A US study spanning over two decades suggests that diet, exercise, and weight management not only delay diabetes but also significantly decrease the likelihood of developing multiple chronic conditions during ageing, highlighting the broader benefits of healthy habits.
A long-running US diabetes prevention study suggests that diet, exercise and weight management may do more than delay diabetes: they may also reduce the chances of developing several chronic illnesses at once over the course of ageing.
Researchers who analysed more than two decades of follow-up from the Diabetes Prevention Program and its extension study examined health records for 1,173 adults who had pre-diabetes when they entered the trial. Participants had originally been assigned to one of three groups: a placebo group, a metformin group or an intensive lifestyle group aimed at healthier eating, more physical activity and a weight loss target of at least 7%.
The latest analysis, published in JAMA, found that people in the lifestyle arm were less likely to develop multi-morbidity, defined as having at least two chronic conditions. Over the study period, that group had a 21% lower risk than the placebo group. The benefit persisted even when diabetes itself was removed from the list of conditions being counted, suggesting the effect was broader than diabetes prevention alone.
The study looked for 15 long-term conditions, including hypertension, coronary artery disease, heart failure, stroke, chronic kidney disease, chronic obstructive pulmonary disease, cancer, dementia, depression, arthritis, osteoporosis, asthma and hyperlipidaemia. After researchers adjusted for factors such as age, sex, race, ethnicity, alcohol use and body mass index, the association between the lifestyle programme and lower disease burden remained.
That finding builds on earlier Diabetes Prevention Program Outcomes Study results showing that the same lifestyle intervention sharply cut the risk of developing diabetes over time, with metformin also providing protection, though to a lesser degree. It also fits with other recent JAMA research showing that structured lifestyle programmes can be delivered in different ways, including in primary care settings and through AI-supported coaching, while still producing meaningful improvements in weight, activity and blood sugar control.
The new paper does not prove that healthier habits directly caused the lower rate of multiple chronic illnesses, but the researchers say the pattern is consistent with the idea that early, sustained lifestyle change can influence health well beyond glucose control. Dana Dabelea, an epidemiologist at the Colorado School of Public Health, said the results highlight the long-term value of healthy eating, regular physical activity and weight management. Marcel Salive of the US National Institute on Aging said preventing diabetes remains important, but avoiding the build-up of several chronic diseases may have even larger implications for quality of life, independence and healthcare costs.
Even so, the broader message is mixed. Across the full study population, including those in the lifestyle group, 85% developed at least two chronic conditions. Still, for a population that is living longer, but not always healthier, the results add to evidence that prevention efforts can shape the later decades of life.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
