According to Gram Research analysis, adding information about physical activity and Mediterranean diet to standard heart disease risk tests improves predictions by 41% in adults over 70, helping doctors better identify who is truly at high risk. However, this lifestyle information doesn’t improve predictions for younger adults, suggesting that age matters when deciding whether to include diet and exercise habits in risk assessments.
A new study from Switzerland found that adding information about physical activity and Mediterranean diet to standard heart disease risk tests makes predictions more accurate—but only for people over 70. Researchers followed 2,587 people for 9 years and discovered that lifestyle factors didn’t improve predictions for younger adults. However, for older adults, knowing about their exercise habits and eating patterns helped doctors better identify who was at higher risk of heart problems. This suggests that personalized lifestyle information could help doctors make better decisions about heart disease prevention in seniors.
Key Statistics
A 2026 cohort study of 2,587 Swiss adults found that adding physical activity and Mediterranean diet information to standard heart disease risk tests improved prediction accuracy from 0.63 to 0.66 in adults aged 70 and older, with a 41% improvement in correctly reclassifying people into appropriate risk categories.
In the CoLaus/PsyCoLaus study, lifestyle factors did not improve cardiovascular risk prediction for 2,348 adults under 70 years old, with prediction accuracy remaining at 0.74 whether or not diet and exercise information was included.
Among 239 participants aged 70 and older followed for a median of 9 years, adding both physical activity and Mediterranean diet adherence to standard risk assessment helped identify 28% of people who actually experienced heart disease events that the standard test alone would have missed.
The Quick Take
- What they studied: Whether adding information about how much people exercise and how well they follow a Mediterranean diet (lots of vegetables, fish, and olive oil) improves doctors’ ability to predict who will have heart disease in the next 10 years.
- Who participated: 2,587 people from Switzerland, average age around 59, followed for about 9 years. About 59% were women. During the study, 145 people had heart disease events.
- Key finding: For people over 70, adding lifestyle information improved heart disease risk predictions by 41%, helping doctors better identify who was truly at high risk. For younger adults, lifestyle information didn’t improve predictions.
- What it means for you: If you’re over 70, your doctor might get better information about your heart disease risk by asking about your exercise habits and diet. For younger adults, standard risk tests appear to work well without lifestyle details. Talk to your doctor about your personal risk factors.
The Research Details
Researchers used data from a large Swiss study that followed people over many years, tracking who developed heart disease. They compared two approaches: using standard heart disease risk tests alone (called SCORE2 for younger people and SCORE2-OP for older people), versus using those same tests plus information about physical activity and diet.
Participants filled out questionnaires about how often they exercised and what they ate. Researchers then used statistical models to see if adding this lifestyle information helped predict heart disease better than the standard tests alone. They measured three things: how well the predictions worked overall, whether the predictions were accurate, and whether the new information changed which risk category people fell into.
The study split participants into two age groups because different risk prediction tools are recommended for different ages. This allowed researchers to see if lifestyle factors mattered differently depending on age.
Standard heart disease risk tests use factors like age, blood pressure, and cholesterol—things doctors can measure in the office. But they don’t include lifestyle habits that people can actually change. This study helps answer whether adding lifestyle information makes predictions more useful for doctors and patients. The age-based findings suggest that lifestyle factors may become more important for predicting heart disease as people get older.
This was a real-world study following actual people over time, which is stronger than just looking at data from one point in time. The study had a reasonable number of heart disease events (145 total), which gives researchers enough data to draw conclusions. However, people self-reported their exercise and diet habits, which can be less accurate than measured data. The study was conducted in Switzerland, so results may not apply equally to all populations worldwide.
What the Results Show
For adults under 70 years old (2,348 participants with 106 heart disease events), adding information about physical activity and Mediterranean diet did not improve heart disease predictions. The standard risk test (SCORE2) worked equally well with or without lifestyle information. The prediction accuracy stayed at 0.74 on a scale where 1.0 is perfect.
For adults 70 and older (239 participants with 39 heart disease events), the results were different. Adding both physical activity and diet information improved the prediction accuracy from 0.63 to 0.66. More importantly, it helped doctors better identify who was truly at high risk versus low risk—a 41% improvement in reclassification. This means the lifestyle information helped move people into more accurate risk categories.
The study found that the combination of physical activity and diet worked better than either factor alone in older adults. When researchers added just one lifestyle factor to the standard test, improvements were smaller. The full model with both factors provided the best predictions for the older age group.
The study looked at how well the predictions matched actual outcomes (calibration). For younger adults, the standard test was well-calibrated. For older adults, the standard test alone was less well-calibrated, but adding lifestyle factors improved this. The study also examined whether physical activity alone or diet alone could improve predictions. In older adults, both factors contributed to better predictions, but the combination was most effective.
Previous research has shown that lifestyle factors like physical activity and diet are important for heart health. However, most standard heart disease risk prediction tools don’t include these factors because they’re harder to measure accurately than blood pressure or cholesterol. This study confirms that for younger adults, standard tests already capture most of the important information. For older adults, it suggests that lifestyle factors may provide additional useful information that standard tests miss. This aligns with emerging research showing that lifestyle factors may become increasingly important predictors as people age.
The study relied on people’s self-reported exercise and diet habits, which can be inaccurate. People might overestimate how much they exercise or forget what they eat. The study was conducted in Switzerland with a mostly European population, so results might not apply to other countries or ethnic groups. The number of heart disease events in older adults was relatively small (39 events), which means the findings for that group are less certain. The study measured lifestyle factors only once at the beginning, but people’s habits change over time. Finally, this was an observational study, so it shows associations but cannot prove that diet and exercise directly cause better predictions.
The Bottom Line
For adults over 70: Talk to your doctor about your physical activity level and diet. This information may help your doctor better assess your heart disease risk. Consider following a Mediterranean diet (rich in vegetables, fish, whole grains, and olive oil) and staying physically active, as these are associated with better heart health. For adults under 70: Standard heart disease risk assessments appear to work well without detailed lifestyle information, but maintaining a healthy diet and exercise routine remains important for overall health. All ages: These findings support the importance of lifestyle factors for heart health, even if they don’t change risk predictions for younger adults.
This research is most relevant for adults over 70 and their doctors. If you’re in this age group and concerned about heart disease risk, ask your doctor whether adding lifestyle information to your risk assessment would be helpful. Younger adults should know that standard risk tests work well for them, but healthy lifestyle habits remain important. People with family history of heart disease or other risk factors should discuss personalized risk assessment with their doctor.
Heart disease risk is assessed over a 10-year period, so changes in diet and exercise habits take time to show benefits. Research suggests that meaningful improvements in heart health markers can appear within weeks to months of lifestyle changes, but the full impact on long-term disease risk develops over years.
Frequently Asked Questions
Does diet and exercise information help predict heart disease risk?
For adults over 70, yes—adding diet and exercise information improves heart disease risk predictions by 41%. For younger adults, standard risk tests work well without this information. However, healthy habits remain important for everyone’s overall heart health.
Should I follow a Mediterranean diet to prevent heart disease?
The Mediterranean diet (vegetables, fish, whole grains, olive oil) is associated with better heart health and improved risk prediction in older adults. While it didn’t change predictions for younger adults in this study, it remains a heart-healthy eating pattern recommended by cardiologists.
How much exercise do I need to reduce heart disease risk?
This study didn’t specify exact exercise amounts, but general guidelines recommend 150 minutes of moderate activity weekly. The research shows that physical activity information helps doctors better assess risk in older adults, making it worth tracking and discussing with your doctor.
At what age does lifestyle information become important for heart disease risk?
This study found that lifestyle factors significantly improved risk predictions starting at age 70. For younger adults, standard medical tests captured most important information. However, healthy lifestyle habits benefit heart health at any age.
Can I use this study to assess my own heart disease risk?
This research is meant for doctors to use when assessing patients, not for self-diagnosis. Talk to your doctor about your personal risk factors, especially if you’re over 70. Your doctor can determine whether adding lifestyle information to your risk assessment would be helpful.
Want to Apply This Research?
- Track weekly physical activity minutes and Mediterranean diet adherence (servings of vegetables, fish, whole grains, and olive oil). Set a goal of 150 minutes of moderate activity per week and aim for at least 5 servings of vegetables daily.
- For users over 70: Log your daily physical activity and meals to see patterns in your lifestyle habits. Use the app to set reminders for exercise and to track Mediterranean diet components. For all users: Monitor how consistent you are with healthy habits week-to-week, and celebrate improvements.
- Monthly review of activity levels and diet patterns. Quarterly check-ins with your doctor to discuss whether lifestyle changes are affecting your heart disease risk assessment. Use the app to identify which lifestyle factors are easiest and hardest to maintain, then focus on building sustainable habits.
This research provides insights into heart disease risk prediction but should not be used for self-diagnosis or to replace medical advice. Heart disease risk is complex and individual. If you have concerns about your cardiovascular health, especially if you’re over 70 or have risk factors like high blood pressure, high cholesterol, or family history of heart disease, consult with your healthcare provider. Your doctor can assess your personal risk using appropriate tools and recommend lifestyle changes or treatments tailored to your situation. This study was conducted in Switzerland and may not apply equally to all populations. Always discuss any major lifestyle changes with your healthcare team before implementing them.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.
