Irrational Beliefs and Type 2 Diabetes

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Rev Diabet Stud, 2021, 17(1):38-49 DOI 10.1900/RDS.2021.17.38

Irrational Beliefs, Dietary Habits and 10-Year Incidence of Type 2 Diabetes; the ATTICA Epidemiological Study (2002-2012)

Christina Vassou1, Mary Yannakoulia1, Ekavi N. Georgousopoulou2, Christina Chrysohoou3, Christos Pitsavos3, Mark Cropley4, Demosthenes B. Panagiotakos1

1Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
2School of Medicine, Sydney, University of Notre Dame, Sydney, Australia
3First Cardiology Clinic, School of Medicine, University of Athens, Greece
4School of Psychology, University of Surrey, Guildford, UK
Address correspondence to: Demosthenes B. Panagiotakos, e-mail: dbpanag@hua.gr

Manuscript submitted December 19, 2020; accepted January 31, 2021.

Keywords: irrational beliefs, type 2 diabetes, incidence, Mediterranean diet, unhealthy lifestyle, depression, anxiety, mental health, literacy

Abstract

OBJECTIVES: The aim of this study was to evaluate the dietary habits and irrational beliefs of apparently healthy individuals in relation to their 10-year diabetes incidence. METHODS: The ATTICA study (2002-2012) is a prospective population-based cohort study, in which 853 participants (453 men (aged 45 ± 13 years) and 400 women (aged 44 ± 18 years)) without a history of cardiovascular disease (CVD) underwent psychological evaluations. Among other things, participants completed the Irrational Beliefs Inventory (IBI, range 0-88), a brief, self-reported measure consistent with the Ellis model of psychological disturbance. Demographic characteristics, detailed medical history, and dietary and other lifestyle habits were evaluated as well. Diagnosis of diabetes at follow-up examination was based on the criteria of the American Diabetes Association. RESULTS: Mean IBI score was 53 ± 10 in men and 51 ± 11 in women (p = 0.68). IBI was positively associated with the 10-year type 2 diabetes incidence (hazard ratio: 1.14; 95% CI: 1.04-1.25) in both men and women, and even more distinctly associated with participants with the following characteristics: lower education status, married, overweight, smokers, anxiety and depressive symptomatology, and unhealthy dietary habits. Especially, participants with increased irrational beliefs and low adherence to the Mediterranean diet were 37% more likely to develop type 2 diabetes than those with the reverse status (hazard ratio: 3.70; 95% CI: 2.32-5.88). CONCLUSIONS: These data support the need for lifestyle changes towards healthier nutrition which can be achieved by educating people so that they are equipped to recognize false and unhelpful thoughts and thus to prevent negative psychological and clinical outcomes such as mental health disorders and type 2 diabetes.

1. Introduction

Despite ongoing progress in treatment and management, diabetes remains a progressively growing disease [1]. The number of diabetic patients worldwide has more than doubled since 1980 and is predicted to reach 700 million adults by 2045 [2]. The global prevalence of diabetes among adults rose from 4.7% in 2000 to 8.5% in 2014 [1, 3]. These findings are critical since diabetes is a well-established cardiovascular risk factor [1]. The exponential increase of diabetes prevalence is also accompanied by a serious financial burden [1]. According to the International Diabetes Federation (IDF), the healthcare expenditure on diabetes in Europe five years ago was 2,198 euros per person per year [4].

Acknowledgments: The authors would like to thank the ATTICA study group of investigators, including Yannis Skoumas, Natassa Katinioti, Labros Papadimitriou, Constantina Masoura, Spiros Vellas, Yannis Lentzas, Manolis Kambaxis, Konstadina Palliou, Vassiliki Metaxa, Agathi Ntzouvani, Dimitris Mpougatsas, Nikolaos Skourlis, Christina Papanikolaou, Georgia-Maria Kouli, Aimilia Christou, Adella Zana, Maria Ntertimani, Aikaterini Kalogeropoulou, Evangelia Pitaraki, Alexandros Laskaris, Mihail Hatzigeorgiou, and Athanasios Grekas for their assistance in the initial physical examination and follow-up evaluation, as well as Efi Tsetsekou for her assistance in psychological evaluations and the laboratory team, including Carmen Vassiliadou and George Dedoussis (genetic analysis), Marina Toutouza-Giotsa, Constadina Tselika, and Sia Poulopoulou (biochemical analysis), and Maria Toutouza (database management).

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