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REVIEW ARTICLE |
Department of Medicine, Beth Israel Deaconess Hospital (L.A.B.), Boston, Massachusetts
Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School and Department of Epidemiology, Harvard School of Public Health (S.L.),Boston, Massachusetts
Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention (M.S.), Atlanta, Georgia
Address correspondence to: Simin Liu, MD, ScD, FACN, Associate Professor of Medicine, Director of Nutrition Research, Division of Preventive Medicine, Harvard Medical School and Brigham and Women’s Hospital, 900 Commonwealth Avenue, Boston, MA 02215. E-mail: siminliu{at}hsph.harvard.edu
Diabetes mellitus is an epidemic of our time. This disease affects nearly 150 million adults worldwide and nearly 11 million in the United States in 2000. Because of the prevalence of obesity and diabetes and associated vascular complications, preventing even a small proportion of cases would save thousands of lives and billions of dollars in healthcare costs and lost productivity. Researchers have made great strides in identifying many lifestyle and dietary factors associated with diabetes, but solidifying the scientific basis for prevention and control of this disease as well as implementation at a national level remains a difficult challenge. The literature on the influence of diet and lifestyle in the development of diabetes is reviewed here, with emphasis on epidemiologic data. We outline a systematic approach to primary and secondary prevention of this disease by evaluating and prioritizing risk factors for which intervention is effective and developing a framework for application of intervention strategies. Effective interventions must target not only the affected individuals but also families, workplaces, schools and communities. Prevention of this devastating disease calls for the identification of culture-sensitive measures that can be applied to the population in general and some high-risk minority groups in particular.
Key words: type 2 diabetes mellitus, coronary heart disease, lifestyle, prevention
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