A longitudinal analysis published in Scientific Reports finds that young adults with higher Life’s Essential 8 (LE8) cardiovascular health scores were markedly less likely to progress from prediabetes to type 2 diabetes, highlighting preventive opportunities early in adulthood. The study, focused on LE8—a composite of diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, blood pressure and blood glucose—compared trajectories among those whose glycemic status worsened, remained stable, or reverted to normal.

Participants who later developed diabetes began with the lowest average LE8 score, about 57, while those who remained prediabetic or returned to normoglycemia started with average scores near 65. The pattern held after accounting for baseline risk factors, suggesting that a multicomponent cardiovascular health metric captures modifiable behaviors and biological factors relevant to diabetes risk in this age group.

“This work adds to a growing body of evidence that a holistic view of cardiovascular health matters for more than heart disease,” said Dr. Aisha Rahman, an epidemiologist at Columbia University who was not involved in the study. “For clinicians and health systems, it reinforces the need to intervene on multiple fronts—diet, sleep, smoking and weight—rather than treating glucose in isolation.”

The paper builds on prior research linking LE8 to cardiovascular outcomes and extends it to diabetes progression, a critical transition that occurs disproportionately in economically disadvantaged and minority communities. Young adults often encounter gaps in preventive care as they age out of pediatric systems, move through college or the workforce, and face barriers to healthy food, safe exercise spaces and consistent health insurance. These social and structural determinants influence several LE8 components simultaneously, the authors note.

Community health leaders say the study’s implications are practical as well as clinical. “We see young people with elevated blood sugars who would benefit from coaching, affordable healthy options and a smoke-free environment,” said Jamal Ortiz, director of a community health center in Houston. “Improving LE8 isn’t just about counseling in a clinic—it’s about investing in neighborhoods.”

Policy experts argue that scaling interventions tied to LE8 could be cost-effective. Expanding routine screening for prediabetes in primary care, integrating sleep and tobacco services into counseling, subsidizing community nutrition programs and supporting active transportation would address multiple LE8 domains simultaneously, potentially reducing future diabetes incidence and cardiovascular burden.

But achieving those gains requires attention to equity. Marginalized populations face higher exposure to tobacco marketing, food deserts, unsafe streets and precarious work schedules that impair sleep—factors that drive lower LE8 scores. “Without targeted policy levers—paid leave, housing improvements, SNAP enhancements—we risk widening disparities even as we reduce overall risk,” said Sara Nguyen, a public health policy analyst.

The study does not prove causation and acknowledges limitations including varying follow-up lengths and measurement constraints. Still, its central message is clear: improving a broad set of cardiovascular health metrics in early adulthood may help prevent diabetes. For health systems, community organizations and policymakers, the research offers a timely reminder that upstream, equitable interventions can alter life courses and reduce the dual burdens of diabetes and cardiovascular disease.