How Healthy Habits Can Help Prevent Multiple Chronic Diseases
New findings from a multi-center study show that lifestyle changes are linked to a lower risk of having two or more long-term health conditions.
A long-term study of adults with prediabetes found that intensive lifestyle intervention reduced the risk of developing multiple chronic diseases over time, reinforcing the role of early behavioral interventions in improving long-term health outcomes and informing broader approaches to disease prevention.
The research comes from the Diabetes Prevention Program (DPP) and its Outcomes Study (DPPOS), which are large, multi-center clinical trials conducted across the United States. University of Miami was one of the clinical sites contributing participants and long-term follow-up data through this national network supporting national research on diabetes prevention and healthy aging.
UM Contributes to Longitudinal Research
“The University of Miami DPP/DPPOS site currently follows approximately 72 participants who have been part of this study for nearly 30 years,” said Diana Soliman, M.D., M.H.S., assistant professor of medicine in the Division of Endocrinology, Diabetes and Metabolism at the University of Miami Miller School of Medicine. “These results show that lifestyle changes made to prevent diabetes can have lasting benefits for overall health as people age.”
The collaborative study, “Lifestyle and Metformin Interventions and Risk of Multimorbidity in Adults with Prediabetes,” published in JAMA, followed participants across the U.S. for more than two decades. Participants, who were originally recruited between 1996 and 1999 because they were at high risk for type 2 diabetes, were randomized to one of three groups: intensive lifestyle intervention, metformin treatment or placebo.
Participants in the lifestyle intervention group had a 21% lower risk of developing multimorbidity over 20 years compared with those assigned to placebo. Multimorbidity is defined as the presence of two or more chronic conditions.
Intervention Focused on Measurable Behavior Change
The lifestyle intervention emphasized:
- Reduced dietary fat
- At least 150 minutes of physical activity per week
- Weight loss of at least 7%
Participants assigned to metformin did not show a statistically significant reduction in the risk of multimorbidity.
The analysis used Medicare claims data through 2021 from 1,173 participants across 27 U.S. clinical sites.
Findings Reflect Broader Impact on Aging and Health Systems
“Preventing diabetes is critically important, but preventing the accumulation of multiple chronic diseases as people age may have even broader implications for quality of life, independence and health care costs,” said lead author Marcel Salive, M.D., of the Division of Geriatrics and Clinical Gerontology, National Institute on Aging, Bethesda, MD.
The study examined 15 chronic conditions commonly tracked in Medicare data, including hypertension, heart disease, stroke, arthritis, chronic kidney disease, COPD, cancer, depression, dementia, osteoporosis and diabetes.
Key Findings
- Lower risk of two or more chronic conditions in the lifestyle intervention group
- Risk reduction remained when diabetes was excluded from the analysis
- Lower incidence of disease combinations, including stroke, chronic kidney disease, heart failure and COPD
- Eighty-five percent of participants developed at least two chronic conditions during follow-up, underscoring the widespread burden of multi-morbidity among older adults
Translating Long-Term Research Into Prevention Strategies
The findings contribute to a growing body of evidence that sustained lifestyle intervention can influence the trajectory of chronic disease development. The results also provide insight into how long-term clinical research can inform scalable prevention strategies and support efforts to reduce health care burden across aging populations.
The DPP has shown that lifestyle intervention can delay or prevent type 2 diabetes. These findings extend that evidence to demonstrate a broader impact on the development of multiple chronic conditions and inform ongoing approaches to population health and prevention.
Dr. Soliman acknowledged the leadership of Ronald Goldberg, M.D., who led the Miami site for nearly three decades.
Tags: Dr. Diana Soliman, lifestyle intervention study, long-term health outcomes, metformin treatment, multimorbidity prevention, type 2 diabetes prevention