Metabolic signatures of healthy lifestyle score and diet in relation to diabetes and disease-free life expectancy
Diabetes is a major threat to public health that may leads to severe complications and premature death. 537 million adults are living with diabetes worldwide in 2021 and the number is projected to increase to 783 million by 2045. Type 2 diabetes can be prevented or at least postponed by lifestyle intervention including weight loss, increased physical activity, improved dietary quality and reduced dietary intakes according to intervention studies. Similarly, it has been shown that an unhealthy lifestyle that is characterized by obesity, smoking, physical inactivity, high consumption of processed red meat and low consumption of whole grain, fruit and vegetables increases the risk. To what extent a healthy lifestyle may prevent other forms of diabetes including type 1 diabetes and latent autoimmune diabetes in adults is not clear, but previous studies including a recent Mendelian randomization study suggest that overweight is indeed causally linked to type 1 diabetes in children. Previous studies have shown that some types of metabolites are associated with the development of type 1 and type 2 diabetes in adulthood. However, there is a lack of comprehensive assessments on how different types of metabolites are affected by lifestyle factors and to what extent such metabolic changes mediates the association between lifestyle factors and diabetes. Diabetes is one of the major chronic diseases globally. It remains unclear how lifestyle-related metabolic signatures affect life expectancy free of major chronic diseases. We aim to (1) investigate the association of healthy lifestyle score, dietary pattern/quality, and some specific food items with both type 1 and type 2 diabetes; (2) investigate the association of healthy lifestyle score, dietary pattern/quality, and some specific food items with 249 NMR metabolites; (3) investigate the mediation role of such metabolic signatures on the association of healthy lifestyle score, dietary pattern/quality, and food items with type 1 diabetes and type 2 diabetes; (4) investigate potential interaction between metabolic signatures and genetic susceptibility to diabetes on the risk of diabetes; (5) investigate the influence of such metabolic signature on disease-free life expectancy.