Abstract
The present study assessed the temporal associations of ~ 300 lifestyle exposures with nine cardiometabolic traits to identify exposures/exposure groups that might inform lifestyle interventions for the reduction of cardiometabolic disease risk. The analyses were undertaken in a longitudinal sample comprising > 31,000 adults living in northern Sweden. Linear mixed models were used to assess the average associations of lifestyle exposures and linear regression models were used to test associations with 10-year change in the cardiometabolic traits. ‘Physical activity’ and ‘General Health’ were the exposure categories containing the highest number of ‘tentative signals’ in analyses assessing the average association of lifestyle variables, while ‘Tobacco use’ was the top category for the 10-year change association analyses. Eleven modifiable variables showed a consistent average association among the majority of cardiometabolic traits. These variables belonged to the domains: (i) Smoking, (ii) Beverage (filtered coffee), (iii) physical activity, (iv) alcohol intake, and (v) specific variables related to Nordic lifestyle (hunting/fishing during leisure time and boiled coffee consumption). We used an agnostic, data-driven approach to assess a wide range of established and novel risk factors for cardiometabolic disease. Our findings highlight key variables, along with their respective effect estimates, that might be prioritised for subsequent prediction models and lifestyle interventions.
Highlights
The present study assessed the temporal associations of ~ 300 lifestyle exposures with nine cardiometabolic traits to identify exposures/exposure groups that might inform lifestyle interventions for the reduction of cardiometabolic disease risk
Environment-wide association studies (EWAS) represent an approach through which multiple environmental factors can be systematically screened for their associations with disease traits in a manner that is to a large degree agnostic to prior knowledge about disease associations; in this sense, the EWAS approach is similar to genome-wide association studies (GWAS)
In analyses assessing average association of lifestyle variables, ‘Physical activity’ and ‘General Health’ were the categories containing the highest number of tentative signals and 11 modifiable variables were prioritized for lifestyle interventions focused on controlling cardiometabolic diseases
Summary
The present study assessed the temporal associations of ~ 300 lifestyle exposures with nine cardiometabolic traits to identify exposures/exposure groups that might inform lifestyle interventions for the reduction of cardiometabolic disease risk. Major progress has been made in discovering genetic loci predisposing to these diseases, facilitated by genome-wide association studies (GWAS). Environmental epidemiology typically involves approaches where hypothesized associations between specific environmental exposures and disease traits are separately tested These studies are limited by the expectations and knowledge about the hypothesized relationships they seek to test, which may cause bias and inhibit discovery[1]. The present study sought to assess the temporal relationships of more than 300 lifestyle exposures (e.g. food items, sleep habits, physical activity, psychosocial factors) with nine cardiometabolic traits (i.e. BMI, blood lipids, blood glucose, and blood pressure) and use these results to identify target lifestyle exposures/exposure groups that could inform lifestyle interventions focused on controlling cardiometabolic diseases
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