Bicycle Network: Health Matters
Learnings from AusDiab 2012
Baker IDI has just released Ausdiab 2012 The Australian Diabetes, Obesity And Lifestyle Study (AusDiab3). This is the landmark third study of a group of 11,000 Australians who have now been interviewed and tested three times over twelve years - the first time this approach has been followed in a developed nation.
21 August 2013
Diabetes, says the Baker IDI Heart and Diabetes Institute (Baker IDI), Is 'one of the most challenging public health problems of our time'.
Baker IDI has just released Ausdiab 2012 The Australian Diabetes, Obesity And Lifestyle Study (AusDiab3). This is the landmark third study of a group of 11,000 Australians who have now been interviewed and tested three times over twelve years. The first time this approach has been followed in a developed nation.
The report reminds that diabetes can strike by itself but also that it travels with a gang of related diseases that inflict heart, eye and kidney disease on sufferers.
People in the survey who had diabetes were more likely to be depressed, twice as likely to suffer cognitive impairment and five times more likely to die than people with normal glucose tolerance – it is a similar risk to that faced by smokers.
Taxpayers are also hit hard by the chronic diseases as the sufferers’ visits to GPs and hospitals increase.
Am I at risk?
Chapters in the report consider the risk factors that are tested by GPs and medical specialists such as glucose tolerance, cholesterol and blood pressure.
In addition the report outlines risk factors that can be assessed at home: age, gender, socio economic status, obesity and physical activity.
Diabetes strikes both men and women. For men the risk of diabetes rises until the age of 55 when it plateaus. Women face increased risk until the age of 65.
AusDiab3 showed that the AusDrisk test is a good predictor. You can take it here.
The report found that people who lived in areas that are more socio-economically disadvantaged had higher risk of diabetes. Specifically those in category one (highest level of disadvantage) had double the risk of those in category five.
Overweight people are twice as likely to get diabetes and obese people are five times more likely to contract the disease.
Obesity is usually assessed using a rule of thumb measure called the Body Mass Index. AusDiab also used the waist circumference classification endorsed by the International Diabetes Federation and generally recognised as a a better predictor of risk. This defines the risk boundary as when your waist measurement is greater than 94cm (men) and 80cm (women).
People tracked by the survey got fatter and wider over the twelve years.
Those aged 25 – 34 gained the most weight and showed the greatest increase in waist measurement.
All the weight groups – normal, overweight and obese – gained weight over the twelve years especially people in remote areas. Throughout the survey a greater proportion of women were obese than men.
Waist measurements also grew. Waist measurements for women living in cities grew more than for women elsewhere. The increase for men was most among those living remotely.
Consequences of obesity
Obese people are known to be at major risk for type 2 diabetes, hypertension, cardiovascular disease, dyslipidaemia, cancers and arthritis.
Twice as many obese people in the study were depressed compared to the other two weight groups. Twice as many obese people had ‘cognitive impairment’ or disability compared to those with a normal body weight. Obese people visited their GP more often.
AusDiab2 (2005) noted that the annual incidence of diabetes increased in those who reported doing insufficient physical activity (<150 minutes a week for adults) compared to those who reported sufficient levels of physical activity.
Physical activity is more prominent in this third report reflecting the growing awareness of the important of physical activity in the prevention of disease.
The latest report notes ‘The health benefits of regular participation in moderate- to vigorous-intensity physical activity are well established. Physical activity reduces the risk of all-cause mortality, cardiovascular disease, type 2 diabetes, some cancers, osteoporosis and depression.’
The latest report also alerts us to the opposite of physical activity – sitting or lying for long periods without moving your whole body. Typical situations include sitting at work or in a car or in front of a TV or internet screen.
Excessive ‘sitting time’ can undo the benefits of time spent in activity. Sitting time, says the report, is associated with an elevated risk for all-cause and cardiovascular mortality, cardiovascular disease, type 2 diabetes and some cancers.
Even if you put together 150 minutes a week of physical activity, you can put yourself at risk through the metabolic consequences of sitting for ten or more hours a day.
Physical activity of participants
63% of the survey participants were getting enough physical activity to protect themselves from disease – this is higher than the population rate of 41%
However physical activity levels were lower amongst those who overweight and lower still among the obese. Those with metabolic syndrome reported significantly lower levels of physical activity and this was confirmed by objective measurements.
On the other side of the ledger – increases in weight were associated with increased time watching TV. AusDiab 2 found that more time watching TV was associated with increased mortality. AusDiab 3 found that obese people accumulated more sitting time - up to three quarters of an hour each day.