Mixed
Unhealthy lifestyle factors (current smoking, low physical activity, and low dietary adherence) increase the risk of myocardial infarction and coronary heart disease, with elevated remnant cholesterol explaining 12-21% of this excess risk.
Your lifestyle choices directly impact a specific type of fat in your blood called remnant cholesterol, which contributes to heart disease risk. Quitting smoking, increasing physical activity, and adhering to dietary guidelines can lower these levels, thereby reducing your risk of heart attack and coronary heart disease. This reduction in risk is partly mediated by the improvement in your remnant cholesterol levels.
Current smoking, low physical activity, and low adherence to dietary guidelines were all associated with higher levels of remnant cholesterol. For current smoking, remnant cholesterol explained 15% (95% confidence interval: 9.7%–20%) of the excess risk of myocardial infarction and 16% (11%–21%) of the excess risk of coronary heart disease. Corresponding values for low physical activity were 20% (13%–27%) and 21% (15%–28%), and for low adherence to dietary guidelines 12% (6.6%–18%) and 14% (8.0%–19%), respectively.
Why this rating
Large prospective cohort study (n=104,867) with long follow-up (median 9.2 years) and robust mediation analysis.
Source
Association of remnant cholesterol with unhealthy lifestyle and risk of coronary heart disease: a population-based cohort study
Mia Ø Johansen et al. · The Lancet Regional Health - Europe · 2025
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