Enjoyment of life predicts reduced type 2 diabetes incidence over 12 years of follow-up: findings from the English Longitudinal Study of Ageing

Abstract

BackgroundSubjective well-being appears to be associated with reduced risk of type 2 diabetes (T2D). However, it is unknown whether this association is similar across different types of well-being. We examined the relationship between hedonic and eudaimonic well-being and incident T2D, and explored the role of sociodemographic, behavioural and clinical factors in these associations.MethodsWe used data from 4134 diabetes-free participants from the English Longitudinal Study of Ageing (mean age =64.97). Enjoyment of life and purpose in life were assessed using items from the CASP-19 to reflect hedonic and eudaimonic well-being, respectively. Participants reported T2D diagnosis over 12 years. We used Cox proportional hazards regression analyses and also explored the percentage of association explained by different covariates.ResultsResults revealed a protective role for enjoyment of life in T2D rate adjusting for sociodemographic (age, sex, wealth, ethnicity, marital status), behavioural (physical activity, smoking, alcohol consumption, body mass index) and clinical (hypertension, coronary heart disease and glycated haemoglobin) characteristics (HR =0.93, p=0.021, 95% CI (0.87, 0.99)). Sociodemographic, behavioural and clinical factors accounted for 27%, 27% and 18% of the association, respectively. The relationship between purpose in life and T2D was non-significant (adjusted HR =0.92, p=0.288, 95% CI (0.78, 1.08)).ConclusionThis study illustrates how the link between subjective well-being and T2D varies between well-being components. It also demonstrates that sociodemographic, behavioural and clinical factors partially explain this association. Intervention studies examining whether changes in enjoyment of life can help delay T2D onset are warranted.

Is more, better? Relationships of multiple psychological well-being facets with cardiometabolic disease.

“…Moreover, in this sample, the subscales demonstrated good convergent and divergent validity, with scores on each subscale correlated in the expected direction with scores of life satisfaction at Wave 2 (the first wave where life satisfaction was measured in ELSA; r s range = .48 to .63), and with depressive symptoms at Wave 1 ( r s range = −.42 to −.35), respectively. Finally, these subscales were associated in the expected direction with other health outcomes in earlier ELSA studies, including Type II diabetes, mortality, and inflammation (Fancourt & Steptoe, 2020; Panagi et al, 2020; Zaninotto et al, 2016).…”

“…More precise estimates might have been obtained with a less coarse measurement scale (e.g., exact date of diagnosis). Although numerous studies have used the CASP subscales to examine PWB’s relationship with health in older adults (e.g., Boehm et al, 2017; Panagi et al, 2020; Poole et al, 2020; Zaninotto et al, 2016), the CASP is not an exhaustive measure of all relevant PWB facets. As a result, key facets associated with health in past studies (e.g., optimism, purpose and meaning in life, and life satisfaction; Boehm et al, 2020; Kim et al, 2013) were not included in our study; future research should examine their potential additive effects on CMD risk.…”

“…Covariates were selected based on past research (e.g., Boehm et al, 2017; Panagi et al, 2020) and were self-reported at baseline, except for self-reported physician diagnosed high blood cholesterol and BMI, which were measured at Wave 2. Sociodemographic factors, which can be related to both PWB and CMD and thus act as confounders (Boehm & Kubzansky, 2012), included age (measured continuously in years, with participants aged >90 years assigned the value of 91 to preserve confidentiality), sex (men, women), ethnicity (White, non-White), marital status (married/cohabiting, not married/cohabiting), educational attainment (university degree or equivalent, higher education but not university degree, A-level [high school equivalent], O-level [national school exam at age 16 years], or less than O-level) and employment status (currently working, not currently working, including unemployed, retired, and on sick leave).…”

“…Cardiometabolic diseases (CMD) including diabetes, heart disease, and stroke are leading causes of death and disability worldwide and engender a high societal and financial burden (American Heart Association, 2019). Research suggests that psychological well-being (PWB) is protective against the development and progression of CMD (Boehm et al, 2016; Lambiase et al, 2015; Panagi et al, 2020). Although the term “psychological well-being” has been used to refer specifically to eudemonic well-being facets such as purpose in life and mastery (Ryff & Keyes, 1995), other authors define PWB as a broad construct that encompasses several facets including eudemonic well-being (e.g., autonomy, mastery) and hedonic well-being (e.g., positive affect, life satisfaction; Diener et al, 2017).…”

Associations between Positive Psychological Well-Being, Psychological Distress, and Physical Activity among Adults with Diabetes

“…Similarly, another recent study in which participants did not have diabetes at baseline, found that PPWB, as measured by the CASP-19, was protective against the development of diabetes over a period of 12 years (Panagi et al, 2021). Perhaps PPWB has an impact on the biological processes implicated in the development of diabetes, such as HbA1c levels or inflammation.…”