Impact of a comprehensive healthy lifestyle on pre-diabetes risk and glycaemic control: insights from NHANES 2005–2018

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 acro...

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Main Authors: Hongmei Xu, Wenyan Xu, Yingying Li, Jiayin Qin, Dandan Sun, Di Bao, Chun Mu, Qiuling Xing
Format: Article
Language:English
Published: BMJ Publishing Group
Series:BMJ Nutrition, Prevention & Health
Online Access:https://nutrition.bmj.com/content/early/2025/07/02/bmjnph-2025-001260.full
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author Hongmei Xu
Wenyan Xu
Yingying Li
Jiayin Qin
Dandan Sun
Di Bao
Chun Mu
Qiuling Xing
author_facet Hongmei Xu
Wenyan Xu
Yingying Li
Jiayin Qin
Dandan Sun
Di Bao
Chun Mu
Qiuling Xing
author_sort Hongmei Xu
collection DOAJ
description 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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spelling doaj-art-5a7baff2b97643e9a4c9c5183231b2e32025-08-20T03:29:14ZengBMJ Publishing GroupBMJ Nutrition, Prevention & Health2516-554210.1136/bmjnph-2025-001260Impact of a comprehensive healthy lifestyle on pre-diabetes risk and glycaemic control: insights from NHANES 2005–2018Hongmei Xu0Wenyan Xu1Yingying Li2Jiayin Qin3Dandan Sun4Di Bao5Chun Mu6Qiuling Xing72 Chongqing Key Laboratory of Child Infection and Immunity, The Childrens Hospital of Chongqing Medical University, Chongqing, China2 School of Social Development and Public Policy, Fudan University, Shanghai, ChinaDepartment of Pharmacology, Seoul National University College of Medicine, Seoul, Korea (the Republic of)Department of Ophthalmology, Peking University International Hospital, Beijing, ChinaNHC Key Lab of Hormones and Development and Tianjin Key Lab of Metabolic Diseases,Tianjin Medical University Chu Hsien-I Memorial Hospital & Institute of Endocrinology, Tianjin, ChinaNHC Key Lab of Hormones and Development and Tianjin Key Lab of Metabolic Diseases,Tianjin Medical University Chu Hsien-I Memorial Hospital & Institute of Endocrinology, Tianjin, ChinaNHC Key Lab of Hormones and Development and Tianjin Key Lab of Metabolic Diseases,Tianjin Medical University Chu Hsien-I Memorial Hospital & Institute of Endocrinology, Tianjin, ChinaNHC Key Lab of Hormones and Development and Tianjin Key Lab of Metabolic Diseases,Tianjin Medical University Chu Hsien-I Memorial Hospital & Institute of Endocrinology, Tianjin, ChinaObjective 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.https://nutrition.bmj.com/content/early/2025/07/02/bmjnph-2025-001260.full
spellingShingle Hongmei Xu
Wenyan Xu
Yingying Li
Jiayin Qin
Dandan Sun
Di Bao
Chun Mu
Qiuling Xing
Impact of a comprehensive healthy lifestyle on pre-diabetes risk and glycaemic control: insights from NHANES 2005–2018
BMJ Nutrition, Prevention & Health
title Impact of a comprehensive healthy lifestyle on pre-diabetes risk and glycaemic control: insights from NHANES 2005–2018
title_full Impact of a comprehensive healthy lifestyle on pre-diabetes risk and glycaemic control: insights from NHANES 2005–2018
title_fullStr Impact of a comprehensive healthy lifestyle on pre-diabetes risk and glycaemic control: insights from NHANES 2005–2018
title_full_unstemmed Impact of a comprehensive healthy lifestyle on pre-diabetes risk and glycaemic control: insights from NHANES 2005–2018
title_short Impact of a comprehensive healthy lifestyle on pre-diabetes risk and glycaemic control: insights from NHANES 2005–2018
title_sort impact of a comprehensive healthy lifestyle on pre diabetes risk and glycaemic control insights from nhanes 2005 2018
url https://nutrition.bmj.com/content/early/2025/07/02/bmjnph-2025-001260.full
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