Anti-inflammatory effect of lifestyle changes in the Finnish Diabetes Prevention Study

Abstract

Aims/hypothesis Subclinical inflammation confers an increased risk of type 2 diabetes, cardiovascular disease, neurodegenerative disorders and other age-related chronic diseases. Physical activity and diet can attenuate systemic immune activation, but it is not known which individual components of a comprehensive lifestyle intervention are most effective in targeting subclinical inflammation.Methods We used data from the baseline examination and the 1 year follow-up of a subsample of 406 of 522 participants of the Finnish Diabetes Prevention Study (DPS) to estimate the effect of individual components of lifestyle intervention on C-reactive protein (CRP) and IL-6 levels, which represent the best characterised proinflammatory risk factors for type 2 diabetes. Changes in metabolic markers, dietary patterns and exercise were analysed to Diabetologia (2009) determine which were most strongly associated with the anti-inflammatory effect of lifestyle changes. Results Lifestyle intervention reduced circulating levels of CRP (p<0.001) and . Increases in fibre intake and moderate to vigorous leisure time physical activity (LTPA), but not total LTPA, predicted decreases in CRP and/or IL-6 and remained associated even after adjustment for baseline BMI or changes in BMI during the first year of the study. Changes in carbohydrate or fat intake were either weakly or not linked to reductions in CRP and IL-6. Conclusions/interpretation The present study assessed the individual effects of dietary and physical activity measures on low-grade inflammation in individuals at high cardiometabolic risk. Our results underline the importance of moderate to vigorous LTPA and a diet rich in natural fibre, and this should be emphasised in lifestyle recommendations.

Prevention strategies for type 2 diabetes should be based on evidence-based medical nutrition data

“…In the DPS, we also found beneficial changes in inflammatory markers [10], and blood pressure [11]. These also suggest that a moderate relative increase in carbohydrates, e.g.…”

The relationship between nutritional status, functional capacity, and health-related quality of life in older adults with type 2 diabetes: A pilot explanatory study

“…In conclusion our results have shown that nutritional status is moderately associated with HRQoL and lower limb strength, which is also associated with HRQoL in patients with T2DM. Physical activity and diet are the cornerstones in the prevention and treatment of T2DM (6,(43)(44)(45); Our data suggest that in the future more emphasis could be placed on interventions to enhance a correct diet through early identification of the risk for malnutrition and stress the needed to improve lower body strength to reinforce better mobility in T2DM population.…”

The global diabetes epidemic as a consequence of lifestyle-induced low-grade inflammation

“…In the Finnish Diabetes Prevention Study increased fibre intake was one of two independent factors predicting decreases in circulating levels of CRP and IL-6 [46]. A recent review of dietary intervention trials reported that in six out of seven trials, daily consumption of 3-8 g fibre per megajoule led to significant decrements in plasma CRP concentrations of 25-54% [47].…”

“…the promotion of insulin resistance and lipolysis, whereas in skeletal muscle insulin action is augmented [70]. It seems difficult to reconcile this systemic pro-inflammatory effect of intense muscle work with the observed anti-inflammatory effect of regular exercise [46,71]. One probable explanation is that the acute pro-inflammatory bout following intense physical exercise is followed by the increase in systemic levels of the anti-inflammatory cytokine IL-10 [72].…”

“…These include weight reduction [58] and dietary changes plus increased physical activity [46] or bariatric surgery [89].…”