New research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]) suggests that lifestyle advice for people with diabetes should be no different from that for the general public, although those with diabetes may benefit more from that same advice. The research is by Dr Diewertje Sluik, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany, and colleagues.

In this new study, the researchers investigated whether the associations between lifestyle factors and mortality risk differ between individuals with and without diabetes.

Within the European Prospective Investigation into Cancer and Nutrition (EPIC), a cohort was formed of 6,384 persons with diabetes and 258,911 EPIC participants without known diabetes. Computer modelling was used to explore the relationship (in both those with and without diabetes) of mortality with the following risk factors: body-mass index, waist/height ratio, 26 food groups, alcohol consumption, leisure-time physical activity, smoking.

Unsurprisingly, the researchers found that overall mortality was 62% higher in people with diabetes compared with those without. Intake of fruit, vegetables, nuts, seeds, pasta, poultry and vegetable oil was related to a lower mortality risk, and intake of butter and margarine was related to an increased mortality risk. While the strength of the association was different in those with diabetes versus those without, the associations were in the same direction in each case (see table 2 full paper). No differences between people with and without diabetes were detected for the other lifestyle factors including adiposity, alcohol consumption, physical activity, and smoking.

The authors say: "It appears that the intake of some food groups is more beneficial (fruits, legumes, nuts, seeds, pasta, poultry, vegetable oil) or more detrimental (soft drinks, butter, margarine, cake, cookies) with respect to mortality risk in people with diabetes. This may indicate that individuals with diabetes may benefit more from a healthy diet than people without diabetes. However, since the directions of association were generally the same, recommendations for a healthy diet should be similar for people with or without diabetes."