Nutrition interventions for the prevention of type 2 diabetes

Abstract

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...

Interleukin (IL)-10 Gene Polymorphisms Are Associated with Type 2 Diabetes With and Without Nephropathy: A Study of Patients from the Southeast Region of Iran

“…The frequency of diabetes mellitus is increasing globally, and it is expected that this latent disorder will affect 200 million people by 2010 and 300 million in 2025 [1]. Type 2, sometimes referred to as non-insulin dependent diabetes mellitus or adult-onset diabetes, is the most prevalent type of diabetes [2].…”

Type 2 Diabetes Prevention Programs; How Far are we?

“…Thus, it is extremely difficult to maintain weight loss, even in studies where the intervention is still in full force and the enrolees are extremely well motivated. In addition, more evidence is needs to establish whether such intensive face-to-face individual implementation strategies are feasible in the long-term, whether group-based or remote contacts provides comparable efficacy in a more cost effective manner, and whether lessskilled personnel can deliver these same interventions [83,84,[92][93][94][95][96][97][98][99]. Actually, the most successful interventions were obtained using many personnel and intensive supervision while the current practice requests less expensive, simple interventions which can be easily carried out in daily practice.…”

“…Barriers in translating intensive interventions to a 'real life' setting include lengthy and unpleasant diagnostic testing procedures to identify pre-diabetes such as 2-hour oral glucose tolerance tests, the cost of highly educated personnel to provide the intervention and offering the intervention in locations such as single medical centres which are near to the homes of the participants [21,[92][93][94][95][96][97][98][99][100][101][102][103].…”

Evidências sobre efeitos da atividade física no controle glicêmico: importância da adesão a programas de atenção em diabetes

“…Programas de atenção primária efetivos para melhorar a saúde e a qualidade de vida da população e para prevenir e reduzir os impactos socioeconômicos associados às DCNT são imprescindíveis 3 . Nesse sentido, programas de educação em DM têm sido desenvolvidos e estudados, principalmente aqueles que contrastam intervenções de terapia medicamentosa com intervenções de mudança no estilo de vida [8][9][10][11] . Instituições de referência em DM, como a International Diabetes Federation (IDF), American Diabetes Association (ADA), a European Association for the Study of Diabetes (EASD) e a Sociedade Brasileira de Diabetes (SBD) apontam o acompanhamento pela hemoglobina-glicada (A1c) -que representa a média das glicemias dos últimos 2 a 4 meses, com predominância estatística dos valores no último mês -como referência básica de controle glicêmico 12,13 .…”