A prospective cohort study in the US revealed that adherence to a healthy lifestyle is associated with a substantially lower risk of cardiovascular disease (CVD) incidence and mortality among adults with type 2 diabetes (T2D). The study included 11,527 participants (8,970 women) with T2D diagnosed during follow-up of an average of 13.3 years, who were free of CVD and cancer at the time of diabetes diagnosis. There were 2,311 incident CVD cases and 858 CVD deaths during follow-up. After multivariate adjustment of covariates, the low-risk lifestyle factors [defined by eating a high-quality diet (top two-fifths of Alternative Healthy Eating Index), nonsmoking, engaging in moderate- to vigorous-intensity physical activity (≥150 min/week), and drinking alcohol in moderation] after diabetes diagnosis were each associated with a lower risk of CVD incidence and CVD mortality. The multivariate-adjusted hazard ratios for participants with 3 or more low-risk lifestyle factors compared with 0 were 0.48, 0.53, 0.33, and 0.32, for total CVD, coronary heart disease, stroke incidence and CVD mortality, respectively. The population-attributable risk for poor adherence to the overall healthy lifestyle (<3 low-risk factors) was 40.9% for CVD mortality. In addition, greater improvements in healthy lifestyle factors from pre-diabetes to post-diabetes diagnosis were also significantly associated with a lower risk of CVD incidence and CVD mortality. For each number increment in low-risk lifestyle factors there was a 14%, 12%, 21%, and 27% lower risk of total CVD, coronary heart disease, stroke incidence and CVD mortality, respectively. Similar results were observed when analyses were stratified by diabetes duration, sex/cohort, body mass index at diabetes diagnosis, smoking status, and lifestyle factors before diabetes diagnosis. The findings are consistent with other studies and suggest that adopting a healthy lifestyle is an effective prevention strategy. Source: http://www.onlinejacc.org/
