Elsevier

Preventive Medicine

Volume 40, Issue 2, February 2005, Pages 145-151
Preventive Medicine

Physical activity, dietary intake and metabolic risk factors in non-diabetic daughters of patients with type II diabetes

https://doi.org/10.1016/j.ypmed.2004.05.004Get rights and content

Abstract

Background. It has been reported that the offspring of patients with type II diabetes have an adverse metabolic risk profile. This study aimed to investigate the impact of habitual physical activity and diet on metabolic risk factors in the daughters of patients with type II diabetes and control subjects.

Methods. Thirty-nine offspring and 39 age- and sex-matched controls completed physical activity and food intake diaries, during the week preceding a fasting blood sample.

Results. The offspring had higher body mass index, percentage body fat, and waist circumference than the control subjects (all P < 0.01). Fasting glucose and insulin, and insulin sensitivity estimated by the homeostasis model assessment (HOMAIR) method, were also higher in the offspring group (all P < 0.01). Daily energy expenditure was lower (P < 0.0001) in the offspring than control group. Dietary profile was not different between the groups. Daily energy expenditure was significantly correlated with waist circumference, fasting insulin, and HOMAIR (all P < 0.05) in offspring but not controls.

Conclusions. Offspring had a less favourable physical and metabolic profile and were less physically active than control subjects. In offspring, central adiposity and metabolic risk factors were influenced by habitual physical activity to a greater degree than in control subjects.

Introduction

The incidence of type II diabetes is increasing rapidly [1] and this is primarily believed to be due to increases in the prevalence of inactivity and obesity. Indeed, it has been suggested that being overweight with an abdominal fat distribution probably accounts for 80–90% [2], and a sedentary lifestyle accounts for at least 25% [3], of all type II diabetes incidence.

However, not all obese people develop diabetes, suggesting that while environmental factors, such as obesity, are probably necessary, they are not in themselves sufficient to precipitate this disease [2]. There is a high concordance of type II diabetes between monozygotic twins [4]. In addition, first degree relatives of patients with type II diabetes have a threefold higher risk of developing diabetes than their counterparts with no family history of diabetes [5], [6] and are often more insulin resistant than matched control subjects [7], [8], [9]. Furthermore, offspring of type II diabetic patients have increased levels of obesity [7], [8], [10] and greater susceptibility to the adverse effect of obesity on glycemia than their counterparts with no family history of diabetes [10]. Thus, the precipitation of metabolic dysfunction and type II diabetes is likely to be influenced not only by environmental factors but also by genetic susceptibility. However, because close family members live in a similar environment, familial lifestyle habits may also contribute to the increased incidence of diabetes seen in certain families.

Insulin resistance, a central feature of the metabolic syndrome, plays a primary role in the pathogenesis of type II diabetes and predates onset of the disease by one or two decades [11], [12]. Accumulating evidence suggests that the deterioration of insulin sensitivity and therefore impairment in insulin-mediated glucose disposal in the major glucose-utilising tissue, such as muscle, could be prevented by exercise. Epidemiological [13], [14], [15], [16] and controlled exercise training [17], [18], [19] studies demonstrate a clear link between physical activity and insulin resistance. Furthermore, several recent large-scale lifestyle intervention trials [20], [21], [22], [23] have shown that increased levels of physical activity can substantially reduce risk of developing type II diabetes in high-risk groups. It could therefore be hypothesised that the adverse metabolic risk profile evident in the offspring of patients with type II diabetes could be modulated by their habitual level of physical activity and/or by dietary intake.

Therefore, the aims of this study were to assess daily activity levels, dietary profile, and metabolic risk factors in the offspring of patients with type II diabetes and age- and sex-matched control subjects and to investigate the impact of habitual physical activity and diet on physical and metabolic profile in offspring and control groups.

Section snippets

Subjects

Subjects were recruited through workplace newsletter advertisements and posters. We also sent 140 letters to patients with type II diabetes asking their adult female offspring to take part in the study. Subjects were from similar socioeconomic backgrounds, with the majority being hospital workers (mainly nurses) and university staff of various grades. This study was carried out at two centres, namely, the University of Glasgow, United Kingdom, and the Lithuanian Academy of Physical Education,

Results

Physical and metabolic characteristics of the subjects are presented in Table 1. The offspring had higher BMI, percentage body fat, and waist circumference than the control subjects (all P < 0.01). The offspring were also more insulin resistant than the control subjects with higher fasting glucose and insulin concentrations and higher HOMAIR (all P < 0.01). There were no significant differences between groups for TG, total, LDL, or HDL cholesterol concentrations. Energy expenditure expressed

Discussion

The aim of this study was firstly to assess daily activity levels, dietary profile, and metabolic risk factors in the offspring of patients with type II diabetes and matched control subjects to determine whether activity levels or dietary profile differed between these two groups. Our second aim was to investigate whether the impact of habitual physical activity and diet on the physical and metabolic profile is different in offspring and control subjects.

In agreement with previous reports [7],

Acknowledgements

The authors acknowledge the financial support of Mars Incorporated. We would also like to thank Ms. Donna Taylor, Ms. Jill Sommerville, Ms. Abigail Fisher, and Ms. Sarah Crymble for their assistance in data collection.

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