ArticleBMJ nutrition, prevention & health2025
Impact of a comprehensive healthy lifestyle on pre-diabetes risk and glycaemic control: insights from NHANES 2005-2018.
Article in BMJ nutrition, prevention & health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the association between a comprehensive multidimensional healthy lifestyle and the risk of pre-diabetes and glycaemic control markers, specifically glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG), and to conduct subgroup analyses to examine these associations across different populations. Methods: A cross-sectional analysis of 9567 adults aged 20 and older was conducted using data from the National Health and Nutrition Examination Survey from 2005 to 2018 participants. A lifestyle score was created based on eight modifiable factors: diet, physical activity, smoking, alcohol consumption, sleep duration, waist circumference, depressive symptoms and marital status. Weighted logistic regression estimated ORs for pre-diabetes, and linear regression assessed associations with HbA1c and FPG. Results: A higher healthy lifestyle score was associated with a significantly lower risk of pre-diabetes and improved glycaemic markers. Compared with participants with 0-2 healthy lifestyle factors, those with 7-8 factors exhibited a 53% lower risk of pre-diabetes (OR: 0.47, 95% CI: 0.31 to 0.69; p<0.001, P for trend <0.001). The results showed significant reductions in HbA1c by 0.08 units (95% CI: -0.16 to -0.01) and in FPG by 2.74 mg/dL (95% CI: -4.47 to -1.01). Stratified analyses showed stronger associations in women, individuals without a family history of diabetes, and those aged 40-59. Sensitivity analyses confirmed the robustness of these findings. Conclusions: The study results highlight the value of a multidimensional, modifiable healthy lifestyle in reducing pre-diabetes risk and improving glycaemic control. These results support integrated lifestyle interventions in population-level pre-diabetes prevention strategies.
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