Life's Essential 8, genetic predisposition, and risk of incident adult-onset asthma: a prospective cohort study

Cardiovascular Health, Genetic Susceptibility, and the Risk of Incident Autoimmune Disorders in the UK Biobank: A Prospective Cohort Study

BACKGROUND

Autoimmune diseases are closely linked to cardiovascular diseases. This study aimed to assess the relationship between cardiovascular health (CVH) defined by Life's Essential 8 (LE8), genetic predisposition, and the risk of 19 autoimmune disorders.

METHODS AND RESULTS

A total of 247 660 participants without prior autoimmune diseases from the UK Biobank were included. CVH was assessed using LE8 scores, categorized into low, moderate, and high. Cox proportional hazards models estimated the association between CVH, genetic susceptibility, and autoimmune disorder risk. Over 13.2 years of follow-up, 11 422 incident autoimmune disorders occurred. Higher CVH levels were associated with reduced risks of overall autoimmune disorders (hazard ratio, 0.68 [95% CI, 0.62-0.74]) and specific conditions, including Graves disease, inflammatory bowel disease, polymyalgia rheumatica, psoriasis, rheumatoid arthritis, and type 1 diabetes. Dose-response analyses revealed a linear negative relationship between continuous LE8 scores and the risks of Graves disease, inflammatory bowel disease, polymyalgia rheumatica, psoriasis, rheumatoid arthritis, and type 1 diabetes (Pnonlinear>0.05). Genetic predisposition to autoimmune disorders (including ankylosing spondylitis, celiac disease, Graves disease, inflammatory bowel disease, polymyalgia rheumatica, psoriasis, rheumatoid arthritis, Sjögren syndrome, systemic lupus erythematosus, systemic sclerosis, and type 1 diabetes) significantly modified these associations (Pinteraction<0.05), with protective effects more pronounced in women, participants aged <65 years, and those with low genetic risk.

CONCLUSIONS

LE8 scores inversely and linearly predicted autoimmune disease incidence. Prioritizing CVH optimization through LE8 adherence may reduce the global autoimmune disease burden.

Dietary advanced glycation end products may increase the incidence of allergic rhinitis depending on genetic susceptibility: a prospective cohort study

Background: Limited evidence exists for the relationship between dietary advanced glycation end product (AGE) intake and allergic rhinitis (AR). Herein, the association between dietary AGEs and the risk of developing AR and whether genetic susceptibility influences the effects of dietary AGEs on AR were explored. Methods: In total, 125 276 participants without AR at baseline and having completed at least two 24-hour dietary recalls from the UK Biobank (2006-2010) were included. Dietary AGEs, specifically Nε-(1-carboxyethyl)-L-lysine (CEL), Nε-(carboxymethyl) lysine (CML), and Nδ-(5-hydro-5-methyl-4-imidazolone-2-yl) ornithine (MG-H1), were quantified by coupling 24-hour food assessments with a validated dietary AGE database. The incidence of allergic rhinitis was determined through hospital admissions. Multivariate Cox regression models were used to calculate the hazard ratios (HR) and 95% confidence intervals (CI) of the association between dietary AGE intake and the risk of AR. Results: During a median follow-up period of 12.4 years, 1171 individuals developed AR. In the fully adjusted model, higher dietary AGEs (HR: 1.27; 95% CI: 1.07, 1.50; P-trend = 0.006) and MG-H1 intake (HR: 1.19; 95% CI: 1.01, 1.41; P-trend = 0.046), especially the dietary AGEs derived from baked foods (HR: 1.23; 95% CI: 1.03, 1.46; P-trend = 0.020) and from nuts and legumes (HR: 1.24; 95% CI: 1.05, 1.47; P-trend = 0.013) were associated with an increased risk of AR. Among participants with a low genetic risk of AR, the HRs (95% CI) of AR were 1.32 (1.01, 1.73) and 1.37 (1.05, 1.79) for dietary AGE and MG-H1 intake, respectively. Conclusions: Dietary AGE intake was associated with an increased risk of AR, which was modified through genetic predisposition.

Association between life's crucial 9 and lung health: a population-based study

BACKGROUND

As a cardiovascular health (CVH) assessment tool, Life's Crucial 9 (LC9) is often associated with diverse chronic health indicators. However, no study has yet explored the association of LC9 with multifactorial components of lung health. Thus, this study aimed to investigate the correlation of LC9 with lung health.

METHODS

This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES), which covers individuals aged 40 years and older with complete LC9 and lung health data. Multiple regression was employed in linear relationships investigation, while Restricted Cubic Spline (RCS) was used to explore nonlinear relationships. Subgroup analyses and interaction tests demonstrated the stability of associations. Combining LC9 to build a Light Gradient Boosting Machine (LightGBM) machine learning (ML) model to predict lung health, Shapley Additive Explanations (SHAP) sorted the contribution of LC9 components to the model.

RESULTS

From a total of 10,461 study participants, 1725 had low CVH, 7476 had moderate CVH, and 1260 had high CVH. There was a strong positive correlation between LC9 score and lung health. This association remained consistent across subcomponent strata. RCS analysis revealed non-linear associations between LC9 and respiratory outcomes, including cough, asthma, and COPD. The LightGBM model incorporating LC9 demonstrated excellent predictive performance for lung health, with favorable metrics in Area Under the Curve (AUC), accuracy, and specificity. SHAP analysis identified depression, nicotine exposure, and BMI scores as the predominant contributors among LC9 components to the model's predictive capability.

CONCLUSION

Individuals with better CVH as assessed by LC9 tended to have better lung health. The combination of the LightGBM model could achieve better prediction results.

Association Between Life's Essential 8 and Frailty in Adults with Asthma

Objectives

To investigate the correlation between Life's Essential 8 (LE8) and frailty in adults with asthma using data from National Health and Nutrition Examination Survey (NHANES).

Methods

We conducted a cross-sectional study by NHANES data (2001-2018) to assess the relationship between LE8 and frailty in asthma patients. Multiple logistic regression, restricted cubic spline (RCS) analysis, and subgroup analyses were performed to evaluate potential associations.

Results

Among the 3, 238 of 91 351 participants, 1066 asthma patients demonstrated frailty and 2172 asthma patients not. When comparing the groups with moderate and high LE8 scores to the group with low LE8 scores, the odds ratios (ORs) (95% confidence intervals) for frailty in asthma were 0.39 (0.27, 0.56) and 0.15 (0.08, 0.27),respectively. Every 10-point increment of LE8 scores was negatively correlated with frailty in asthma. Similar trends were observed for health behavior and health factor scores. ORs for frailty in asthma were 0.54 (0.41, 0.72) and 0.41(0.27, 0.64) when comparing the groups with moderate and high health behavior scores to the group with low health behavior scores. ORs for frailty in asthma were 0.68 (0.48, 0.98) and 0.50 (0.28, 0.88) when comparing the groups with moderate and high health factor scores to the group with low health factor scores. ORs for frailty in asthma were 0.78 (0.72, 0.84) both in the every 10-point increment of health behavior and health factor scores.

Conclusions

Higher LE8 scores, along with health behavior and health factor scores, were linearly and inversely associated with the prevalence frailty in adults with asthma, suggesting that improved LE8 may reduce frailty risk in asthma population.

Associations between life's essential 8 and arthritis among adults in United States: a national-wide longitudinal study

BACKGROUND

Arthritis, a common condition in the U.S., is caused by autoimmune reactions, osteoarticular injuries, and uric acid deposition. It affects around 25% of adults and is strongly linked to cardiovascular disease. The American Heart Association's Life's Essential 8 (LE8) composite, which considers cardiovascular health factors, has been studied for its predictive capacity in assessing arthritis risk. The study aims to provide tailored prevention recommendations and monitor factors associated with arthritis within the LE8 framework specifically for arthritic individuals.

METHODS

This population-based study used data from the U.S. NHANES (2017-2020) for adults aged 20 + . Multivariate logistic and restricted cubic spline modeling explored the relationship between LE8 and arthritis, revealing significant nonlinearity (P < 0.001). Gradient Boosting Decision Trees were employed to conduct a predictive model of Arthritis risk.

RESULTS

Through study, we found that idealer LE8 scores correlated with poorer arthritis risk. Subgroup analyses ideallighted poorer scores for smoking (P < 0.002, poor_socre and intermediate_score) and physical activity(P = 0.001, poor_score) as significant risk factors. Gradient Boosting Decision Trees predicted disease risk, with age, HDL cholesterol, and blood pressure identified as the three most significant predictive factors.

CONCLUSION

The LE8 score in U.S. adults shows a negative association with arthritis outcomes, with arthritis prevalence decreasing as the score increases. poorer Smoke and Physical Exercise Time components and intermediate Blood Glucose scores may be arthritis risk factors. The LE8 may help identify arthritis risk early and reduce its burden.

Association of Life's Essential 8 and Life's Simple 7 with metabolic-associated fatty liver disease in the United States

BACKGROUND

Cardiovascular health (CVH) plays a crucial role in overall health, but its association with metabolic-associated fatty liver disease (MAFLD) remains unclear.

AIM

To investigate the relationship between CVH, measured using Life's Essential 8 (LE8) and Life's Simple 7 (LS7), and the prevalence of MAFLD.

METHODS

This cross-sectional study had a sample of 2234 individuals, representing approximately 120 million individuals in the United States. Baseline parameters were compared between the LE8 and LS7 groups. Logistic regression models were used to evaluate the relationship between LE8, LS7, and MAFLD, while taking into account confounding factors. The investigation employed restricted cubic splines to investigate non-linear associations. Subgroup analyses and sensitivity studies were performed to evaluate the strength and reliability of the results.

RESULTS

Higher LE8 and LS7 scores were significantly associated with a decreased risk of MAFLD, even after controlling for demographic, socioeconomic, and clinical variables. This association demonstrated a non-linear pattern, with the most dramatic risk reduction observed at higher CVH levels. Individual CVH components, notably healthy behaviors and factors, exhibited strong relationships with MAFLD. Subgroup analyses indicated consistent relationships across several demographics. Sensitivity tests utilizing other MAFLD definitions validated the robustness of the findings.

CONCLUSION

Higher adherence to CVH criteria, as indicated by LE8 and LS7 scores, is associated with a significantly lower risk of MAFLD. These results emphasize the need to advance CVH to control and avoid MAFLD.

Associations between asthma and Life's Essential 8: a cross-sectional study

Background

Asthma is a serious respiratory disease attributed to multiple factors. The Life's Essential 8 (LE8), introduced by the American Heart Association, aims to improve and maintain cardiovascular health. However, the correlation between LE8 components and asthma remains unclear. We hypothesized that LE8 is a protective factor against asthma.

Materials and methods

Multiple logistic regression analysis, restricted cubic spline (RCS) analysis, and subgroup analysis were used to analyze the data collected from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018.

Results

A total of 3,360 participants with asthma were included in the analysis. With all confounders controlled for, LE8 scores were negatively correlated with asthma prevalence (odds ratio (OR) per 10-point increment, 0.85 [95% confidence interval (CI), 0.82-0.88]). Compared to low LE8 scores, moderate and high LE8 scores were associated with reduced asthma risk, with adjusted ORs (95% CIs) of 0.59 (0.51-0.68) and 0.48 (0.39-0.58), respectively. Non-linear correlations were observed between LE8 scores and asthma (p non-linear = 0.01) and between health factor scores and asthma (p non-linear = 0.01). However, a linear dose-response correlation was noted between health behavior scores and asthma (p non-linear = 0.30). Subgroup analysis showed no significant interaction effects (p > 0.05), except in the sex and drinking status subgroups (p for interaction = 0.02).

Conclusion

Asthma is associated with components of LE8, which warrants further attention and may contribute to reducing asthma prevalence.

Association between Life's Essential 8 and risk of heart failure: findings from the Kailuan study

AIMS

The impact of Life's Essential 8 (LE8) on heart failure (HF) remains poorly understood. We examined the associations between three forms of LE8 measurements and HF.

METHODS AND RESULTS

A total of 35 896 participants without a prior history of HF from the Kailuan community were included. The LE8 status was measured in 2014. A latent mixture model was employed to identify the trajectories of LE8 during 2006 to 2014. The LE8 annual change rate was defined as the slope of the linear regression equation fitted by five LE8 measurements. Cox proportional hazards models were used to assess the risk of HF associated with LE8, after adjusting for potential confounding variables. The predictive performance was quantified and compared using the C-index. Five distinct LE8 trajectories were identified. 461 HF events documented during follow-up. The LE8 trajectories presenting an upward trend in LE8 were associated with a reduced risk of HF, even when the initial LE8 level was low [HR (95% confidence interval) for moderate-increasing vs. moderate-decreasing trajectory was 0.43 (0.34, 0.55)]. The LE8 status was inversely associated with HF risk. A higher LE8 annual increase was associated with a lower risk of HF. The LE8 trajectory was more accurate in predicting the risk of HF compared with LE8 status.

CONCLUSION

LE8 was inversely associated with HF risk. Individuals with initially low LE8 levels experienced a reversal in HF risk upon improvement. Both LE8 trajectories and status are practicable in identifying individuals at high risk of HF, LE8 trajectories may provide added prognostic information.

Life's Essential 8, genetic susceptibility, and risk of incident pancreatic cancer: A prospective cohort study

The association between the American Heart Association (AHA) Life's Essential 8 (LE8) and the risk of pancreatic cancer (PC) remains unclear. Our goal was to assess the relationships between LE8, genetic susceptibility, and PC risk. This cohort consisted of 234,102 participants from the UK Biobank. The components of LE8 include diet, nicotine exposure, sleep, physical activity, blood glucose, body mass index, blood lipids, and blood pressure. LE8 is classified into three categories: low cardiovascular health (CVH), moderate CVH, and high CVH. Measurements were made using Cox proportional risk models to estimate impact of associations between LE8, genetic susceptibility, and incidence of PC in participants. Compared to participants with low LE8 scores, those with moderate and high LE8 scores had a 53% (HR, 0.47; 95% CI, 0.39-0.57) and 70% (HR, 0.30; 95% CI, 0.22-0.41) lower risk of developing PC, respectively. Interestingly, among individuals with high genetic risk, high LE8 scores were associated with greater benefits (HR, 0.24; 95% CI, 0.15-0.40), whereas the protective effect was weaker among those with low genetic risk (HR, 0.40; 95% CI, 0.21-0.75). Participants with a high LE8 score and a low polygenic risk score (PRS) had the lowest risk of PC (HR, 0.19; 95% CI: 0.11-0.33). Furthermore, we observed a significant additive interaction between LE8 and PRS. A higher LE8 score is associated with a lower risk of PC, especially for participants with a high PRS. These findings have important implications for participants most genetically predisposed to PC and for targeted strategies for PC prevention.

Associations Between Life's Essential 8 and Major Ocular Diseases in the American Middle-Aged and Elderly Population

PURPOSE

To explore the correlation between cardiovascular health (CVH) and ocular diseases, given their shared risk factors and biological mechanisms, this study utilizes the newly updated Life's Essential 8 (LE8) algorithm.

DESIGN

A cross-sectional study.

METHODS

This analysis, conducted from February 15 to April 1, 2024, in Changchun, includes data from 4146 participants aged 40 and above, drawn from the National Health and Nutrition Examination Survey database (2005-2008). It covers information on visual health status, dietary habits through interviews, and professional ophthalmological examinations. Participants' CVH status was assessed using the LE8 algorithm, and relationships with major ocular diseases such as retinopathy, cataracts, diabetic retinopathy, glaucoma, and age-related macular degeneration were explored through weighted logistic regression analysis, restricted cubic splines, stratified analysis, and sensitivity analysis.

RESULTS

After multivariable adjustment, lower LE8 scores showed a significant positive relationship with any ocular disease (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.39-2.96, P = .001), any objectively determined ocular disease (OR: 2.24, 95% CI: 1.48-3.38, P < .001), retinopathy (OR: 2.88, 95% CI: 1.89-4.41, P < .001), diabetic retinopathy (OR: 10.23, 95% CI: 3.11-33.61, P < .001), and glaucoma (OR: 2.76, 95% CI: 1.47-5.21, P = .003), with all trends significant (all P < .01). Additionally, lower scores in the behavioral subdomain were significantly correlated with an elevated risk of cataracts (OR: 1.45, 95% CI: 1.03-2.04). Subgroup analyses revealed more pronounced negative correlations between LE8 and retinopathy among females and those suffering from chronic kidney disease.

CONCLUSIONS

A low CVH score was linked to an increased likelihood of ocular diseases in a US-populated-based study. This correlation supports the potential benefits of enhancing cardiovascular wellness to mitigate the development of ocular conditions.

Life's Essential 8, genetic susceptibility and the risk of psoriatic disease: a prospective cohort study

BACKGROUND

Psoriatic disease (PsD) is closely associated with cardiovascular (CV) disease. The Life's Essential 8 (LE8) score is a new metric to assess CV health (CVH), where a higher score indicates better CVH. However, the longitudinal association between LE8 score and the risk of PsD remains uncertain.

OBJECTIVES

To investigate, in a cohort study, the association between LE8 score, genetic susceptibility and the risk of PsD.

METHODS

This cohort study included 261 642 participants in the UK Biobank without PsD at baseline. LE8 comprises eight indicators: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose and blood pressure. Cox proportional hazard models were used to examine the association between participants' LE8 scores, genetic risk of PsD and the risk of PsD. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated.

RESULTS

During an average follow-up of 12.3 years, 1501 participants developed PsD. Compared with participants with low LE8 scores, the HRs of developing PsD for those with moderate and high LE8 scores were 0.51 (95% CI 0.43-0.59) and 0.34 (95% CI 0.27-0.42) after adjustments, respectively. Dose-response analysis revealed a linear negative association between continuous LE8 score and the risk of developing PsD (P < 0.001), with no evidence of nonlinear association detected. Genetic susceptibility to PsD did not modify this association (P-interaction = 0.63). Subgroup analyses revealed that women had a more pronounced beneficial association between LE8 scores and PsD risk (P-interaction = 0.02).

CONCLUSIONS

Our study suggests that a higher LE8 score, regardless of genetic risk, is associated with a lower risk of PsD, particularly in women. Consequently, maintaining good CVH status is recommended to prevent PsD and assess associated risks.

Association between cardiovascular health assessed by life's essential 8 and hyperuricemia in U.S. adults: the NHANES 2009-2020

Background

This study presented the new Life's Essential 8 (LE8) framework for examining cardiovascular health (CVH) to analyze the potential relationship between the latter and hyperuricemia (HUA) in the U.S. population.

Methods

Data on individuals aged at least 20 years were collected from the National Health and Nutrition Examination Survey (NHANES) 2009-2020. Smoothed curve fitting and multivariate logistic regression analyses were then performed on a sample of 25,681 adults to explore the association between LE8 and HUA. A sensitivity analysis was conducted to examine the robustness of the research findings.

Results

The study found a strong negative association between LE8 and HUA, with an odds ratio (OR) of 0.71 and a 95% confidence interval (CI) from 0.69 to 0.73 after adjusting for multiple confounding factors. The sensitivity analysis further validated the robustness of this association. This analysis consistently showed negative associations across different genders, ages, races, and education levels (p < 0.05), but there were no significant relationships with marital status. The association between uric acid levels and LE8 displayed an inverted L-shaped curve, with an inflection point around 41.43.

Conclusions

The findings indicate a strong negative relationship between LE8 and HUA among the U.S. population, suggesting that higher scores on the LE8, which assesses CVH, were associated with reduced uric acid levels. The consistent negative association underscores the LE8 framework's potential as a valuable tool for understanding and managing HUA in CVH.

10-year trajectory of Life's Essential 8 and incident hypertension: a community-based cohort study

BACKGROUND

The health effects of Life's Essential 8 (LE8) on chronic diseases have been disclosed, but its association with hypertension remains unknown. The current study aimed to explore the potential link between 10-year LE8 trajectory and the incidence of hypertension.

METHODS

LE8 was constructed from four behaviors and four metabolic factors, ranging from 0 to 100. Latent mixture models were used to identify trajectories of LE8 scores during 2006 to 2016. Incident hypertension was diagnosed based on self-reported clinical diagnoses and physical examinations from 2016 to 2020. Cox models were employed to assess the association of LE8 trajectories with hypertension. In addition to incorporating the mean hs-CRP levels from 2006 to 2016, age, sex, monthly income, educational level, and occupation at recruitment were adjusted for as confounding factors.

RESULTS

7500 participants aged 40.28 ± 10.35 years were included in the study, of whom 2907 (38.76%) were women. Five LE8 trajectory patterns were identified. After around four-year follow-up, 667 hypertension events were observed. Compared to the Low-Stable trajectory, the hazard ratios and 95% confidence intervals for the Moderate-Increasing, Moderate-Decreasing, Moderate-Stable, and High-Stable trajectories were 0.51 (0.40, 0.65), 0.81 (0.64, 1.02), 0.45 (0.36, 0.58), 0.23 (0.16, 0.33), respectively. The risk of incident hypertension decreased as participants improved their LE8 status. The robustness of the primary results was confirmed through several sensitivity analyses.

CONCLUSIONS

LE8 trajectories were associated with the incident hypertension. People who improved their LE8 scores over time experienced a decreased risk of hypertension, even if they started with lower LE8 scores initially.

Association of Life's Essential 8 cardiovascular health with breast cancer incidence and mortality according to genetic susceptibility of breast cancer: a prospective cohort study

BACKGROUND

Accumulating evidence suggests that cardiovascular diseases and breast cancer share a number of common risk factors, however, evidence on the association between cardiovascular health (CVH) and breast cancer is limited. The present study aimed to assess the association of CVH, defined by Life's Essential 8 (LE8) and genetic risk with breast cancer incidence and mortality among premenopausal and postmenopausal women.

METHODS

We used data from the UK Biobank and conducted the multivariate Cox proportional-hazards models to examine associations of LE8 score and genetic risk with breast cancer incidence and mortality. Date on LE8 score was collected between 2006 and 2010 and composed of eight components, including behavioral metrics (diet, tobacco or nicotine exposure, physical activity, and sleep health), and biological metrics (body mass index, blood lipids, blood glucose, and blood pressure). The polygenic risk score (PRS) was calculated as the sum of effect sizes of individual genetic variants multiplied by the allele dosage.

RESULTS

A total of 150,566 premenopausal and postmenopausal women were included. Compared to postmenopausal women with low LE8 score, those with high LE8 score were associated with 22% lower risk of breast cancer incidence (HR: 0.78, 95% CI: 0.70-0.87) and 43% lower risk of breast cancer mortality (HR: 0.57, 95% CI: 0.36-0.90). By contrast, we did not observe the significant association among premenopausal women. Further analyses stratified by PRS categories showed that high LE8 score was associated with 28% and 71% decreased risk of breast cancer incidence (HR: 0.72, 95% CI: 0.60-0.87) and mortality (HR: 0.29, 95% CI: 0.10-0.83) compared to low LE8 score among high genetic risk groups, but no significant associations were found among low genetic risk groups. Furthermore, compared with postmenopausal women with high LE8 score and low genetic risk, those with low LE8 score and high genetic risk were associated with increased risk of breast cancer incidence (HR: 6.26, 95% CI: 4.43-8.84).

CONCLUSIONS

The present study suggests that better CVH is a protective factor for both breast cancer incidence and mortality among postmenopausal women. Moreover, the risk of developing breast cancer caused by high genetic susceptibility could be largely offset by better CVH.

Life's essential 8, genetic susceptibility, and risk of inflammatory bowel diseases: a population-based cohort study

BACKGROUND

Evidence has shown that the individual metrics in Life's Essential 8 (LE8), an updated cardiovascular health (CVH) concept proposed by the American Heart Association, play a role in the development of inflammatory bowel disease (IBD). However, epidemiological evidence on the overall LE8 on IBD risk remains limited. We aimed to assess the longitudinal associations of LE8-defined CVH and the risks of IBD and its subtypes, ulcerative colitis (UC) and Crohn's disease (CD). We also tested whether genetic susceptibility could modify these associations.

METHODS

A total of 260,836 participants from the UK Biobank were included. LE8 scores were determined by 8 metrics (physical activity, diet, nicotine exposure, sleep, body mass index, blood pressure, blood glucose, and blood lipids), and were divided into three levels: low CVH (0-49), moderate CVH (50-79), and high CVH (80-100). Cox proportional hazards models were used to calculate the hazard ratios (HRs) and confidence intervals (CIs) of the risk of IBD in relation to CVH status.

RESULTS

Over a median follow-up 12.3 years, we documented 1,500 IBD cases (including 1,070 UC and 502 CD). Compared to participants with low CVH, the HRs (95% CIs) of those with high CVH for IBD, UC, and CD were 0.67 (0.52, 0.83), 0.70 (0.52, 0.93), and 0.55 (0.38, 0.80), respectively. These associations were not modified by genetic susceptibility (all P for interactions > 0.05). The lowest HR (UC: 0.30, 95% CI: 0.20-0.45; CD: 0.33, 95% CI: 0.20-0.57) was observed in participants with both high CVH and low genetic risk.

CONCLUSIONS

Better CVH, defined by LE8, was associated with significantly lower risks of IBD, UC, and CD, irrespective of genetic predisposition. Our results underscore the importance of adherence to LE8 guidelines for maintaining CVH as a potential strategy in the prevention of IBD.