The Obesity Epidemic and Rising Diabetes Incidence in a Low-Income Racially Diverse Southern US Cohort
Abstract
Background
Obesity is a major risk factor for diabetes.
The study explores the magnitude of risk and variation between blacks and whites in a southern US population heavily affected by obesity.
Methods
Study involved 24,000 black and 14,064 white adults aged 40-79 from the Southern Community Cohort Study.
Participants were followed for up to 10 years (median 4.5 years).
Incidence rates, odds ratios (OR), and 95% confidence intervals (CI) were calculated based on BMI and other factors such as tobacco/alcohol use, diet, physical activity, and socioeconomic status (SES).
Results
Diabetes risk increased with rising BMI, with trends differing between races (p-interaction < .0001).
For BMI ≥ 40 kg/m², the adjusted OR for diabetes was 11.9 for whites and 4.0 for blacks.
Diabetes incidence was more than double in blacks compared to whites at normal BMI, but this racial difference attenuated at higher BMIs.
Conclusions
High rates of obesity-associated diabetes observed.
Effective strategies are needed to curb obesity to prevent a rise in diabetes cases.
Introduction
Obesity Trends
National surveys show obesity has risen since the 1980s, especially in the South.
Higher obesity prevalence among blacks and low-income groups.
Obesity is a known risk factor for Type 2 diabetes.
Study Context
Conducted within a diverse cohort in the southern US overlapping with the obesity belt.
SCCS participants largely from underserved populations.
Methods
Study Design and Participants
Southern Community Cohort Study targets health disparities among blacks and whites.
Includes over 85,000 adults, two-thirds African American, aged 40-79.
Data collected through questionnaires on demographics, lifestyle, and medical history.
Follows participants for health status updates and diabetes incidence.
Statistical Analysis
Logistic regression models used to estimate ORs for incident diabetes.
Models assessed BMI, smoking, alcohol, diet, physical activity, SES, etc.
Results
Diabetes Incidence
17% of blacks and 9% of whites reported newly diagnosed diabetes.
Diabetes incidence higher among those with lower education and income.
BMI and Diabetes
High BMI was a strong risk factor for diabetes in both blacks and whites.
Racial differences in ORs for diabetes with BMI noted, stronger trends among whites.
Other Risk Factors
Smoking linked to higher diabetes risk.
Alcohol consumption showed reduced diabetes risk.
Physical activity and healthier eating modestly associated with lower diabetes incidence.
Discussion
Key Findings
Obesity epidemic linked to rising diabetes incidence.
Higher diabetes risk found in low SES and obese groups.
Stronger BMI-diabetes link in whites than blacks.
Implications
Urgent need for obesity prevention strategies.
Addressing SES disparities may benefit diabetes prevention efforts.
Acknowledgments
Study supported by Vanderbilt University Medical Center and National Cancer Institute.
Data Availability
Data available through SCCS, subject to review for privacy concerns.