matter more for you, counts as different advice.

What do you think — should health-care professionals point out what lifestyle factors are most important for the health of people with diabetes, or simply give recommendations in each area? Is it appropriate to mention the death risk associated with a lifestyle factor, or is this too morbid and not positive enough? Does your health-care team go over diet and lifestyle recommendations at your office checkups? If so, do they help you prioritize the changes you can make? Leave a comment below!



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