Prevention of Type 2 Diabetes by Lifestyle Changes: A Systematic Review and Meta-Analysis
Prevention of type 2 diabetes (T2D) is a great challenge worldwide. The aim of this evidence synthesis was to summarize the available evidence in order to update the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy. We conducted a systematic re...
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| Veröffentlicht in: | Nutrients 2019-11, Vol.11 (11), p.2611 |
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| creator | Uusitupa, Matti Khan, Tauseef A Viguiliouk, Effie Kahleova, Hana Rivellese, Angela A Hermansen, Kjeld Pfeiffer, Andreas Thanopoulou, Anastasia Salas-Salvadó, Jordi Schwab, Ursula Sievenpiper, John L |
| description | Prevention of type 2 diabetes (T2D) is a great challenge worldwide. The aim of this evidence synthesis was to summarize the available evidence in order to update the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy. We conducted a systematic review and, where appropriate, meta-analyses of randomized controlled trials (RCTs) carried out in people with impaired glucose tolerance (IGT) (six studies) or dysmetabolism (one study) to answer the following questions: What is the evidence that T2D is preventable by lifestyle changes? What is the optimal diet (with a particular focus on diet quality) for prevention, and does the prevention of T2D result in a lower risk of late complications of T2D? The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was applied to assess the certainty of the trial evidence. Altogether seven RCTs (N = 4090) fulfilled the eligibility criteria and were included in the meta-analysis. The diagnosis of incident diabetes was based on an oral glucose tolerance test (OGTT). The overall risk reduction of T2D by the lifestyle interventions was 0.53 (95% CI 0.41; 0.67). Most of the trials aimed to reduce weight, increase physical activity, and apply a diet relatively low in saturated fat and high in fiber. The PREDIMED trial that did not meet eligibility criteria for inclusion in the meta-analysis was used in the final assessment of diet quality. We conclude that T2D is preventable by changing lifestyle and the risk reduction is sustained for many years after the active intervention (high certainty of evidence). Healthy dietary changes based on the current recommendations and the Mediterranean dietary pattern can be recommended for the long-term prevention of diabetes. There is limited or insufficient data to show that prevention of T2D by lifestyle changes results in a lower risk of cardiovascular and microvascular complications. |
| doi_str_mv | 10.3390/nu11112611 |
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The aim of this evidence synthesis was to summarize the available evidence in order to update the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy. We conducted a systematic review and, where appropriate, meta-analyses of randomized controlled trials (RCTs) carried out in people with impaired glucose tolerance (IGT) (six studies) or dysmetabolism (one study) to answer the following questions: What is the evidence that T2D is preventable by lifestyle changes? What is the optimal diet (with a particular focus on diet quality) for prevention, and does the prevention of T2D result in a lower risk of late complications of T2D? The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was applied to assess the certainty of the trial evidence. Altogether seven RCTs (N = 4090) fulfilled the eligibility criteria and were included in the meta-analysis. The diagnosis of incident diabetes was based on an oral glucose tolerance test (OGTT). The overall risk reduction of T2D by the lifestyle interventions was 0.53 (95% CI 0.41; 0.67). Most of the trials aimed to reduce weight, increase physical activity, and apply a diet relatively low in saturated fat and high in fiber. The PREDIMED trial that did not meet eligibility criteria for inclusion in the meta-analysis was used in the final assessment of diet quality. We conclude that T2D is preventable by changing lifestyle and the risk reduction is sustained for many years after the active intervention (high certainty of evidence). Healthy dietary changes based on the current recommendations and the Mediterranean dietary pattern can be recommended for the long-term prevention of diabetes. There is limited or insufficient data to show that prevention of T2D by lifestyle changes results in a lower risk of cardiovascular and microvascular complications.</description><identifier>ISSN: 2072-6643</identifier><identifier>EISSN: 2072-6643</identifier><identifier>DOI: 10.3390/nu11112611</identifier><identifier>PMID: 31683759</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Beverages ; Bias ; Clinical trials ; Diabetes ; Diabetes Complications - prevention & control ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - prevention & control ; Diet ; diet therapy ; Disease prevention ; eating habits ; Endocrinology ; Exercise ; Female ; Gastrointestinal surgery ; glucose tolerance ; Glucose Tolerance Test ; glucose tolerance tests ; guidelines ; Health Behavior ; Hospitals ; Humans ; Internal medicine ; Intervention ; Legumes ; Life Style ; lifestyle ; Lifestyles ; Male ; Meat ; Medicine ; Meta-analysis ; Metabolism ; noninsulin-dependent diabetes mellitus ; Nutrient deficiency ; Nutrition research ; nutritional adequacy ; optimal nutrition ; physical activity ; Physical fitness ; Prevention ; Public health ; randomized clinical trials ; Review ; risk factors ; risk reduction ; saturated fats ; Systematic review</subject><ispartof>Nutrients, 2019-11, Vol.11 (11), p.2611</ispartof><rights>2019. This work is licensed under https://creativecommons.org/licenses/by/4.0/ (the “License”). 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The aim of this evidence synthesis was to summarize the available evidence in order to update the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy. We conducted a systematic review and, where appropriate, meta-analyses of randomized controlled trials (RCTs) carried out in people with impaired glucose tolerance (IGT) (six studies) or dysmetabolism (one study) to answer the following questions: What is the evidence that T2D is preventable by lifestyle changes? What is the optimal diet (with a particular focus on diet quality) for prevention, and does the prevention of T2D result in a lower risk of late complications of T2D? The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was applied to assess the certainty of the trial evidence. Altogether seven RCTs (N = 4090) fulfilled the eligibility criteria and were included in the meta-analysis. The diagnosis of incident diabetes was based on an oral glucose tolerance test (OGTT). The overall risk reduction of T2D by the lifestyle interventions was 0.53 (95% CI 0.41; 0.67). Most of the trials aimed to reduce weight, increase physical activity, and apply a diet relatively low in saturated fat and high in fiber. The PREDIMED trial that did not meet eligibility criteria for inclusion in the meta-analysis was used in the final assessment of diet quality. We conclude that T2D is preventable by changing lifestyle and the risk reduction is sustained for many years after the active intervention (high certainty of evidence). Healthy dietary changes based on the current recommendations and the Mediterranean dietary pattern can be recommended for the long-term prevention of diabetes. There is limited or insufficient data to show that prevention of T2D by lifestyle changes results in a lower risk of cardiovascular and microvascular complications.</description><subject>Beverages</subject><subject>Bias</subject><subject>Clinical trials</subject><subject>Diabetes</subject><subject>Diabetes Complications - prevention & control</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - prevention & control</subject><subject>Diet</subject><subject>diet therapy</subject><subject>Disease prevention</subject><subject>eating habits</subject><subject>Endocrinology</subject><subject>Exercise</subject><subject>Female</subject><subject>Gastrointestinal surgery</subject><subject>glucose tolerance</subject><subject>Glucose Tolerance Test</subject><subject>glucose tolerance tests</subject><subject>guidelines</subject><subject>Health 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of Type 2 Diabetes by Lifestyle Changes: A Systematic Review and Meta-Analysis</title><author>Uusitupa, Matti ; Khan, Tauseef A ; Viguiliouk, Effie ; Kahleova, Hana ; Rivellese, Angela A ; Hermansen, Kjeld ; Pfeiffer, Andreas ; Thanopoulou, Anastasia ; Salas-Salvadó, Jordi ; Schwab, Ursula ; Sievenpiper, John L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-2ce6aa3cb068fb07ac71ba9ac6c3a399b1e2d5f89da6fc394fb0d9d850db30f33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Beverages</topic><topic>Bias</topic><topic>Clinical trials</topic><topic>Diabetes</topic><topic>Diabetes Complications - prevention & control</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - prevention & control</topic><topic>Diet</topic><topic>diet therapy</topic><topic>Disease prevention</topic><topic>eating 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Tauseef A</au><au>Viguiliouk, Effie</au><au>Kahleova, Hana</au><au>Rivellese, Angela A</au><au>Hermansen, Kjeld</au><au>Pfeiffer, Andreas</au><au>Thanopoulou, Anastasia</au><au>Salas-Salvadó, Jordi</au><au>Schwab, Ursula</au><au>Sievenpiper, John L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevention of Type 2 Diabetes by Lifestyle Changes: A Systematic Review and Meta-Analysis</atitle><jtitle>Nutrients</jtitle><addtitle>Nutrients</addtitle><date>2019-11-01</date><risdate>2019</risdate><volume>11</volume><issue>11</issue><spage>2611</spage><pages>2611-</pages><issn>2072-6643</issn><eissn>2072-6643</eissn><abstract>Prevention of type 2 diabetes (T2D) is a great challenge worldwide. The aim of this evidence synthesis was to summarize the available evidence in order to update the European Association for the Study of Diabetes (EASD) clinical practice guidelines for nutrition therapy. We conducted a systematic review and, where appropriate, meta-analyses of randomized controlled trials (RCTs) carried out in people with impaired glucose tolerance (IGT) (six studies) or dysmetabolism (one study) to answer the following questions: What is the evidence that T2D is preventable by lifestyle changes? What is the optimal diet (with a particular focus on diet quality) for prevention, and does the prevention of T2D result in a lower risk of late complications of T2D? The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was applied to assess the certainty of the trial evidence. Altogether seven RCTs (N = 4090) fulfilled the eligibility criteria and were included in the meta-analysis. The diagnosis of incident diabetes was based on an oral glucose tolerance test (OGTT). The overall risk reduction of T2D by the lifestyle interventions was 0.53 (95% CI 0.41; 0.67). Most of the trials aimed to reduce weight, increase physical activity, and apply a diet relatively low in saturated fat and high in fiber. The PREDIMED trial that did not meet eligibility criteria for inclusion in the meta-analysis was used in the final assessment of diet quality. We conclude that T2D is preventable by changing lifestyle and the risk reduction is sustained for many years after the active intervention (high certainty of evidence). Healthy dietary changes based on the current recommendations and the Mediterranean dietary pattern can be recommended for the long-term prevention of diabetes. There is limited or insufficient data to show that prevention of T2D by lifestyle changes results in a lower risk of cardiovascular and microvascular complications.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>31683759</pmid><doi>10.3390/nu11112611</doi><orcidid>https://orcid.org/0000-0002-6887-0016</orcidid><orcidid>https://orcid.org/0000-0002-2902-8053</orcidid><orcidid>https://orcid.org/0000-0001-8844-4121</orcidid><orcidid>https://orcid.org/0000-0003-2700-7459</orcidid><orcidid>https://orcid.org/0000-0001-6052-2001</orcidid><orcidid>https://orcid.org/0000-0003-1838-7525</orcidid><orcidid>https://orcid.org/0000-0003-0491-3993</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Beverages Bias Clinical trials Diabetes Diabetes Complications - prevention & control Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - prevention & control Diet diet therapy Disease prevention eating habits Endocrinology Exercise Female Gastrointestinal surgery glucose tolerance Glucose Tolerance Test glucose tolerance tests guidelines Health Behavior Hospitals Humans Internal medicine Intervention Legumes Life Style lifestyle Lifestyles Male Meat Medicine Meta-analysis Metabolism noninsulin-dependent diabetes mellitus Nutrient deficiency Nutrition research nutritional adequacy optimal nutrition physical activity Physical fitness Prevention Public health randomized clinical trials Review risk factors risk reduction saturated fats Systematic review |
| title | Prevention of Type 2 Diabetes by Lifestyle Changes: A Systematic Review and Meta-Analysis |
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