People who are a low weight at birth and have unhealthy habits as adults, such as eating nutritionally poor diets or smoking, may have a greater risk of developing type 2 diabetes than people born at an average weight who live similar lifestyles, according to a new study led by researchers from Harvard T.H. Chan School of Public Health. In the first study to comprehensively assess how early development interacts with adult behavior to influence type 2 diabetes risk, the researchers found that 18% of cases were attributable to the combined effect of low birth weight and unhealthy adult lifestyles.

“Most cases of type 2 diabetes could be prevented by the adoption of a healthier lifestyle, but these findings suggest that efforts focused on early life development, such as improving nutrition for pregnant women, could prevent additional cases,” said Lu Qi, associate professor in the Department of Nutrition at Harvard Chan School and Channing Division of Network Medicine, Brigham and Women’s Hospital, and the study’s senior author.

Qi and colleagues studied health data collected from 149,794 healthy men and women tracked by three large ongoing trials (Health Professionals Follow-up Study, Nurses’ Health Study, and Nurses’ Health Study II) for 20-30 years. Participants were scored on five lifestyle factors: diet, smoking, physical activity, alcohol consumption, and body mass index. Those who did not provide their birth weight were excluded from this analysis.

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