Figure S1. Proportion of DM incidence in different quadrants formed by the weighted cutoff of factors F1 and F2: high F1 and low F2 (A); high F1 and high F2 (B); low F1 and low F2 (C); and low F1 and high F2 (D). ○, 55-64 age group; ⊕, 65-74 age group; ●, 75+ age group.
(I) Participants without IGT/MS at baseline (n = 1,452)
(II) Participants with IGT/MS at baseline (n = 1,973)
Principal component analysis outcomes and cutoffs for F1 and F2
Table S1 summarizes the factor loadings of the first 2 factors of the principal component analysis (PCA) by rotation method of varimax applied to the baseline measurements of diet, physical activity, psychosocial score, and WC of the 4,879 participants with linked NHI records. The cutoffs at the bottom line were determined by the maximum sum of sensitivity and specificity of DM at baseline from Receiver Operating Characteristic (ROC).
Classifications of risk groups based on the cutoffs
Based on the weighted cutoffs as given in Table S1, 3 fictitious individuals A, B, and C, with WC and lifestyle scores (WC, diet, log-physical activity, psychosocial score) = and , respectively, are classified as uncertain, low risk (group 0), and high risk (group 1), respectively. The matrix calculation is as follows:
.
The resultant factors for individuals A, B, and C fell into the 2nd, 3rd, and 4th quadrant determined by the cutoffs . Classification of the risk group for individuals A, B, C is completed.
Questionnaire for physical activity
Part A. Labor work
E7. During the last year, did you do any work requiring strenuous efforts? (E.g. farm work, moving cargo, heavy work, deep sea fishing, or heavy housework etc.)
□0 No【Go to E8】 □1 Yes
E7a. In the past year, what kinds of labor did you do?【Fill in the name and code of labor accoding to frequency】 / E7b. How many times did you do this kind of labor in the past year? / E7c. How much time did you spend on this labor each time in the past year? / E7d. Do you feel short of breath when you do this kind of labor?Name / Code / 1 No / 2 Slightly / 3 Moderate / 4 Very
1. / times / hours minutes / 1 / 2 / 3 / 4
2. / times / hours minutes / 1 / 2 / 3 / 4
3. / times / hours minutes / 1 / 2 / 3 / 4
4. / times / hours minutes / 1 / 2 / 3 / 4
5. / times / hours minutes / 1 / 2 / 3 / 4
Labor name and code:
01. Farm work 02. Moving heavy objects 03. Fishing 04. Mining
05. Harvest crops in the ocean 06. Recycling 07. Construction work 08. Forestry work
09. Hunting 10. Heavy housework 11. Other【Please specify】
Part B. Exercise
E8. During the last year, have you done any exercise? (E.g. Running, Tai chi, or Dancing)
【Attention interviews: Labor from work, such as farm work, moving cargo, or heavy housework, doesn’t count as exercise】
□0 No【Go to E9】 □1 Yes
【Fill in the exercise name and code according to frequency】 / E8b. In the past year, how many times did you【Read the item to the left】? / E8c. In the past year, how much time did you spend on【Read the item to the left】each time? / E8d. Do you feel short of breath when you【Read the item to the left】?
1 No / 2 Slightly / 3 Moderate / 4 Very
Name / Code
(1) / times / hours minutes / 1 / 2 / 3 / 4
(2) / times / hours minutes / 1 / 2 / 3 / 4
(3) / times / hours minutes / 1 / 2 / 3 / 4
(4) / times / hours minutes / 1 / 2 / 3 / 4
(5) / times / hours minutes / 1 / 2 / 3 / 4
Exercise name and code:
010 Walking 020 Jogging030 Fast walking040 Jump roping
050 Swimming 061 Gymnastics (stretching of limbs) 062 Swing arms
063 Yoga 071 Waitankung 072 Neitankung 073 Fa-Lun Kung
074 Yuanji dance 075 Tai chi076 Shiang kung
077 Other Gigongs【Please specify】
081 Soccer 082 Golf083 Badminton084 Ping pong
085 Croquet 086 Tennis087 Pool088 Basketball
089 Other ball sports【Please specify】
090 Aerobics, DDR 091 Folk dance, ballroom dancing…
100 Bicycling 110 Mountain climbing
120 Weight training (weight lifting) 130 Stair climbing
140 Hula hoop 150 Other【Please specify】
Table S1 Factor loadings of factors F1 and F2 of PCA by rotation method of varimax and the corresponding cutoffs55-64
(n = 1,469) / 65-74
(n = 2,161) / 75+
(n = 1,249) / Overall
(n = 4879)
Men / Women / Men / Women / Men / Women
F1 / F2 / F1 / F2 / F1 / F2 / F1 / F2 / F1 / F2 / F1 / F2 / F1 / F2
Cutoff / 0.5 / 0.3 / – 0.3 / 0.1 / – 0.9 / – 0.1 / – 1.0 / – 0.3 / – 1.4 / 0.0 / – 0.9 / 0.1 / – 0.2 / 0.2
WC / – 0.07 / 0.91 / 0.01 / 0.97 / 0.01 / 1.00 / 0.12 / 0.91 / –0.04 / 1.00 / 0.01 / 0.99 / 0.02 / 0.96
Diet score / 0.65 / – 0.32 / 0.67 / – 0.26 / 0.65 / – 0.04 / 0.46 / – 0.48 / 0.63 / – 0.07 / 0.61 / 0.01 / 0.45 / – 0.19
Physical activity† / 0.66 / – 0.11 / 0.68 / 0.04 / 0.67 / – 0.01 / 0.73 / – 0.06 / 0.66 / – 0.03 / 0.70 / – 0.11 / 0.51 / 0.02
Psychosocial score / 0.69 / 0.33 / 0.66 / 0.12 / 0.69 / 0.08 / 0.78 / 0.08 / 0.73 / 0.03 / 0.70 / 0.13 / 0.53 / 0.17
†The physical activity score was log-transformed.
Table S2 Odds ratios for cross-sectional associations between HLF factors, IGT, and DM
Age group / Overall
55-64 / 65-74 / 75+
Healthy lifestyle factors (non-DM vs DM)
(n = 1,628) / (n = 2,378) / (n = 1,343) / (n = 5,349)
Non-smoking (<5 packs) / Adj.† / 0.98(0.66,1.46) / 0.78(0.57,1.07) / 0.82(0.56,1.2) / 0.86(0.7,1.05)
Non-adj. / 0.75(0.56,1.01) / 0.73(0.58,0.92)** / 0.82(0.62,1.07) / 0.74(0.64,0.86)***
WC (man<90 cm,
woman<80 cm) / Adj.† / 0.39(0.29,0.52)*** / 0.58(0.46,0.72)*** / 0.69(0.51,0.92)* / 0.54(0.47,0.63)***
Non-adj. / 0.35(0.27,0.45)*** / 0.48(0.4,0.58)*** / 0.58(0.45,0.74)*** / 0.45(0.4,0.51)***
No alcohol/betel nut / Adj.† / 0.67(0.44,1.02) / 0.8(0.55,1.15) / 1.28(0.76,2.15) / 0.84(0.66,1.06)
Non-adj. / 0.66(0.46,0.96)* / 0.72(0.52,0.99)* / 1.17(0.72,1.9) / 0.81(0.65,1)*
Top 30% physical activity / Adj.† / 1.10(0.82,1.47) / 0.97(0.78,1.22) / 0.77(0.55,1.09) / 0.98(0.84,1.15)
Non-adj. / 1.03(0.8,1.34) / 0.97(0.79,1.18) / 0.83(0.61,1.13) / 0.94(0.82,1.08)
Top 40% diet score / Adj.† / 0.89(0.67,1.19) / 0.96(0.78,1.18) / 0.75(0.58,0.99)* / 0.9(0.78,1.04)
Non-adj. / 1(0.78,1.29) / 1.01(0.84,1.21) / 0.79(0.62,1)* / 0.95(0.84,1.08)
Top 40% psychosocial score / Adj.† / 0.92(0.70,1.22) / 0.84(0.68,1.03) / 0.85(0.64,1.12) / 0.86(0.75,0.99)*
Non-adj. / 0.9(0.7,1.15) / 0.9(0.75,1.08) / 0.84(0.65,1.08) / 0.88(0.78,1)
Healthy lifestyle factors (IGT vs DM)
(n = 970) / (n = 1,519) / (n = 895) / (n = 3,384)
Non-smoking (< 5 packs) / Adj.† / 0.84(0.54,1.29) / 0.77(0.54,1.09) / 0.77(0.49,1.2) / 0.8(0.64,1.01)
Non-adj. / 0.8(0.58,1.12) / 0.85(0.65,1.11) / 0.8(0.58,1.09) / 0.8(0.68,0.95)*
WC (man<90 cm, woman<80 cm) / Adj.† / 0.51(0.37,0.71)*** / 0.71(0.55,0.92)** / 0.87(0.62,1.22) / 0.68(0.58,0.81)***
Non-adj. / 0.46(0.35,0.61)*** / 0.57(0.46,0.7)*** / 0.72(0.54,0.96)* / 0.57(0.49,0.66)***
No alcohol/betel nut / Adj.† / 0.62(0.39,1.01) / 0.73(0.48,1.11) / 1.29(0.72,2.34) / 0.8(0.61,1.05)
Non-adj. / 0.65(0.42,1)* / 0.72(0.49,1.06) / 1.26(0.73,2.18) / 0.81(0.63,1.03)
Top 30% physical activity / Adj.† / 0.96(0.7,1.33) / 0.99(0.77,1.28) / 0.77(0.52,1.14) / 0.97(0.81,1.15)
Non-adj. / 0.91(0.68,1.21) / 0.96(0.77,1.21) / 0.86(0.6,1.22) / 0.92(0.78,1.07)
Top 40% diet score / Adj.† / 0.91(0.66,1.26) / 0.95(0.75,1.2) / 0.73(0.54,1)* / 0.9(0.77,1.06)
Non-adj. / 0.99(0.75,1.32) / 0.97(0.79,1.2) / 0.79(0.6,1.04) / 0.96(0.83,1.1)
Top 40% psychosocial score / Adj.† / 0.86(0.63,1.17) / 0.83(0.65,1.04) / 0.8(0.58,1.1) / 0.82(0.7,0.96)*
Non-adj. / 0.86(0.66,1.13) / 0.88(0.72,1.09) / 0.77(0.58,1.02) / 0.84(0.73,0.97)*
Healthy lifestyle factors (non-DM vs IGT)
(n = 1,253) / (n = 1,656) / (n = 913) / (n =3,822)
Non-smoking (< 5 packs) / Adj.† / 1.46(0.99,2.15) / 1.17(0.84,1.63) / 1.26(0.83,1.9) / 1.28(1.04,1.58)*
Non-adj. / 0.92(0.69,1.23) / 0.77(0.59,1.01) / 1.04(0.77,1.42) / 0.88(0.75,1.04)
WC (man<90 cm, woman<80 cm) / Adj.† / 0.56(0.43,0.74)*** / 0.66(0.52,0.83)*** / 0.6(0.44,0.83)** / 0.61(0.53,0.72)***
Non-adj. / 0.59(0.46,0.74)*** / 0.75(0.62,0.92)*** / 0.64(0.48,0.84)** / 0.66(0.58,0.75)***
No alcohol/betel nut / Adj.† / 1.04(0.67,1.64) / 1.13(0.73,1.75) / 0.93(0.52,1.66) / 1.06(0.81,1.39)
Non-adj. / 1.08(0.72,1.61) / 1.01(0.68,1.5) / 0.99(0.57,1.7) / 1.04(0.82,1.34)
Top 30% physical activity / Adj.† / 1.26(0.95,1.67) / 1.01(0.79,1.29) / 0.97(0.67,1.4) / 1.05(0.89,1.23)
Non-adj. / 1.18(0.92,1.51) / 1.04(0.84,1.3) / 0.9(0.64,1.26) / 1.04(0.9,1.21)
Top 40% diet score / Adj.† / 0.85(0.65,1.11) / 0.99(0.79,1.25) / 1.08(0.8,1.46) / 0.96(0.83,1.11)
Non-adj. / 0.87(0.69,1.11) / 0.96(0.78,1.18) / 0.97(0.74,1.28) / 0.93(0.82,1.07)
Top 40% psychosocial score / Adj.† / 1.25(0.97,1.63) / 1.04(0.83,1.29) / 1.16(0.85,1.59) / 1.12(0.96,1.29)
Non-adj. / 1.14(0.91,1.44) / 1.03(0.84,1.27) / 1.24(0.94,1.65) / 1.1(0.96,1.26)
†Adjusted for gender, age group, education, income, site, SBP, medication for high SBP, CHOL. *P < 0.05; **P < 0.01; ***P < 0.001
Table S3. Relative risk of healthy lifestyle factors and WC on DM incidence: (A) without IGT/MS at baseline
Overall factors without PCA‡
(n = 1,452) / Model 1: cutoff without stratification＃
(n = 855) / Model 2: cutoff by age and gender separately＃
(n = 855) / Model 3: cutoff weighted by age and gender＃
(n = 855)
Adjusted† / Non-adjusted / Adjusted† / Non-adjusted / Adjusted† / Non-adjusted / Adjusted† / Non-adjusted
Age 55-64 / 0.62 (0.32, 1.21) / 0.58 (0.31, 1.10) / 0.92 (0.40,2.14) / 0.76 (0.34,1.71) / 0.53 (0.22, 1.32) / 0.50 (0.21, 1.20) / 0.78 (0.33,1.86) / 0.71 (0.30, 1.64)
Age 65-74 / 0.90 (0.51, 1.58) / 0.89 (0.51, 1.56) / 0.78 (0.35,1.73) / 0.73 (0.33,1.60) / 0.72 (0.35, 1.49) / 0.72 (0.35, 1.47) / 0.99 (0.46,2.10) / 0.95 (0.45, 2.00)
Gender (Male) / 1.33 (0.73, 2.41) / 1.32 (0.74, 2.36) / 1.62 (0.74,3.54) / 1.63 (0.77,3.44) / 1.76 (0.80, 3.85) / 1.67 (0.78, 3.58) / 1.53 (0.71,3.30) / 1.62 (0.77, 3.43)
Non-smoking (< 5 packs) / 1.14 (0.59, 2.20) / 1.14 (0.59, 2.20) / 1.55 (0.63,3.82) / 1.57 (0.63, 3.86) / 1.28 (0.55, 2.97) / 1.27 (0.54, 2.95) / 1.29 (0.54, 3.10) / 1.32 (0.55, 3.16)
No alcohol/betel nut / 0.62 (0.30, 1.29) / 0.62 (0.30, 1.27) / 0.47 (0.18,1.25) / 0.45 (0.17,1.21) / 0.65 (0.24, 1.77) / 0.65 (0.24, 1.75) / 0.47 (0.18,1.20) / 0.46 (0.18, 1.17)
WC / 1.01 (0.99, 1.04) / 1.02 (0.99, 1.04) / 0.59 (0.25,1.35) / 0.56 (0.24,1.28) / 0.84 (0.34, 2.09) / 0.80 (0.32, 1.97) / 0.56 (0.26, 1.21) / 0.52 (0.25, 1.11)
Diet / 0.98 (0.92, 1.03) / 0.98 (0.92, 1.03)
Physical activity / 0.99 (0.92, 1.08) / 0.99 (0.92, 1.08)
Psychosocial / 0.99 (0.96, 1.02) / 0.99 (0.96, 1.02)
†Adjusted for SBP, CHOL, medication for high SBP, CHOL
‡The participants considered here were those without DM or IGT or MS at baseline.
＃The participants considered here were those without IGT or MS at baseline and belonged to the risk group 0 or group 1. The last value of the column was the RR of group 0 versus group1. Model 1 adopted a cutof cutoff without stratification for age and gender subgroup; model 2 adopted a cutoff for each age and gender subgroup separately; model 3 adopted a cutoff weighted by the proportion of subjects in each age
and gender subgroup.
Relative risk of healthy lifestyle factors and WC on DM incidence: (B) with IGT/MS at baseline
Overall factors without PCA‡
(n = 1,973) / Model 1: cutoff without stratification＃
(n = 906) / Model 2: cutoff by age and gender separately＃
(n = 906) / Model 3: cutoff weighted by age and gender＃
(n = 906)
Adjusted† / Non-adjusted / Adjusted† / Non-adjusted / Adjusted† / Non-adjusted / Adjusted† / Non-adjusted
Age 55-64 / 0.74 (0.48, 1.16) / 0.67 (0.43, 1.03) / 0.51 (0.27, 0.97)* / 0.49 (0.26, 0.91)* / 0.48 (0.25, 0.95)* / 0.47 (0.25, 0.90)* / 0.46 (0.24,0.88)* / 0.44 (0.23, 0.82)*
Age 65-74 / 1.05 (0.73, 1.52) / 1.01 (0.70, 1.45) / 0.90 (0.54, 1.48) / 0.88 (0.53,1.45) / 0.91 (0.53, 1.55) / 0.88 (0.52, 1.50) / 0.75 (0.44, 1.28) / 0.73 (0.43, 1.23)
Gender (Male) / 0.98 (0.67, 1.44) / 0.93 (0.64, 1.36) / 1.21 (0.72, 2.03) / 1.16 (0.69, 1.93) / 1.32 (0.77, 2.27) / 1.36 (0.80, 2.32) / 1.32 (0.76, 2.29) / 1.30 (0.76, 2.24)
Non-smoking (< 5 packs) / 1.04 (0.66, 1.64) / 1.02 (0.65, 1.60) / 1.39 (0.71, 2.74) / 1.37 (0.69, 2.69) / 1.24 (0.65, 2.36) / 1.20 (0.63, 2.29) / 1.32 (0.66, 2.65) / 1.29 (0.65, 2.57)
No alcohol/betel nut / 1.18 (0.65, 2.15) / 1.17 (0.65, 2.12) / 0.97 (0.38, 2.45) / 0.97 (0.38, 2.47) / 1.20 (0.49, 2.92) / 1.16 (0.48, 2.80) / 0.74 (0.31,1.77) / 0.75 (0.32, 1.78)
WC / 1.02 (1.00, 1.03) / 1.02 (1.01, 1.04)* / 0.61 (0.38, 1.00) / 0.61 (0.38,0.99)* / 0.61 (0.35, 1.04) / 0.58 (0.34, 0.99)* / 0.55 (0.33,0.92)* / 0.53 (0.32, 0.87)*
Diet / 0.98 (0.95, 1.02) / 0.99 (0.95, 1.02)
Physical activity / 1.04 (0.98, 1.10) / 1.04 (0.98, 1.10)
Psychosocial / 0.99 (0.97, 1.00) / 0.99 (0.97, 1.00)
†Adjusted for SBP, CHOL, medication for high SBP, CHOL
‡The participants considered here were those without DM but with IGT or MS at baseline.
＃The participants considered here were those with IGT or MS at baseline and belonged to the risk group 0 or group 1. The last value of the column was the RR of group 0 versus group1. Model 1 adopted a
cutoff without stratification for age and gender subgroup; model 2 adopted a cutoff for each age and gender subgroup separately; model 3 adopted a cutoff weighted by the proportion of subjects in each age
and gender subgroup.
*P<.05