TY - JOUR
T1 - The PREVIEW intervention study: Results from a 3-year randomized 2 x 2 factorial multinational trial investigating the role of protein, glycaemic index and physical activity for prevention of type-2 diabetes
AU - Raben, Anne
AU - Vestentoft, Pia Siig
AU - Brand-Miller, Jennie
AU - Jalo, Elli
AU - Drummen, Mathjis
AU - Simpson, Liz
AU - Martinez, J Alfredo
AU - Handjieva-Darlenska, Teodora
AU - Stratton, Gareth
AU - Huttunen-Lenz, Maija
AU - Lam, Tony
AU - Sundvall, Jouko
AU - Muirhead, Roslyn
AU - Poppitt, Sally
AU - Ritz, Christian
AU - Pietiläinen, Kirsi H
AU - Westerterp-Plantenga, Margriet
AU - Taylor, Moira A
AU - Carretero, Santiago Navas
AU - Handjiev, Svetoslav
AU - McNarry, Melitta A
AU - Hansen, Sylvia
AU - Råman, Laura
AU - Brodie, Shannon
AU - Silvestre, Marta P
AU - Adam, Tanja C
AU - Macdonald, Ian A
AU - San-Cristobal, Rodrigo
AU - Boyadjieva, Nadka
AU - Mackintosh, Kelly A
AU - Schlicht, Wolfgang
AU - Liu, Amy
AU - Larsen, Thomas Meinert
AU - Fogelholm, Mikael
N1 - This article is protected by copyright. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Aim: To compare the impact of two long-term weight-maintenance diets, a high protein (HP) and low glycaemic index (GI) diet versus a moderate protein (MP) and moderate GI diet, combined with either high intensity (HI) or moderate intensity physical activity (PA), on the incidence of type 2 diabetes (T2D) after rapid weight loss.Materials and Methods: A 3-year multicentre randomized trial in eight countries using a 2 x 2 diet-by-PA factorial design was conducted. Eight-weeks weight reduction was followed by a 3-year randomized weight-maintenance phase. In total, 2326 adults (age 25-70 years, body mass index ≥ 25 kg/m2) with prediabetes were enrolled. The primary endpoint was 3-year incidence of T2D analysed by diet treatment. Secondary outcomes included glucose, insulin, HbA1C and body weight.Results: The total number of T2D cases was 62 and cumulative incidence rate was 3.1%, with no significant differences between the two diets, PA or their combination. T2D incidence was similar across intervention centres, irrespective of attrition. Signficantly fewer participants achieved normoglycaemia in the HP compared with the MP group (P < .0001). At 3 years, normoglycemia was lowest in HP-HI (11.9%) compared with the other three groups (20.0%-21.0%, P < .05). There were no group differences in body weight change (-11% after 8-week weight reduction; -5% after 3- year weight maintenance) or in other secondary outcomes.Conclusions: Three-year incidence of T2D was much lower than predicted and did not differ between diets, PA or their combination. Maintaining the target intakes of protein and GI over 3 years was difficult, but the overall protocol combining weight loss, healthy eating and PA was successful in markedly reducing the risk of T2D. This is an important clinically relevant outcome.
AB - Aim: To compare the impact of two long-term weight-maintenance diets, a high protein (HP) and low glycaemic index (GI) diet versus a moderate protein (MP) and moderate GI diet, combined with either high intensity (HI) or moderate intensity physical activity (PA), on the incidence of type 2 diabetes (T2D) after rapid weight loss.Materials and Methods: A 3-year multicentre randomized trial in eight countries using a 2 x 2 diet-by-PA factorial design was conducted. Eight-weeks weight reduction was followed by a 3-year randomized weight-maintenance phase. In total, 2326 adults (age 25-70 years, body mass index ≥ 25 kg/m2) with prediabetes were enrolled. The primary endpoint was 3-year incidence of T2D analysed by diet treatment. Secondary outcomes included glucose, insulin, HbA1C and body weight.Results: The total number of T2D cases was 62 and cumulative incidence rate was 3.1%, with no significant differences between the two diets, PA or their combination. T2D incidence was similar across intervention centres, irrespective of attrition. Signficantly fewer participants achieved normoglycaemia in the HP compared with the MP group (P < .0001). At 3 years, normoglycemia was lowest in HP-HI (11.9%) compared with the other three groups (20.0%-21.0%, P < .05). There were no group differences in body weight change (-11% after 8-week weight reduction; -5% after 3- year weight maintenance) or in other secondary outcomes.Conclusions: Three-year incidence of T2D was much lower than predicted and did not differ between diets, PA or their combination. Maintaining the target intakes of protein and GI over 3 years was difficult, but the overall protocol combining weight loss, healthy eating and PA was successful in markedly reducing the risk of T2D. This is an important clinically relevant outcome.
KW - Faculty of Science
KW - Behaviour change
KW - Carbohydrate
KW - Dietary intervention
KW - Exercise intervention
KW - Glycaemic control
KW - Obesity
U2 - 10.1111/dom.14219
DO - 10.1111/dom.14219
M3 - Journal article
C2 - 33026154
VL - 23
SP - 324
EP - 337
JO - Diabetes, Obesity and Metabolism
JF - Diabetes, Obesity and Metabolism
SN - 1462-8902
IS - 2
ER -