Lifestyle interventions to tackle obesity may be most effective at reducing the risk of diabetes, according to research on twins.
Lifestyle interventions were found to be less good at reducing the risk of cardiovascular disease or death in the Swedish study.
Dr Peter Nordstrom of the Umea University, Sweden, and colleagues say that despite the "obesity epidemic", rates of death and heart attack are falling, and that this trend is not explained by preventive medicine alone.
So they looked at the role of genetics in obesity and illness. Specifically, they compared the risk of heart attack, type 2 diabetes, and death in monozygotic (identical) twins with significantly different body mass indexes.
A total of 4,046 twin pairs with an average age of 58 years were identified from the nationwide Swedish twin registry, and their health was followed for about 12 years.
During this time, 5% of the heavier twins had a heart attack and 13.6% died, versus 5.2% and 15.6% respectively among the leaner twins.
Even in twin pairs which varied by a body mass index score of 7.0 or more, where the heavier twin had a score of 30.0 or more, the risk of heart attack or death was not greater in the heavier twins. However, the risk of diabetes was about twice as high in heavier twins.
Full results appeared in JAMA Internal Medicine on Monday (1 August).
"In monozygotic twin pairs, higher body mass index was not associated with an increased risk of heart attack or death but was associated with the onset of diabetes," the authors write.
"These results may suggest that lifestyle interventions to reduce obesity are more effective in decreasing the risk of diabetes than the risk of cardiovascular disease or death."
Nordstrom, P. et al. Risks of Myocardial Infarction, Death, and Diabetes in Identical Twin Pairs With Different Body Mass Indexes. JAMA Internal Medicine 1 August 2016 doi:10.1001/jamainternmed.2016.4104 [abstract]
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