Each 1-SD increase in a composite healthy lifestyle score was associated with a lower incidence of type 1 diabetes (HR 0.80; 95% CI 0.73-0.89).
Cohort (n=297,400)
Yes
Does a higher composite healthy lifestyle score reduce the incidence of type 1 diabetes and its complications (CVD, MVD, mortality)?
Adherence to a healthy lifestyle is associated with lower incidence of type 1 diabetes and reduced risks of cardiovascular and microvascular complications among those with the disease.
Hazard Ratio: 0.8 (95% CI 0.73–0.89)
Introduction and Objective: To investigate associations between a composite healthy lifestyle score (CHS) and type 1 diabetes (T1D) incidence, complications, and mortality, exploring gene-environment interactions and mediating pathways. Methods: Multi-cohort study integrating NHANES (cross-sectional), a Chinese case-control study (JSPH), and UK Biobank (prospective). CHS (0-100) included smoking, sleep, diet, and physical activity. Outcomes were T1D incidence, cardiovascular (CVD) and microvascular (MVD) disease, and mortality. Analyses used logistic/Cox regression, mediation, and LASSO for a metabolic signature. A polygenic risk score (PRS) assessed genetic susceptibility. Results: Among 297,400 UKB participants, each 1-SD increase in CHS was associated with lower T1D incidence (HR 0.80, 95% CI 0.73-0.89). Protective associations were consistent in NHANES (OR 0.82, 95% CI 0.70-0.97) and JSPH (OR 0.54, 95% CI 0.37-0.78), with strongest protection at intermediate genetic risk (HR 0.64, 95% CI 0.54-0.76). In T1D patients, healthier lifestyle reduced risks of CVD (HR 0.79, 95% CI 0.70-0.88), MVD (HR 0.83, 95% CI 0.75-0.91), and mortality (HR 0.74, 95% CI 0.68-0.80). Mediation analyses showed protection was mediated through immunometabolic pathways: 17.1% for T1D, 19.9% for CVD, and 21.4% for MVD, supported by a 68-metabolite signature. Conclusion: Adherence to a healthy lifestyle lowers T1D risk and complications, partly via immunometabolic pathways, with effect modification by genetic susceptibility. Disclosure S. Li: None. Y. Chen: None. Y. Gu: None. Funding Noncommunicable Chronic Diseases-National Science and Technology Major Project (2023ZD0507400, 2023ZD0507402, 2023ZD0507403)
LI et al. (2026) conducted a cohort in Type 1 diabetes (n=297,400). Composite healthy lifestyle score (CHS) vs. Lower healthy lifestyle score was evaluated on Type 1 diabetes incidence (HR 0.80, 95% CI 0.73-0.89). Each 1-SD increase in a composite healthy lifestyle score was associated with a lower incidence of type 1 diabetes (HR 0.80; 95% CI 0.73-0.89).