Obesity Linked to Over Half of New Type 2 Diabetes Cases in US Annually

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Obesity is linked to 30%-53% of new type 2 diabetes (T2D) cases in the US every year, according to new research published February 10, 2021 in the Journal of the American Heart Association.

The study, aimed at quantifying the impact of obesity rates on incident T2D in the US, also provides insight into how other factors, such as ethnicity and gender, may influence T2D risk.

“Our study highlights the meaningful impact that reducing obesity could have on Type 2 diabetes [sis] prevention in the United States. Decreasing obesity needs to be a priority,” said first author Natalie A. Cameron, MD, resident physician of internal medicine, McGaw Medical Center Northwestern University, Chicago, Illinois, in an American Heart Association (AHA) press release. “Public health efforts that support healthy lifestyles, such as increasing access to nutritious foods, promoting physical activity and developing community programs to prevent obesity, could substantially reduce new cases of Type 2 diabetes [sis].”

Researchers used data from the Multi-Ethnic Study of Atherosclerosis (MESA), an ongoing study of adults aged 45-84 years who did not have cardiovascular disease upon recruitment, and 4 pooled cycles (2001-2016) of the National Health and Nutrition Examination Survey (NHANES).

MESA data included in the current study was collected during 5 visits from 2000-2017 at 6 centers across the US.

Cameron and colleagues limited data to participants aged 45-79 years and included only those who were non-Hispanic White, non-Hispanic Black, or Mexican American who did not have either type 1 diabetes or T2D at the beginning of the study.

Results showed that among NHANES participants only, the overall prevalence of obesity increased from 34% to 41% and was consistently higher among adults with T2D. When examining data from only MESA, researchers found 11.6% of participants developed T2D after 9 years and those with obesity were about 3-times as likely to develop T2D vs those without obesity (20% vs 7.3%, respectively).

In both groups, the results highlighted gender, racial, and economic disparities:

• Obesity was responsible for the development of T2D in 30%-52% of cases.
• A greater proportion of participants with obesity had a yearly family income of <$50 000, and they were more likely to be non-Hispanic Black or Mexican American.
• Obesity prevalence was lowest among non-Hispanic White women, but this group experienced the highest obesity-related T2D.

“Our study confirms there is a higher prevalence of obesity among non-Hispanic Black adults and Mexican-American adults compared to non-Hispanic white adults. We suspect these differences may point to important social determinants of health that contribute to new cases of Type 2 diabetes [sis] in addition to obesity,” added Cameron in the AHA press release.

The authors also noted that the study is limited by the inclusion of only middle-aged to older adults without cardiovascular disease, so the results may not be generalizable to the entire US population. Future research is needed to assess the burden of obesity on new T2D cases in other age groups and racial and ethnic groups, concluded authors.