Lifestyle clusters related to type 2 diabetes and diabetes risk in a multi-ethnic population: The HELIUS study.

Little is known about how health-related behaviours cluster across different populations and how lifestyle clusters are associated with type 2 diabetes (T2D) risk. We investigated lifestyle clusters and their association with T2D in a multi-ethnic population. 4396 Dutch, 2850 South-Asian Surinamese, 3814 African Surinamese, 2034 Ghanaian, 3328 Turkish, and 3661 Moroccan origin participants of the HELIUS study were included (2011-2015). K-medoids cluster analyses were used to identify lifestyle clusters. Logistic and cox regression analyses were performed to investigate the association of clusters with prevalent and incident T2D, respectively. Pooled analysis revealed three clusters: a 'healthy', 'somewhat healthy', and 'unhealthy' cluster. Most ethnic groups were unequally distributed: Dutch participants were mostly present in the 'healthy' cluster, Turkish and Moroccan participants in the 'somewhat healthy' cluster, while the Surinamese and Ghanaian participants were equally distributed across clusters. When stratified for ethnicity, analysis revealed three clusters per ethnic group. While the 'healthy' and 'somewhat healthy' clusters were similar to those of the pooled analysis, we observed considerable differences in the ethnic-specific 'unhealthy' clusters. Fruit consumption (3-4 days/week) was the only behaviour that was consistent across all ethnic-specific 'unhealthy' clusters. The pooled 'unhealthy' cluster was positively associated with prediabetes (OR: 1.34, 95%CI 1.21-1.48) and incident T2D (OR: 1.23, 95%CI 0.89-1.69), and negatively associated with prevalent T2D (OR: 0.80, 95%CI 0.69-0.93). Results were similar for most, but not all, ethnic-specific clusters. This illustrates that targeting multiple behaviours is relevant in prevention of T2D but that ethnic differences in lifestyle clusters should be taken into account.

A cidade dos outros / The city of the others

Os percursos costumeiros dentro da cidade em que vivemos desenham nosso "mapa da cidade". A tipologia deste mapa depende fundamentalmente de nosso nível social. Examinou-se, anteriormente, o mapa da cidade dos pacientes que saíram do hospital psiquiátrico, para avaliar os efeitos da desinstitucionalização. Hoje, examina-se como vive o clandestino dentro das cidades italianas. O mapa do clandestino se baseia na degradação; evidencia mecanismos de intolerância e de acolhida; permite entender como as pessoas se enrijecem em suas posições ou, ao contrário, como as identidades dos sujeitos interagem e favorecem mudanças e emancipação. A escolha se funda na disponibilidade dos sujeitos e é fortemente influenciada pelas políticas públicas de respeito dos direitos das pessoas.

In the city where we live each one of us usually goes to those places that have a special meaning. All these places describe one's map of the city. But the use of the city depends above of all on the social standing of a person.Before, it was considered the city map of patients discharged from psychiatric hospitals to understand the impact of deinstitutionalization . Today , it is necessary to consider the underground life of "illegal" immigrants in Italian cities. Their maps describe the social mechanism of refusal or acceptance. This helps us understand how people refuse to budge from their respective standpoints or on the contrary how the identities interact with each other and change. The choice results from the individual receptivity, but above all from human rights policies.