The associations were largely consistent and significant among individuals from different socioeconomic background s and baseline characteristics .
Conclusions /interpretationAdoption of a healthy lifestyle is associated with substantial risk reduction in type 2 diabetes and long-term adverse outcomes among diabetic individuals .
Aims /hypothesisA healthy lifestyle has been widely recommended for the prevention and management of type 2 diabetes .
However , no systematic review has summarised the relationship between combined lifestyle factors ( including , but not limited to , smoking , alcohol drinking , physical activity , diet and being overweight or obese ) and  incident type 2 diabetes and risk of health outcomes among diabetic individuals .
Cumulative Exposure to Ideal Cardiovascular Health and Incident Diabetes in a Chinese Population: The Kailuan Study
Background It is unclear whether ideal cardiovascular health ( CVH ) , and particularly cumulative exposure to ideal CVH ( cumCVH ) , is associated with incident diabetes . We aim ed to fill this research gap . Methods and Results The Kailuan Study is a prospect i ve cohort of 101 510 adults aged 18 to 98 years recruited in 2006–2007 and who were subsequently followed up at 2‐ ( Exam 2 ) , 4‐ ( Exam 3 ) , and 6 ( Exam 4)‐year intervals after baseline . The main analysis is restricted to those individuals with complete follow‐up at all 4 examinations and who had no history of diabetes until Exam 3 .  Cumulative exposure to ideal CVH ( cumCVH )  was calculated as the summed CVH score for each examination multiplied by the time between the 2 examinations ( score × year ) . Logistic regression models were used to assess the association between cumCVH and incident diabetes . In fully adjusted models , compared with the lowest quintile of cumCVH , individuals in the highest quintile had ~68 % ( 95 % confidence interval [ CI ] 60‐75 ) lower risk for incident diabetes ( compared with 61 % [ 95 % CI 52‐69 ] lower risk when using baseline CVH ) . Every additional year lived with a 1‐unit increase in ideal CVH was associated with a 24 % ( 95 % CI 21‐28 ) reduction in incident diabetes . Conclusions Ideal CVH is associated with a reduced incidence of diabetes , but the association is likely to be underestimated if baseline measures of CVH exposure are used . Measures of cumulative exposure to ideal CVH are more likely to reflect lifetime risk of diabetes and possibly other health outcomes . Clinical Trial Registration URL : https://www.chictr.org . Unique identifier : ChiCTRTNC‐11001489
The associations were largely consistent and significant among individuals from different socioeconomic background s and baseline characteristics .
Conclusions /interpretationAdoption of a healthy lifestyle is associated with substantial risk reduction in type 2 diabetes and long-term adverse outcomes among diabetic individuals .
Aims /hypothesisA healthy lifestyle has been widely recommended for the prevention and management of type 2 diabetes .
However , no systematic review has summarised the relationship between combined lifestyle factors ( including , but not limited to , smoking , alcohol drinking , physical activity , diet and being overweight or obese ) and  incident type 2 diabetes and risk of health outcomes among diabetic individuals .