Healthy lifestyle linked to 25% lower coronary heart disease risk
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Key takeaways:
- Adhering to a healthy lifestyle could reduce CHD risk regardless of genetic susceptibility to abdominal obesity.
- The more favorable lifestyle included factors like healthy diet and sleep habits.
Adhering to a healthy lifestyle could reduce coronary heart disease risk regardless of genetic susceptibility to abdominal obesity, according to the results of research published in the American Journal of Clinical Nutrition.
Body fat around one’s visceral organs, also known as abdominal adiposity, is a well-known risk factor for coronary heart disease (CHD), Youngwon Kim, PhD, an assistant professor at the University of Hong Kong Li Ka Shing, told Healio. However, he said there has been no research exploring if adhering to a healthy lifestyle could help prevent CVD events.
“It is widely acknowledged that abdominal obesity is influenced by a combination of genetic and environmental factors, such as lifestyle choices,” Kim said. “We carried out this piece of work to shed light on the interplay between genetic susceptibility to abdominal obesity and lifestyle behaviors on CHD risk and multiple cardiometabolic risk markers.”
To evaluate the associations, they included data from 282,316 white British adults from the U.K. Biobank study. The researchers assessed 12 CVD risk markers at baseline, and the follow-up period for incident CHD was 13.8 years. They evaluated genetic risk for abdominal obesity — defined by the waist-to-hip ratio (WHR) — with weighted polygenic risk scores (PRSs) and calculated lifestyle scores based on five healthy lifestyle factors:
- healthy diet;
- regular physical activity;
- no current smoking;
- drinking alcohol fewer than three times per week; and
- sleeping for 7 to 9 hours each night.
Kim and colleagues found that adhering to a healthy lifestyle could reduce CHD risk regardless of genetic susceptibility to abdominal obesity; those who had medium or high genetic risk for abdominal obesity but adhered to a healthy lifestyle saw a lower risk for developing CHD compared with those with low genetic risk and an unhealthy lifestyle.
More specifically, adhering to a favorable lifestyle (having four or five healthy lifestyle factors) was linked to a 25% lower risk for CHD (HR = 0.75; 95% CI, 0.7-0.81) compared with those adhering to an unfavorable lifestyle (zero or one factor), regardless of PRS for high WHR.
“This finding highlights the potential effectiveness of lifestyle modification interventions in preventing coronary heart disease events, among individuals with high genetic susceptibility to abdominal obesity,” Kim said. “Future clinical trials could consider focusing on promoting healthy lifestyle measures for individuals at high genetic risk of abdominal obesity for the primary prevention of coronary heart disease events.”
Having a healthy lifestyle was also connected with healthier levels of CVD risk markers except high-density lipoprotein and random glucose, regardless of PRS for high WHR. The estimated 12-year absolute CHD risk was higher for those with an unfavorable lifestyle at low genetic risk (2.08%) than for those with favorable lifestyle at medium genetic risk (1.67%) and high genetic risk (1.73%).
“Our study emphasizes the potential importance of preemptively identifying individuals who have high genetic predisposition to abdominal obesity, and then intervening with them to help them adopt a healthier lifestyle for prevention of adverse cardiovascular events,” Kim said. “While having access to and assessing genetic information can be challenging in the real-world clinical setting, we encourage primary care physicians to consider tapping into individuals’ genetic make-up as part of their routine clinical practice moving forward.”
Perspective
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This research underscores the intricate interplay between genetics and lifestyle in CVD risk. Although genetic predisposition influences susceptibility to CHD even for those with a high or medium genetic risk, this highlights the significant role of lifestyle choices in mitigating genetic risk factors. Additionally, advancements in epigenetics and nutrigenomics underscore the need to move beyond a one-size-fits-all approach in CVD prevention and treatment. Instead, they emphasize the potential for tailored interventions that account for an individual's unique genetic and epigenetic profile, offering promising avenues for personalized approaches to CVD prevention and treatment in the ongoing battle against CVD.
Perspective
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Fatima Cody Stanford, MD, MPH, MPA, MBA, FAAP, FACP, FAHA, FAMWA, FTOS
We are aware that genetic susceptibility to obesity worsens health outcomes in individuals with this predisposition. This study demonstrated that persons with higher genetic risk and favorable lifestyles as denoted by regular physical activity, no current smoking, a healthy diet, less than three times per week of alcohol consumption and 7 to 9 hours per day of sleep had a lower likelihood of developing CHD than those without a genetic risk and unhealthy lifestyles. However, there is one major issue with this study: there was no racial or ethnic diversity. This study evaluated only British white individuals, which makes it difficult to extrapolate to those who may be more at risk for heart disease.
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