Study on Lifestyle Intervention and Impaired Glucose Tolerance Maastricht (SLIM): preliminary results after one year

Department of Human Biology, Maastricht University, Maastricht, The Netherlands.
International Journal of Obesity (Impact Factor: 5.39). 03/2003; 27(3):377-84. DOI: 10.1038/sj.ijo.0802249
Source: PubMed

ABSTRACT Important risk factors for the progression from impaired glucose tolerance to type II diabetes mellitus are obesity, diet and physical inactivity. The aim of this study is to evaluate the effect of a lifestyle-intervention programme on glucose tolerance in Dutch subjects with impaired glucose tolerance (IGT).
A total of 102 subjects were studied, randomised into two groups. Subjects in the intervention group received regular dietary advice, and were stimulated to lose weight and to increase their physical activity. The control group received only brief information about the beneficial effects of a healthy diet and increased physical activity. Before and after the first year, glucose tolerance was measured and several other measurements were done.
Body weight loss after 1 y was higher in the intervention group. The 2-h blood glucose concentration decreased 0.8+/-0.3 mmol/l in the intervention group and increased 0.2+/-0.3 mmol/l in the control group (P<0.05). Body weight loss and increased physical fitness were the most important determinants of improved glucose tolerance and insulin sensitivity.
A lifestyle-intervention programme according to general recommendations is effective and induces beneficial changes in lifestyle, which improve glucose tolerance in subjects with IGT. Body weight loss and increased physical fitness were the most important determinants of improved glucose tolerance and insulin sensitivity.

Download full-text


Available from: Marco Mensink, Jul 15, 2014
  • Source
    • "Australia 56 0.56 NA 30.1 <30% TF, <10% SF moderate intensity, 30 min/S, most days/wk 12 Bo et al. 2007 [31] Italy 56 0.58 MS 30.0 reduced TF and SF intake moderate intensity (i. e. brisk walking), ~150 min/wk 13 Arciero et al. 2006 [32] USA 43 0.48 NA 27.8 high protein (40%) and low fat (20%) diet resistance and cardiovascular training, 20 min/S, 4–6 S/wk 14 Brekke et al. 2005 [33] Sweden 42 0.37 NA 26.1 <30% TF intake, <10% SF intake walking or more intensive exercise, 30 min/S, 4–5 S/wk 15 Watkins et al. 2003 [34] USA 50 0.50 NA 33.7 500 kcal/d restriction, <20% TF cycle ergometry and jogging, or walking, ~60 min/S, 3–4 S/wk 16 Lindstrom et al. 2003 [35] Finland 55 0.66 IGT 31.3 200 kcal/d restriction, <30% TF, <10% SF endurance exercise & resistance training, >30 min/S 17 Esposito et al. 2003 [36] Italy 35 1.00 NA 34.5 1400 kcal/d, 55% carbohydrate, 30% TF, <10% SF aerobic exercise (walking and swimming) 18 Mensink et al. 2003 [37] Netherlands 56 0.43 IGT 29.5 >55% carbohydrate, <30% TF, <10% SF moderate physical activity, >30 min/S, 5 S/wk 19 McAuley et al. 2002 [38] New Zealand 46 0.71 IR 34.5 400 kcal/d restriction, 27% TF, 9% SF Moderate exercise plus resistance training, >20 min/S, 5 S/wk 20 Miller et al. 2002 [39] USA 54 0.62 NA 33.7 500 kcal/d restriction, 27% TF, 6% SF aerobic (brisk walking and biking), 30–45 min/S, 3 S/wk 21 Reseland et al. 2001 [40] Norway 45 0.00 MS 27.5 400 kcal/d restriction, <30% TF endurance exercise, 1 h/S, 3 S/wk 22 Oldroyd et al. 2001 [41] UK 58 0.40 IGT 30.2 <30% TF intake, ~50% carbohydrate aerobic exercise, 20–30 min/S, 2–3 S/wk 23 Kuller et al. 2001 [42] USA 47 1.00 NA 25.0 Calorie restriction upto 1300 kcal, 25% TF, 7% SF increasing physical activity to 1250 kcal expended weekly 24 Ornish et al. 1998 [43] USA 60 0.09 NA 26.9 10%-fat vegetarian diet moderate-intensity aerobic, 1 h/S, 5 S/wk 25 Stefanick et al. 1998 (female) [16] USA 57 1.00 NA 25.6 <30% TF intake, <7% SF intake aerobic (jogging and brisk walking), 60 min/S, 3 S/wk 26 Stefanick et al. 1998 (male) [16] USA 48 1.00 NA 27.8 <30% TF intake, <7% SF intake aerobic (jogging and brisk walking), 60 min/S, 3 S/wk variance τ 2 . If τ 2 = 0, homogeneity is implied among true effects across individual studies such that μ=θ. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background and aims Fasting insulin (FI), fasting glucose (FG), systolic blood pressure (SBP), high density lipoproteins (HDL), triacylglycerides (TAG), and body mass index (BMI) are well-known risk factors for type 2 diabetes. Reliable estimates of lifestyle intervention effects on these factors allow diabetes risk to be predicted accurately. The present meta-analyses were conducted to quantitatively summarize effects of diet and exercise intervention programs on FI, FG, SBP, HDL, TAG and BMI in adults without diabetes. Materials and methods MEDLINE and EMBASE were searched to find studies involving diet plus exercise interventions. Studies were required to use adults not diagnosed with type 2 diabetes, involve both dietary and exercise counseling, and include changes in diabetes risk factors as outcome measures. Data from 18, 24, 23, 30, 29 and 29 studies were used for the analyses of FI, FG, SBP, HDL, TAG and BMI, respectively. About 60% of the studies included exclusively overweight or obese adults. Mean age and BMI of participants at baseline were 48 years and 30.1 kg/m2. Heterogeneity of intervention effects was first estimated using random-effect models and explained further with mixed-effects models. Results Adults receiving diet and exercise education for approximately one year experienced significant (P <0.001) reductions in FI (-2.56 ± 0.58 mU/L), FG (-0.18 ± 0.04 mmol/L), SBP (-2.77 ± 0.56 mm Hg), TAG (-0.258 ± 0.037 mmol/L) and BMI (-1.61 ± 0.13 kg/m2). These risk factor changes were related to a mean calorie intake reduction of 273 kcal/d, a mean total fat intake reduction of 6.3%, and 40 minutes of moderate intensity aerobic exercise four times a week. Lifestyle intervention did not have an impact on HDL. More than 99% of total variability in the intervention effects was due to heterogeneity. Variability in calorie and fat intake restrictions, exercise type and duration, length of the intervention period, and the presence or absence of glucose, insulin, or lipid abnormalities explained 23-63% of the heterogeneity. Conclusions Calorie and total fat intake restrictions coupled with moderate intensity aerobic exercises significantly improved diabetes risk factors in healthy normoglycemic adults although normoglycemic adults with glucose, insulin, and lipid abnormalities appear to benefit more.
    Diabetology and Metabolic Syndrome 11/2014; 6. DOI:10.1186/1758-5996-6-127 · 2.50 Impact Factor
  • Source
    • "Previous studies have investigated the feasibility and efficacy of intervention for the prevention and management of diabetes. Additionally, it has recently been demonstrated that multicomponent lifestyle intervention can prevent or at least postpone type 2 diabetes [6] [7] [8] [9] [10] [11]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study was conducted to compare the effects of two years of lifestyle intervention to no intervention or one year of intervention on diabetes risk factors in male workers with impaired fasting glucose (IFG) or diabetes. We conducted a randomized lifestyle intervention trial designed to alter personal lifestyles among 123 industrial male workers (CG; control group, n=75; OIG; one-year intervention group, n=23; TIG; two-year intervention group, n=25). The intervention consisted of two parts, the main program (face-to-face counseling five times/12 weeks) and a follow-up program (e-mail counseling ten times/30 weeks). Assessments included biochemical characteristics, anthropometry and nutrient intake at baseline and after two years. After two years, systolic blood pressure, HOMA-IR, HDL cholesterol and total energy intake (p<0.05) were reduced in the OIG group, while weight, body mass index, waist circumference, blood pressure, fasting plasma glucose (FPG), HbA1c and nutrient intake (total energy, carbohydrate, protein and sodium) were significantly decreased (p<0.05, respectively) in the TIG group. When compared to the CG, subjects in OIG and TIG showed significant improvements in the level of FPG and HbA1c (p<0.05). Continuous lifestyle intervention for two years is more effective at improving diabetes risk factors than OIG.
    Diabetes research and clinical practice 10/2010; 90(1):26-33. DOI:10.1016/j.diabres.2010.06.006 · 2.54 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Type 2 diabetes is a serious, costly, and increasingly common disease. Several conditions commonly seen in family medicine settings confer increased risk of developing diabetes. Among these conditions are impaired glucose tolerance, impaired fasting glucose, obesity, gestational diabetes, hypertension, hyperlipidemia, and menopause. We here present the results of a systematic review of the literature examining the evidence for different strategies aimed at preventing type 2 diabetes in patients with these conditions. The strongest evidence supports an intensive lifestyle intervention designed to induce modest weight loss. The greatest degree of prevention, based on lesser quality evidence, may be imparted by bariatric surgery. Metformin and troglitazone have appreciable evidence in specific populations, and orlistat and acarbose have slightly less evidence among obese patients, for preventing diabetes. Ramipril, captopril, losartan, pravastatin, and estrogens show some very preliminary promise for preventing diabetes in patients treated for hypertension, hyperlipidemia, and menopause, but each needs a more rigorous evaluation. Although more questions remain to be answered, family physicians now have tools available to help our patients lead lives free of diabetes.
    The Journal of the American Board of Family Practice / American Board of Family Practice 01/2005; 18(1):37-43. DOI:10.3122/jabfm.18.1.37
Show more