A “health behavior change score” summed the number of healthy behavior changes in the year after diabetes diagnosis. One point was assigned to each category of four health behavior change factors: increasing physical activity; decreasing/stopping alcohol con sumption; increasing both daily fiber and vitamin C intake; and decreasing both daily energy and total fat intake. These health behaviors were chosen based on the reported benefits of physical activity (25,26) and diet (27,28) on diabetes progression, and to reduce problems with collinearity through the use of multiple measures of the same underlying behavior. Health behavior change scores (ranging from 0 to 4) were calculated for those individuals with complete data on all four health behavior categories, with higher scores reflecting adoption of healthier behaviors between baseline and 1 year.