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Can loneliness result in diabetes? Latest study reveals the role of physical activity and BMI

In a recent study published within the journal Nutrients, researchers evaluate the mediating effects of physical activity, body mass index (BMI), and weight loss program quality on the link between feeling lonely and diabetes.



Study: The Association of Loneliness with Diabetes Is Mediated by Physical Activity and BMI but Not Weight-reduction plan Quality. Image Credit: asylsun / Shutterstock.com

Background

Loneliness, a subjective emotional state, is related to an increased risk of diabetes and heart problems. A few of the underlying mechanisms that contribute to this increased risk include depression, impaired cognitive performance, and nursing home admission.

Loneliness deteriorates health through various pathways, including weight loss program quality, physical activity, alcoholic beverages, smoking, and sleep patterns. Psychological aspects comparable to perceived stress and depression have inconsistent effects on this association, which could also be affected by unhealthy dietary behaviors and obesity. Thus, additional research is required to explore the mediating pathways between loneliness and obesity to support the event of effective health interventions.

In regards to the study

In the current study, researchers investigate whether physical activity, BMI, and weight loss program quality mediate the connection between loneliness and diabetes amongst white and African-American adults between 36 and 77 years of age in america.

The study included 1,713 individuals who participated in follow-up visits of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study between 2013 and 2017 and had complete information on explanatory, predictor, and consequence variables were included in the present study. The HANDLS trial was conducted in 2004 and included 3,720 individuals to judge the impact of socioeconomic aspects on health discrepancies amongst white and African-American Baltimore residents.

Participants were classified as non-diabetic, pre-diabetic, or diabetic based on fasting blood glucose levels, medications, and self-reports. The three-item University of California Los Angeles (UCLA) scale measured loneliness based on a scarcity of companionship, feeling neglected, and social isolation.

Healthy Eating Index (HEI) 2010 scores were based on participant responses from two 24-hour weight loss program recalls obtained using the automated multiple-pass method (AMPM) by america Department of Agriculture (USDA) to evaluate weight loss program quality.

All participants received food booklets and other aids to estimate portion size. Food items were coded using the USDA Food and Nutrient Database for Dietary Studies (FNDDS).

Physical activity was assessed using the Baecke questionnaire, and mediation evaluation was performed using the Hayes PROCESS macro-model. Covariates included age, sex, race, education, household income, and alcohol intake.

Study findings

The mean participant age was 57, 59% of whom were women, 39% were white, and 38% had below-poverty income. Inside the study cohort, 16% and 24% were classified as pre-diabetic and diabetic, respectively. About 14% of participants often felt the absence of a companion; nonetheless, only 8% reported feelings of social isolation.

Among the many participants, 24%, 26%, and 51% were normal-weight, chubby, and obese, respectively. Pre-diabetes and diabetes were more often reported amongst white and African-American individuals, respectively.  

Whites were more more likely to report feeling neglected as in comparison with African-American adults. Feeling lonely showed significant but inverse correlations with weight loss program quality and physical activity.

Through the PROCESS Macro Model, nine direct paths connecting loneliness to diabetes were established, by which loneliness affects weight loss program quality, BMI, or physical activity and, because of this, contributes to diabetes risk.

The likelihood of poor weight loss program quality increased with feeling lonely. Age, female sex, higher educational attainment, and income 125% above poverty levels were significantly related to raised dietary quality. Comparatively, being younger, male, or having accomplished more years of education increased the likelihood of greater physical activity levels.

Physical activity was a predictive factor that significantly contributed to variations in BMI values. Higher BMI values were significantly related to younger age, being female, having an income exceeding 125% poverty status, and consuming fewer alcoholic beverages.

High BMI values were found to significantly increase the danger of diabetes in a dose-dependent manner, with a greater increase in BMI resulting in the next risk of diabetes. Physical activity and BMI had a major and indirect on the effect of loneliness on diabetes risk. Race nor poverty status significantly impacted the effect of loneliness on diabetes.

Conclusions

Feeling lonely had significant but inverse associations with physical exertion and dietary quality, which aligns with previous studies.

The event of mental health disorders like depression and loneliness is usually multifaceted, because the chronic inflammation related to various diseases, including diabetes, shares similar pathology with depression. Moreover, poor mental health often results in low-quality diets which might be high in processed foods and low in fruit and vegetables, along with poor sleep habits and increased mental distress.

The complex interplay between lifestyle and genetic aspects on loneliness and diabetes emphasizes the importance of developing targeted intervention programs which will improve each mental and physical health outcomes.  

Journal reference:

  • Kuczmarski, M. F., Orsega-Smith, E., Evans, M.K., & Zonderman, A.B. (2023). The Association of Loneliness with Diabetes Is Mediated by Physical Activity and BMI but Not Weight-reduction plan Quality. Nutrients 15; 4923. doi:10.3390/nu15234923
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