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Review
. 2025 Aug;50(4):240-245.
doi: 10.1007/s00059-025-05309-x. Epub 2025 Mar 14.

Diabetes, obesity, and cardiovascular disease-what is the impact of lifestyle modification?

Celina Seth  1   2 , Veronika Schmid  1   2 , Stephan Mueller  1   3   2 , Mark Haykowsky  4 , Stephen J Foulkes  4   5 , Martin Halle  1   3   2 , Simon Wernhart  6   7   8
Affiliations
Review

Diabetes, obesity, and cardiovascular disease-what is the impact of lifestyle modification?

Celina Seth et al. Herz. 2025 Aug.

Erratum in

Abstract
in English, German

Diabetes, obesity, and cardiovascular disease (CVD) represent an escalating global health challenge, contributing significantly to morbidity, mortality, and healthcare costs. Evidence from large cohort studies and clinical trials underscores the impact of diabetes and obesity as major risk factors for CVD, causing systemic inflammation, insulin resistance, and neurohormonal activation. Frequently, a sedentary lifestyle and unbalanced dietary habits are associated with these risk factors. Physical activity and exercise training interventions, a Mediterranean and plant-based diet, smoking cessation, and reduction of alcohol have shown promise in mitigating these risks. The implementation of lifestyle and pharmacotherapy have emerged as new pillars of preventive medicine. This review discusses the evidence of lifestyle interventions to reduce the burden of diabetes, obesity, and CVD. It is highlighted that only a multifaceted, sustained approach integrating lifestyle interventions and pharmacological strategies can reduce the burden of disease and improve long-term outcomes.

Diabetes, Adipositas und Herz-Kreislauf-Erkrankungen stellen eine größer werdende globale Gesundheitsherausforderung dar und tragen erheblich zur Morbidität, Mortalität und zu den Kosten im Gesundheitswesen bei. In dieser Übersichtsarbeit werden die Pathophysiologie dieser Erkrankungen diskutiert und die Auswirkungen von Diabetes und Adipositas als wichtige Risikofaktoren von Herz-Kreislauf-Erkrankungen hervorgehoben, deren gemeinsame Endstrecke systemische Entzündung, Insulinresistenz, und eine neurohormonelle Aktivierung darstellt. Körperliche Inaktivität und eine unausgewogene Ernährung sind häufig mit diesen Risikofaktoren assoziiert. Körperliche Aktivität und strukturiertes Training, eine mediterrane und pflanzliche Ernährung, eine Raucherentwöhnung und eine Reduktion des Alkoholkonsums haben sich als vielversprechend erwiesen, um diese Risiken zu vermindern. Die Rolle einer Pharmakotherapie zusätzlich zur Lebensstilintervention gewinnt zudem immer mehr an Bedeutung. Diese Übersichtsarbeit thematisiert die Evidenz einer Lebensstilintervention zur Reduktion von Diabetes, Adipositas und kardiovaskulären Erkrankungen. Es wird hervorgehoben, dass nur ein integrativer, nachhaltiger Ansatz, der Lebensstil- und Arzneimittelinterventionen beinhaltet, die Krankheitslast reduzieren kann und die kardiovaskuläre Morbidität zu senken vermag.

Keywords: Body weight; Cardiac events; Diabetes mellitus; Nutrition; Physical activity.

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Conflict of interest statement

Declarations. Conflict of interest: S. Wernhart has received honoraria for lectures from Bristol-Myers Squibb. S. Mueller has received personal fees from Bristol-Myers Squibb (consulting services). M. Halle reports honoraria for lectures from Abbott, Amgen, Astra-Zeneca, Boehringer-Ingelheim, BMW, Bristol-Myers Squibb, Daiichi-Sankyo, Lilly, Medi, MSD Sharp & Dohme GmbH, Norsan, Novartis, Pfizer and Roche, and consulting fees from Medical Park. C. Seth, V. Schmid, M. Haykowsky, and S.J. Foulkes declare that they have no competing interests. For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

References

    1. Mensah GA et al (2023) Global burden of cardiovascular diseases and risks, 1990–2022. J Am Coll Cardiol 82(25):2350–2473
    1. Federation WHO (2023) World obesity Atlas 2023. https://data.worldobesity.org/publications/?cat=19 (Created 1 Dec 2024). Accessed 6 Feb 2025
    1. Organization WH, Europe RO (2022) WHO European regional obesity report 2022. https://iris.who.int/handle/10665/353747 (Created 27 Nov 2024). Accessed 6 Feb 2025
    1. Timmis A et al (2022) European society of cardiology: cardiovascular disease statistics 2021. Eur Heart J 43(8):716–799
    1. Kitzman DW, Upadhya B, Vasu S (2015) What the dead can teach the living: systemic nature of heart failure with preserved ejection fraction. Circulation 131(6):522–524

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