medwireNews: Following a healthy lifestyle halves the risk for developing cardiovascular disease (CVD) in adults with type 2 diabetes, research shows.
Making lifestyle improvements following diabetes diagnosis also significantly reduces CVD risk, report Qi Sun (Harvard Medical School, Boston, Massachusetts, USA) and colleagues in the Journal of the American College of Cardiology.
For the study, an overall healthy lifestyle was defined as adhering to at least three of four low-risk factors, namely eating a high-quality diet (top two-fifths of Alternative Healthy Eating Index), not smoking, engaging in moderate- to vigorous-intensity physical activity (≥150 min/week), and drinking alcohol in moderation (5–15 g/day for women, 5–30 g/day for men).
Only 12.9% of the 8970 women and 27.4% of 2557 men included in the study met these criteria at diabetes diagnosis. Women were most likely to report one low-risk factor (45.9%) whereas men were most likely to report two (37.8%).
During an average of 13.3 years of follow-up, there were 2311 incident CVD cases and 858 CVD deaths.
After adjustment for multiple potential confounders, including age, sex, and diabetes duration, the researchers found that participants with three or more low-risk lifestyle factors had approximately half the risk for total CVD and coronary heart disease (CHD; hazard ratios [HR]s=0.48 and 0.53, respectively) as those with no low-risk lifestyle factors, and around one-third of the risk for stroke and CVD mortality (HRs=0.33 and 0.32, respectively).
Furthermore, individuals who improved their lifestyle following their diabetes diagnosis significantly reduced their risk for CVD. Specifically, each additional low-risk lifestyle factor they initiated was associated with a significant 14% lower risk for total CVD, 12% lower risk for CHD, 21% lower risk for stroke, and a 27% lower risk for CVD mortality.
Of note, having just one low-risk lifestyle factor was associated with 38% and 37% lower risks for CVD incidence and mortality, respectively, compared with having none but the researchers point out that poor adherence to an overall healthy lifestyle (<three low-risk factors) accounted for 40.9% of CVD mortality.
Kim Connelly (University of Toronto, Ontario, Canada) and co-authors of an accompanying editorial describe the study as “important” but point out that 96% of women and 92% of men studied were White, indicating that the findings “need to be corroborated in more diverse multiethnic populations with variable socioeconomic status to better understand the true magnitude of the benefits observed.”
They conclude: “[D]espite further pharmacological advances in diabetes, the cornerstone of cardiovascular risk reduction will commence with lifestyle interventions.”
By Laura Cowen
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