Lifestyle Changes Significantly Reduce Heart Disease Risk in Women with Past Gestational Diabetes

A comprehensive study conducted by researchers from the Yong Loo Lin School of Medicine at the National University of Singapore (NUS Medicine) in collaboration with Harvard T.H. Chan School of Public Health has demonstrated that women with a history of gestational diabetes mellitus (GDM) can greatly lower their chances of developing future cardiovascular disease (CVD) by maintaining healthy lifestyle habits over the long term.

Gestational diabetes, characterized by elevated blood sugar levels during pregnancy, is among the most common pregnancy complications worldwide. The research, published in the Journal of the American Heart Association (JAHA), analyzed data from over 4,300 women involved in the long-term Nurses' Health Study II. These women had previously experienced GDM but were free of heart disease and diabetes at the beginning of the study.

The findings revealed that women who committed to five key healthy behaviors—maintaining a healthy weight, avoiding smoking, engaging in regular physical activity, consuming a high-quality diet, and limiting alcohol intake—reduced their risk of developing cardiovascular conditions by as much as 86% compared to those who did not adopt these habits. Remarkably, women who consistently practiced all five healthy behaviors experienced no cardiovascular events during nearly 28 years of follow-up.

Dr. Yang Jiaxi, senior research fellow at the Global Center for Asian Women's Health (GloW) at NUS Medicine, emphasized that "CVD is not an unavoidable consequence for women with a history of GDM. Small, sustained lifestyle changes after pregnancy can lead to significant risk reductions." The study also pointed out that improvements in lifestyle habits over time correlated with decreased CVD risk, whereas lapses in these behaviors increased the risk.

Co-first author Dr. Frank Qian, a public health expert previously affiliated with Harvard T.H. Chan School of Public Health, highlighted the importance of counseling and creating supportive environments for women after GDM. "Preventing or delaying cardiovascular events requires a proactive approach in healthcare and community settings," he stated.

The research underscores the urgency of targeted public health initiatives, especially in Singapore where cardiovascular diseases accounted for nearly 31% of all deaths in 2023. Given Asia's high GDM prevalence and its association with increased CVD risk, early intervention focusing on healthy weight, diet, and physical activity could significantly impact women's long-term heart health.

Professor Zhang Cuilin, chair of women's health at NUS Medicine and senior author, remarked, "Supporting women in adopting healthier lifestyles post-GDM is crucial for reducing their future risk of chronic diseases. Our ongoing research aims to uncover effective strategies and underlying mechanisms for sustained interventions."

This landmark study highlights the vital role of lifestyle modifications in preventing cardiovascular disease among women with prior gestational diabetes, offering a promising pathway for long-term health improvement.