Diabetes incidence is skyrocketing, much of it apparently due to rising rates of obesity. Add to that the estimated 57 million Americans who have pre-diabetes, people who have higher than normal blood sugar and are at increased risk of developing diabetes. For people who wonder whether lifestyle in middle age and beyond really can prevent diabetes, a recent study suggests that it can.

In the study, 9 of 10 new cases of diabetes in adults over age 65 were attributable to 5 lifestyle factors: weight, diet, activity, tobacco and alcohol. Amidst discussions of the personal and national costs of diabetes and its complications, the impact of focusing on moderate changes in lifestyle demands attention.

The study tracked 4,883 men and women age 65 and older for ten years. After adjusting for age, sex, race, education and income, researchers found that diets highest in fiber with a healthier balance of fats and lower in refined grains and sweets was one link to lower risk of diabetes. Other habits of people less likely to develop diabetes were long-term avoidance of tobacco, light to moderate alcohol consumption, healthy weight and/or waist circumference, and regular physical activity.

The significance of avoiding excess body fat seen in past research was repeated here; that alone was enough to cut diabetes risk almost 50 percent. Overall, the rate of diabetes was 35 percent lower for each one additional healthy lifestyle factor, such as simply walking more than average and eating more healthfully (more fiber, less sweets, healthier fats). People whose lifestyle ranked healthier than average in all five categories slashed their risk of diabetes by 89 percent.

But can someone whose lifestyle falls in the high-risk, unhealthy group – and perhaps has for years – change behavior? Yes, according to a body of research. For example, a new German study of 182 overweight and obese middle age people with pre-diabetes. After a 12-month program, participants lost weight, increased exercise and improved eating habits. Fasting blood sugar levels dropped.

Two large studies, the American Diabetes Prevention Program and the Finnish Diabetes Prevention Study, had previously shown that a low fat diet, increased physical activity and weight loss could decrease incidence of type 2 diabetes by 58 percent in adults showing signs of prediabetes. The majority of people in these studies could attain the goal of a five to seven percent weight loss. However, both lifestyle change programs relied on intensive long-term individual counseling.

Together, these studies provide a vital message: Lifestyle change works, and your habits don’t have to be perfect to make a difference. “Small Steps. Big Rewards” is free information you can get from the National Institutes of Health about how to achieve the Diabetes Prevention Program goals. (Order or read online at the National Diabetes Education Program Web site.)

If you have trouble creating or maintaining a healthier lifestyle on your own, you’re not alone. In each of these studies, those in a program that shared tips and showed people how to set goals and solve problems did better than those simply given written information. So check with your local hospital or community centers to see what’s available. If no program exists, request that they start one.

The American Institute for Cancer Research (AICR) is the cancer charity that fosters research on the relationship of nutrition, physical activity and weight management to cancer risk, interprets the scientific literature and educates the public about the results. It has contributed more than $87 million for innovative research conducted at universities, hospitals and research centers across the country. AICR has published two landmark reports that interpret the accumulated research in the field and is committed to a process of continuous review. AICR also provides a wide range of educational programs to help millions of Americans learn to make dietary changes for lower cancer risk. Its award-winning New American Plate program is presented in brochures, seminars and on its Web site, www.aicr.org. AICR is a member of the World Cancer Research Fund International.