Study links eight heart-healthy habits to lower diabetes risk in postmenopausal women

Type 2 diabetes is often associated with excessive sugar intake, but lifestyle factors including body weight, exercise, and smoking habits can also influence risk.

A new study has found that greater adherence to eight habits for cardiovascular health is associated with lower rates of diabetes for postmenopausal women.

“Our findings suggest that the same factors we often talk about for heart health may also be important for diabetes prevention and remain relevant across the aging process. It is never too late to benefit from improving your cardiovascular health,” says the study’s lead author Andrea Glenn, assistant professor of nutrition and food studies at NYU Steinhardt.

Glenn and her co-authors used data from the Women’s Health Initiative, a long-term study tracking the health outcomes of postmenopausal women (age 50 and up). The researchers used health data (surveys and blood testing) on 19,403 participants whose information was collected between 1993 and 2024. To examine the association between heart health and type 2 diabetes, the researchers used Life’s Essential 8 (LE8), measures outlined by the American Heart Association to improve cardiovascular health: improving diet, exercising, quitting tobacco, getting adequate sleep, maintaining a healthy weight (body mass index), and managing cholesterol, blood sugar, and blood pressure.

Using self-reported data on habits such as sleep and smoking, and markers for blood glucose, cholesterol, and blood pressure, they assessed participants’ LE8 scores from 0-100, with higher scores indicating better health (low 0-49; moderate 50-79; and high 80-100). They used a similar analysis using five of the eight lifestyle factors (LE5)— diet, exercise, smoking, sleep duration, and BMI—available in a larger cohort of the Women’s Health Initiative (99,269 participants).

The women were followed for an average of 16 years; researchers determined whether they developed type 2 diabetes during this period and analyzed whether diabetes was associated with heart healthy measures. They also assessed if outcomes varied by demographic factors such as race and ethnicity.

The study, published in Diabetology, found that for those being evaluated by the LE8 criteria, 20% of women developed type 2 diabetes. Comparing high to low LE8 groups, women in the highest LE8 category had a 57% lower risk of type 2 diabetes. Of the individual LE8 factors, blood sugar and BMI had the strongest associations with risk of developing type 2 diabetes.

For LE5, 17.7% of women developed type 2 diabetes over the follow-up period. Comparing high to low LE5 groups, women in the highest LE5 category had a 40% lower risk of type 2 diabetes. Again, BMI was most strongly associated with developing type 2 diabetes.

Women younger than 60 had the lowest risk of type 2 diabetes among those with higher LE8 and LE5 scores. The study also found that Hispanic women had a greater risk reduction with higher scores. For waist circumference, women with a waist equal to or less than 31.5 inches had the lowest risk among those with high scores.

“One next step is to better understand how Life’s Essential 8 can be used in clinical and public health settings as a practical framework for diabetes prevention,” says Glenn. “It would also be useful to test whether interventions designed to improve Life’s Essential 8 can lower diabetes risk in real-world settings.”