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07-05-2018 | Lifestyle interventions | News

Healthy lifestyle combats cardiometabolic risk regardless of genetic risk

medwireNews: A healthy lifestyle bestows the same degree of relative risk reduction for type 2 diabetes irrespective of whether people have high or low genetic risk for the condition, shows an analysis of UK Biobank data.

If all 339,003 people analyzed had maintained an ideal lifestyle, 72% of the 4379 new incidences of diabetes might have been prevented, the researchers report in JAMA Cardiology. This rose to 90% when restricted to those categorized as having a poor (as opposed to intermediate) lifestyle.

Pim van der Harst (University Medical Center Groningen, the Netherlands) and co-researchers categorized people’s lifestyle as being ideal or poor based on having at least three healthy or unhealthy lifestyle factors relating to BMI, smoking, physical activity, and diet. An intermediate lifestyle was anything that fell between the ideal and poor categories.

The researchers also looked at cardiovascular outcomes, for which the effect was less strong, with 19%, 25%, 37%, and 44% of all incidences of stroke, atrial fibrillation, coronary artery disease, and hypertension preventable had all individuals maintained an ideal lifestyle. They caution, however, that the observational study design cannot prove cause and effect.

The participants were all White British and were aged an average of 57 years. Their genetic propensity to develop type 2 diabetes, based on 38 previously established single nucleotide polymorphisms, was also associated with diabetes incidence, with those in the highest quintile of genetic risk a significant 1.91-fold more likely to develop the condition than those in the bottom quintile.

Lifestyle had similar effects in all genetic risk categories, so among people with an ideal lifestyle having a high genetic risk increased the absolute risk for diabetes significantly but only slightly, at 0.52% versus 0.27% for low genetic risk. But a poor lifestyle had a large effect on people in both genetic risk groups, increasing the risk for diabetes to a corresponding 5.54% and 3.87%, amounting to relative risk increases of 15.46- and 10.82-fold versus low genetic risk and an ideal lifestyle.

For the cardiovascular outcomes the genetic risk effects were similar to that seen for diabetes, but the lifestyle effects were weaker.

“These findings indicate the strong potential benefits of adherence to multiple ideal behavioral lifestyle factors regardless of [genetic risk],” say the researchers.

“Therefore, preventive policies should promote stricter adherence to multiple ideal behavioral lifestyle factors (eg, eliminating smoking, eating a healthy diet, maintaining a healthy weight, and engaging in regular physical activity) for all.”

However, they emphasize the challenges of communicating individual genetic risk, noting that knowledge of their genetic risk “may lead individuals to believe they are destined to develop diseases regardless of their lifestyle and may insufficiently motivate behavior changes.”

By Eleanor McDermid

medwireNews is an independent medical news service provided by Springer Healthcare. © 2018 Springer Healthcare part of the Springer Nature group

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