Diabetes mellitus is escalating globally and it is predicted that 200 million individuals worldwide will have diabetes by 2010 and 300 million by 2025. However, there is compelling evidence from many studies that for subjects with impaired fasting glucose or impaired glucose tolerance the presentation of type 2 diabetes can be delayed by lifestyle modification. The aim of the present review is to present a summary of lifestyle modification interventions that have included a dietary component in their overall diabetes prevention programme. Medline, allied health literature and diabetes journals were searched for peer-reviewed literature using the terms 'diet*' and 'diabetes' and 'intervention'. Inclusion criteria were: peer-reviewed studies from 1975 to 2008; a sample of at least fifty subjects; a healthy eating and/or physical activity component; prevention of diabetes as a primary goal. Generally, the participants were in a high-risk category for the development of diabetes. Outcomes were evaluated at two points in time (pre-and post-intervention) in terms of knowledge, behaviour change and clinical improvement, which included weight, blood pressure, BMI, body fat, waist circumference, waist :hip ratio and physiological and/or biochemical measures. Findings indicate that the most successful interventions combine individual dietary counselling with an activity component. Further factors predicting success are weight loss achieved, duration and intensity of the intervention and dietary compliance.
Nutrition interventions: Type 2 diabetes: Diabetes prevention: Lifestyle modificationWith the global escalation of diabetes mellitus it is predicted that 200 million individuals worldwide will have diabetes by 2010 (1) and 300 million by 2025 (2) . The cumulative lifetime risk of developing diabetes for individuals born in the USA in 2000 is 38 . 5 % for women and 32 . 8% for males (3) . However, there is impelling evidence from many studies that subjects with impaired fasting glucose or impaired glucose tolerance (IGT) can be delayed by lifestyle modification (4) .The Nurses' Study, in which 84 941 female nurses were followed from 1980 to 1996 was one of the first cohorts to provide evidence on the importance of lifestyle and development of type 2 diabetes (5) . A low-risk group for development of diabetes was defined as one with five variables: BMI < 25 kg/m 2 ; diet high in cereal fibre and PUFA and low in trans-fatty acids with a low glycaemic load; moderate-to-vigorous physical activity (PA) for ‡30 min/d; not smoking; consumption of on average ‡15 ml spirits or ‡ 125 ml wine daily. Furthermore, overweight or obesity was found to be the single most important predictor of diabetes. Lack of PA, unhealthy diet, smoking, and abstinence from alcohol were all shown to be associated with an increased risk of diabetes even after adjusting for BMI.It is generally accepted that b-cell dysfunction and insulin resistance are major factors involved in development of diabetes. It is proposed that subjects at risk of diabetes hav...