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Abstract

IntroductionThe Western lifestyle, characterized by high caloric intake and reduced physical activity, is responsible for the increase of overweight and obesity. To date, more than 50% [1] of the adult Dutch population is overweight and this is an important factor in the development of the metabolic syndrome. The progressive fat accumulation in the visceral compartment and the liver causes insulin resistance (IR) leading to a reactive overproduction of insulin. This is the central driver in the aetiology and progression of type 2 diabetes (T2DM). It also leads to a low grade systemic inflammation that plays an important role in atherogenesis developing cardiovascular diseases [2-4] and non-alcoholic steatohepatitis (NASH) [5,6]. In the Netherlands, over 1.2 million persons have diabetes and in a growing number of patients, insulin is often added to the oral drug therapy. Diabetes has a serious impact on quality of life and health care costs. Prevention is an important issue and challenge, in which lifestyle Crimson PublishersWings to the Research