A healthy lifestyle can improve the risk of artery disease in type 2 diabetics
The current study aimed to evaluate the association between a healthy lifestyle – based on six modifiable lifestyle factors – and the risk of peripheral artery disease (PAD*) among individuals with Type 2 diabetes (T2D). The results suggest that improving healthy lifestyle factors may ameliorate the risk of PAD in type 2 diabetics.
Peripheral artery disease (PAD) affects more than 200 million people worldwide, it is a leading cause of lower extremity amputations, and is associated with a significantly increased risk of cardiovascular morbidity and mortality. Individuals with type 2 diabetes are at a 2-4 times increased risk of developing PAD compared with those without the condition. The evidence regarding modifiable lifestyle factors and peripheral artery disease among adults with T2D remains limited.
In this study, the researchers intended to investigate the association between a set of modifiable lifestyle-related factors and the incidence of PAD in a large prospective study of 14,543 diabetics from the UK Biobank. A healthy lifestyle score using non-smoking, regular physical activity, high quality diet, moderate consumption of alcoholic beverages, optimal waist-to-hip ratio (WHR), and adequate sleep duration was defined and categorized into unfavorable, intermediate, and favorable lifestyles. They also created a genetic risk score using 19 single nucleotide polymorphisms previously found to be associated with PAD.
15% of the participants were classified as following an unfavorable lifestyle, 65% an intermediate lifestyle and 21% a favorable lifestyle. After following up the type 2 diabetics for an average of 13.5 years, 628 cases of PAD were documented.
The results showed that in this large prospective study of type 2 diabetics, a favorable lifestyle including non-smoking, regular physical activity, healthy diet, moderate consumption of alcoholic beverages, maintaining a normal waist-to-hip ratio, and getting adequate sleep was associated with a 73% lower incidence of PAD. Furthermore, it was observed that even among individuals at increased genetic risk, those who had a favorable lifestyle, had a lower risk of PAD. Thus, these results suggest that improving healthy lifestyle factors may ameliorate the risk of PAD in individuals with T2D.
(**) Definition of healthy lifestyle factors:
A healthy diet was considered as adequate consumption of at least half of 10 food groups (fruit, vegetable, whole grains, fish/shellfish, dairy, vegetable oils, refined grains, processed meats, unprocessed meats, and sugar-sweetened beverages).
Information on alcohol intake was self-reported, and healthy drinking was defined as moderate alcohol intake (1–14 g/day for women or 1–28 g/day for men).
Given the U-shaped relationship between sleep duration and PAD, adequate sleep duration (7–8 h/day) was classified as the healthy group.
