Table 3.

Hazard ratio (95% CI) of CVD mortality according to individual and combined lifestyle factors after diabetes diagnosis

	Person Years	CVD Mortality
		Cases	HR* (95% CI)
Cigarette smoking
Never	72333	320	1.00 (ref)
Past	79909	457	1.27 (1.09–1.47)
Current 1–14 cigarettes/day	6284	35	1.57 (1.10–2.24)
Current ≥15 cigarettes/day	7989	46	2.21 (1.60–3.04)
Alcohol consumption (g/day)
0	92009	555	1.00 (ref)
1.0–4.9	41150	163	0.82 (0.69–0.99)
5.0–14.9	19652	73	0.62 (0.48–0.80)
≥15.0	13705	67	0.81 (0.62–1.07)
Physical activity (hours/week)
0	95684	629	1.00 (ref)
0.1–0.9	31717	121	0.79 (0.65–0.97)
1.0–3.4	15973	46	0.65 (0.48–0.88)
≥3.5	23142	62	0.62 (0.47–0.82)
Alternative healthy eating index (quintiles)
Q 1	34514	213	1.00 (ref)
Q 2	33691	188	0.97 (0.79–1.19)
Q 3	33219	168	0.90 (0.74–1.11)
Q 4	33781	158	0.84 (0.68–1.04)
Q 5	31312	131	0.77 (0.62–0.97)
Number of low-risk factors†
None	7215	47	1.00 (ref)
One	70510	442	0.63 (0.46–0.86)
Two	62348	294	0.46 (0.34–0.64)
Three or more	26443	75	0.32 (0.22–0.47)
PAR‡, %			40.9 (28.5–52.0)

^*Adjusted for age (years), sex (men or women), ethnicity (Caucasian, African American, Hispanic, or Asian), body mass index at diabetes diagnosis (<25.0, 25.0–29.9, 30.0–34.9, ≥35.0 kg/m²), menopausal status (women only), family history of diabetes (yes/no), family history of myocardial infarction (yes/no), current aspirin use (yes/no), current multivitamin use (yes/no), and diabetes duration (years). Individual lifestyle factors were mutually adjusted.

^†Low-risk lifestyle factors: non-smoking, moderate to vigorous physical activity (≥150 min/week), high quality diet (top two fifths of Alternative Healthy Eating Index), and moderate alcohol consumption (5–15 g/day for women and 5–30 g/day for men).

^‡PAR: population attributable risk, theoretically attributable to non-adherence to three or more low-risk lifestyle factors.