- In a new observational study, GLP-1 use along with healthy lifestyle habits was associated with a lower risk of cardiovascular problems for people with type 2 diabetes.
- Participants who used GLP-1 and followed six to eight healthy habits had a 43% lower risk of problems like heart attack and stroke compared to those who did not use GLP-1 and followed three or fewer healthy habits.
- GLP-1 use and adherence to healthy habits also reduced the risk of cardiovascular problems independently of each other.
GLP-1 medications are known to treat diabetes and aid in weight loss.
The name GLP-1 is short for glucagon-like peptide-1 receptor agonist. They work by mimicking the effects of a hormone called glucagon-like peptide-1 that plays a role in blood sugar regulation as well as affecting digestion and feelings of fullness after eating.
People with type 2 diabetes, obesity, or both often receive advice about lifestyle habits that can help manage these conditions, and this is also the case when doctors prescribe GLP-1.
Healthy habits such as a healthy diet, exercise, and avoiding smoking can help with blood sugar control and aid in healthy weight loss.
While several studies have looked at how healthy lifestyle choices can support the use of GLP-1 drugs, less attention has been paid to their long-term effects on heart health.
This new study, published in
For the study, researchers examined data from 98,261 people with type 2 diabetes who were enrolled in the US Veterans Affairs’ Million Veteran Program between January 10, 2011, and September 30, 2023.
Each participant had no previous history of heart attack, stroke or advanced chronic kidney disease. More than 13,000 participants used GLP-1.
The researchers identified eight healthy lifestyle habits to look for in the study, which were:
medical news today speak to frank huMD, PhD, Frederick J. Steyer, professor of nutrition and epidemiology and chair of the department of nutrition at the Harvard T.H. Chan School of Public Health, Boston, MA, is one of the study’s authors.
Hu explained that they assessed participants’ diets using the Healthy Plant-Based Diet Index (HPDI): “a diet score that rewards greater intake of healthy plant foods (such as whole grains, fruits, vegetables, nuts, and legumes) while penalizing intake of less healthy plant foods and animal foods to reflect the quality of the overall plant-based diet.”
Researchers define a healthy diet as one that reaches the upper 40% of the hPDI.
The study authors also wanted to see whether participants experienced major adverse cardiovascular events, or MACEs. This included non-fatal strokes or heart attacks as well as deaths from cardiovascular causes.
With this information, the study authors then assessed how the risk of MACE related to GLP-1 use and adherence to eight healthy lifestyle habits.
Overall, the researchers found that the use of GLP-1 along with adherence to healthy habits was associated with a greater reduction in the risk of MACE than that provided by medication or lifestyle habits.
During the years the researchers observed, a total of 10,433 participants experienced MACE.
Participants who used GLP-1 and followed six to eight healthy habits had a 43% lower risk of MACE compared with those who did not use GLP-1 and followed three or fewer healthy habits.
GLP-1 use and adherence to healthy habits also improved MACE risk on their own. Participants who followed all eight healthy habits had a 60% lower risk of MACE compared with those who followed one or none. Using GLP-1 was associated with a 16% lower risk than not using it.
mnt Hu asked whether any healthy habits have more impact than others.
“All eight individual lifestyle habits are important for reducing cardiovascular risk,” Hu replied. “Among them, being physically active, not smoking and not abusing drugs are the most important.
“But diet, sleep, stress management, avoiding heavy alcohol consumption, and social relationships contributed to reduced cardiovascular risk.”
Researchers believe these findings underscore how important a healthy lifestyle can be, even with unprecedented medical interventions.
“Even in the era of highly effective GLP-1 pharmacotherapy, lifestyle habits remain central to diabetes management and cardiovascular risk reduction and can substantially enhance the benefits of modern drugs,” Hu said. Press release.
It is worth noting that the majority of participants in this study were white, male veterans. This means the results may not reflect what would happen in the broader population, although they were consistent here across different genders, as well as different racial and ethnic groups.
The study was also an observational one, so it may be that there were other factors that influenced the results.
Despite these potential limitations, the researchers believe their findings provide more evidence that a healthy lifestyle should remain an important aspect of disease treatment and prevention.
“From a public health perspective, the results underscore the continued importance of population-level investment and policy in promoting healthy diet, physical activity, sleep, stress management, and social connection, even in the modern pharmaceutical era.”
-Frank Hu, MD, PhD
“As innovative treatments expand, scalable lifestyle interventions remain essential to reducing the overall burden of heart disease and other chronic diseases,” Hu said.
