Life's Simple 7 and Incidence of Diabetes Among American Indians: The Strong Heart Family Study.

Publication Type:

Journal Article


Diabetes care (2014)


2014, May 2014, Public Health Sciences Division


OBJECTIVEThe American Heart Association's recommendations for optimal health, summarized in Life's Simple 7, have been associated with reduced risk of cardiovascular disease (CVD)-related end points, but no studies have examined the association of these goals with incident type 2 diabetes, which is associated with high risk for CVD. The purpose of this analysis was to examine the associations of Life's Simple 7 goals with incident diabetes among American Indians, a population at high risk of cardiometabolic diseases.RESEARCH DESIGN AND METHODSStrong Heart Family Study participants without diabetes (n = 1,639) at baseline and who participated in a follow-up examination were included in the analysis. Risk scores ranging from 0 to 7 were created using physical activity, diet, BMI, smoking, blood pressure, fasting glucose, and cholesterol metrics in accordance with Life's Simple 7 goals. Diabetes was defined using 2003 American Diabetes Association criteria, including use of insulin or oral antidiabetes medication or a follow-up fasting plasma glucose level ≥126 mg/dL. Generalized estimating equations were used to examine the association of risk scores with incident diabetes.RESULTSDuring a mean 5-year follow-up (range 4-8 years), we identified 210 cases of incident type 2 diabetes. Compared with participants who achieved 0-1 goals, those who achieved 2-3 or 4+ goals had lower odds of diabetes, with odds ratios = 0.40 (95% CI 0.29-0.56) and 0.11 (95% CI 0.05-0.21), respectively.CONCLUSIONThe adoption of as few as two or three Life's Simple 7 goals is associated with a lower risk of diabetes.