A meta-analysis evaluates the effectiveness of programs combining a balanced diet with regular physical activity in the prevention of type 2 diabetes.
The Spanish meta-analysis of Orozco and colleagues published in the journal Cochrane Collaboration in 2009 assessed, on the basis of 8 randomized controlled clinical trials, the efficacy of a program supervised by a professional combining endurance at least 150 minutes per week and a balanced diet on the prevention of type 2 diabetes in high risk adults. The results show that the risk of type 2 diabetes in 6 years is reduced by 37% for those who completed the program compared to those who followed standard recommendations for health promotion or who do not.
The Study Rationale
Type 2 diabetes is associated with chronic hyperglycemia, that is to say at too high a level of sugar in the blood. Obesity, glucose intolerance, hypertension, family history of type 2 diabetes, dyslipidemia are factors that can increase the risk of type 2 diabetes. Complications affect eyes, kidneys, nerves and blood vessels. Individuals also risk developing cardiovascular disease.
Type 2 diabetes is the most common type of diabetes. In Western countries, this chronic disease affects 7% of the population. The increase impact is already observed in industrialized and developing countries. This impact is associated with too salty food, too sweet and too fatty and physical inactivity. Type 2 diabetes is a major health problem worldwide. The issue is whether a change in eating habits and increased daily energy expenditure reduced the onset of type 2 diabetes in people at risk.
Change eating habits and weekly physical activity decreases risk of type 2 diabetes?
Can a prevention program combining a balanced diet and regular physical activity supervised by a professional reduce risk of type 2 diabetes in people at risk for diabetes?
The systematic review pooled 8 randomized controlled trials including individuals 50 years on average with carbohydrate, lipid and/or vascular disorders. It also includes the analysis individuals overweight or obese but non-diabetic and whose with a minimum of one parent with diabetes type 2. The meta-analysis compares 2,241 people on a combined exercise program and balanced diet to 2,509 people following health standard recommendations.
The Non-Pharmacological Intervention (NPI) assessed
The duration of the interventions ranged from 1 year to 6 years. The dietary change was to reduce calorie intake, reduce fat intake and high carbohydrate foods and increase consumption of foods rich in fiber. Physical activity programs included a minimum of 150 minutes per week of endurance activity (moderate) such as brisk walking, cycling or jogging. The activities were supervised by professionals.
The results of the meta-analysis show a reduction in the incidence of type 2 diabetes by 37% the development program combining regular physical activity and a healthy diet in individuals with disorders of carbohydrate, lipid and vascular. This intervention has a positive effect on weight, waist circumference and blood pressure. These benefits are likely to decrease the risk of medium-term cardiovascular disease in these populations.
Change food behavior and physical endurance activity enough to prevent type 2 diabetes in a third of the study participants.
What it means for Persons at Risk with Type 2 Diabetes
Combine physical endurance activity 150 minutes per week with a healthy diet, moderate, high fiber and low in saturated fat, salt and sugar prevents Type 2 diabetes in a third of people at risk for diabetes. This type of intervention decreases body weight and waist circumference. It increases blood pressure, which reduces the risk of cardiovascular disease.
What it means for Healthcare Professionals
An intervention combining regular exercise endurance (1h30 per week) and a balanced diet supervised by a professional reduces the incidence of type 2 diabetes in high risk individuals. Encourage that behavior change is critical to a disease whose prevalence is increasing.
What it means for Researchers
This meta-analysis shows promising results in a non-drug intervention to prevent the onset of chronic disease such as type 2 diabetes, but the results lack statistical power because the populations of 8 randomized controlled trials are heterogeneous. Moreover, most participants hardly change their health behaviors vis-à-vis physical activity and diet. The lack of data on quality of life, mortality, comorbidity and on lipid levels associated with type 2 diabetes does not allow a definitive conclusion regarding the question. Future randomized trials should be performed to more targeted populations depending on the age, body mass index, level of glucose tolerance and blood pressure.
What it means for Policymakers
A prevention program based on physical activity and healthy diet supervised by a professional can reduce by 37% the risk of developing type 2 diabetes This chronic disease whose number is increasing causes major complications cardiovascular, eye, kidney, and neurological, very costly for the health system. A change in health behaviors in both areas could prevent the onset of type 2 diabetes in many people at risk. Further research is needed to determine the cost effectiveness of this kind of non-drug interventions.
Orozco LJ, Buchleitner AM, Gimenez-Perez G, Roqué i Figuls M, Richter B, Mauricio D (2008). Exercise or exercise and diet for preventing type 2 diabetes mellitus. Cochrane Database of Systematic Reviews, 3, CD003054.
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To reference this Blog en Sante © article.
Ninot G (2015). Changing Eating Habits and Physical Activity Prevents Type 2 Diabetes. Blog en Sante, A40.
© Copyright 2015 Gregory Ninot. All rights reserved.