This November 10, 2016 NEJM article reviews 4 large studies and concludes that exercise and a healthy diet and reduction of unhealthy habits like smoking can counteract genetic predispositions.

A new analysis of data from more than 55,000 people provides an answer. It finds that by living right — by not smoking, by exercising moderately and by eating a healthy diet heavy in fruits, vegetables and grains — people can tamp down even the worst genetic risk.


About 365,000 people die of coronary heart disease — the most common type — annually in the United States, and 17.3 million worldwide, making it one of the biggest killers.

The investigators found that genes can double the risk of heart disease, but a good lifestyle cuts it in half. Just as important, they found, a terrible lifestyle erases about half of the benefits of good genetics.

One study the group analyzed involved black and white Americans aged 45 to 64. A good lifestyle in those with the highest genetic risk cut the 10-year likelihood of heart disease to 5.1 percent from 10.7 percent. Another study involved 21,222 American women aged 45 and older who were health professionals; their 10-year risk fell to 2 percent from 4.6 percent in the high-risk group if they also had a healthy lifestyle. In a third study, Swedish participants aged 44 to 73 had a 10-year risk reduction to 5.3 percent from 8.2 percent. And finally, in a study of Americans aged 55 to 80, those with genetic risk but a healthy lifestyle had significantly less calcium, a sign of heart disease, in their coronary arteries.

Dr. Lauer also was encouraged by the finding that the fourth study, which used imaging, showed the same pattern as the others that used heart attacks and other signs of heart disease as endpoints.

Original Article from The New England Journal of Medicine — Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease

Source: Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease — NEJM