Health habits - good or bad - are often interrelated. For example, heavy smokers may not exercise regularly while people who monitor what they eat may also try hard to maintain a healthy body weight. And new evidence shows that two potent risk factors for type 2 diabetes - obesity and lack of exercise - may be even more harmful in combination with one another. Harvard University researchers examined this possibility and the results were recently published in The New England Journal of Medicine.

Tracking health habits

The study involved 85,000 healthy women who were part of the larger Nurses'Health Study. Beginning in 1980, approximately every two years they completed questionnaires about their weight, diet, physical activity, health status, smoking habits, alcohol intake, and medical history. The researchers used this information to categorize each volunteer as low to high risk for developing type 2 diabetes. New cases that occurred during the 16-year study were also recorded.

Type 2 diabetes can be prevented

Although body weight was the strongest predictor of type 2 diabetes, lack of activity, poor diet, and smoking also influenced diabetes risk. The researchers estimated that 87% of the new diabetes cases could have been prevented if all of the volunteers were at a normal weight, ate a healthful diet, and exercised regularly.

Adopting these healthful behaviors even appears to reduce diabetes risk among those who might be 'predisposed'because of a family history of diabetes. In the study even the effects of being overweight - the biggest risk factor - were minimized by the combination of a healthful diet, regular exercise, not smoking, and a moderate amount of alcohol consumption.

There are compelling reasons to take steps in order to avoid diabetes. Diabetes can lead to numerous other health concerns, including heart disease, nerve damage, kidney failure, and poor vision. It is disturbing to note that less than 10% of the women studied were considered 'low-risk'for each health behavior.

Start with small steps

The following recommendations are based on the study's criteria for 'low-risk.' To reduce the likelihood of developing type 2 diabetes, try to incorporate at least one of them now and then gradually add more over time.

• Achieve a healthy body weight or, at the very least, maintain your weight.
• Eat a diet that is high in fiber. Good sources are whole grains and cereals, fruits and vegetables, and dried beans.
• Limit and replace saturated fat from meat, butter, and full-fat dairy products with polyunsaturated fat from vegetable oils (peanut, corn, canola).
• Choose whole wheat bread and cereals over white or refined breads and cereals.
• Participate in moderate to vigorous activity for 30 minutes each day.
• Stop smoking.
• Research indicates that moderate alcohol consumption (1/2 glass of wine or beer or ½ ounce of liquor) decreases diabetes risk. If you enjoy moderate amounts, fine. But if you currently avoid alcohol, this is not a reason to start.