Wang, Qiaoye;
(2025)
An Investigation into the associations between lifestyle, the Mediterranean diet, and risk of Cardiometabolic Multimorbidity: Findings from multiple UK population-based cohort studies.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Background Cardiometabolic multimorbidity (CMM), the co-existence of two or more cardiometabolic diseases (CMD), is an increasing public health challenge. An overall healthy lifestyle is known to associate with CMM in young and middle-aged populations, but the extent of its impact on cardiometabolic health in older adults remains less studied. Healthy diet is an integral component of healthy lifestyle, and Mediterranean diet is among the most well-examined healthy diets for cardiometabolic health. However, data are limited on the association of Mediterranean diet with CMM development and potential pathways through which it may affect CMM risk in the UK population. Aims To investigate and quantify the impact of a composite lifestyle on cardiometabolic health in older adults, and to specifically examine the role of adherence to the Mediterranean diet, and potential modulation of an association with CMM by plasma n-3 polyunsaturated fatty acids (PUFA) and blood lipids. Methods Data from five distinct UK population-based cohorts, ranging from 4,252 to 30,376 British adults, are used to investigate the associations, utilising Cox regression, multi-state modelling, and multinomial logistic regression. Baron and Kenny mediation analysis is conducted to examine the mediation effects. Results Living a composite healthy lifestyle is associated with an additional gain of 4 years of CMD-free life for older adults. Baseline adherence to the Mediterranean diet is associated with lower risks of a first CMD (FCMD) and the subsequent transition to CMM, with stronger associations observed during 10- and 15-year follow-up periods in preventing the transition from FCMD to CMM. This association is substantially mediated by circulating docosahexaenoic acid (DHA) [one of the n-3 PUFA] and triglycerides. Conclusions Adopting a healthy lifestyle increases year of life living without CMD in older adults. Additionally, adherence to the Mediterranean diet, through its influence on DHA and triglycerides, may be beneficial in preventing CMM development.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | An Investigation into the associations between lifestyle, the Mediterranean diet, and risk of Cardiometabolic Multimorbidity: Findings from multiple UK population-based cohort studies |
| Language: | English |
| Additional information: | Copyright © The Author 2025. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10206398 |
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