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Our results showed that among all modifiable risk factors included, waist circumference had the biggest direct effect on type 2 diabetes, followed by HDL-cholesterol. Less TV watching and more physical activity were found to play an important role in improving clinical markers that were directly associated with type 2 diabetes. Education had the biggest positive effects on all lifestyle behaviors except for unhealthy sleep duration.
For primary prevention, this simultaneous quantification of multiple risk factors and their intersecting pathways puts scattered evidence together and enables the identification of key upstream prevention targets for type 2 diabetes.