The Role of Diet and Lifestyle in Primary, Secondary, and Tertiary Diabetes Prevention: A Review of Meta-Analyses

Department of Hygiene, School of Medicine, University of Athens, Athens, Greece.
The Review of Diabetic Studies 03/2010; 7(1):26-35. DOI: 10.1900/RDS.2010.7.26
Source: PubMed


Prevention of diabetes is crucial to lowering disease incidence, and thus minimizing the individual, familial, and public health burden. The purpose of this review is to gather current information from meta-analyses on dietary and lifestyle practices concerning reduction of risk to develop type 2 diabetes. Low glycemic index dietary patterns reduce both fasting blood glucose and glycated proteins independent of carbohydrate consumption. Diets rich in whole-grain, cereal high fiber products, and non-oil-seed pulses are beneficial. Whereas, frequent meat consumption has been shown to increase risk. Regarding non-alcoholic beverages, 4 cups/day of filtered coffee or tea are associated with a reduced diabetes risk. In contrast, the consumption of alcoholic beverages should not exceed 1-3 drinks/day. Intake of vitamin E, carotenoids, and magnesium can be increased to counteract diabetes risk. Obesity is the most important factor accounting for more than half of new diabetes' cases; even modest weight loss has a favorable effect in preventing the appearance of diabetes. Also, physical exercise with or without diet contributes to a healthier lifestyle, and is important for lowering risk. Finally, there is a positive association between smoking and risk to develop type 2 diabetes. As far as secondary and tertiary prevention is concerned, for persons already diagnosed with diabetes, there is limited evidence of the effectiveness of diet or lifestyle modification on glycemic control, but further studies are necessary.

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    • "Effective management of diabetes includes adoption of healthy lifestyle behaviours and an often complex medication regimen. Both approaches have been shown to lower and stabilise glucose levels [4] [5]. Evidence suggests that good glycaemic control reduces the risk of long-term micro-and macro-vascular complications [6] [7]. "
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    ABSTRACT: Aims To examine the association between health status, diabetes-specific quality of life (QoL) and glycaemic control among individuals with type 2 diabetes. Methods 1876 individuals with screen-detected diabetes and a mean age of 66 years underwent assessment of self-reported health status (SF-36), diabetes-specific QoL (the Audit of Diabetes Dependent Quality of Life (ADDQoL19)) and glycated haemoglobin (HbA1c) at five years post-diagnosis in the ADDITION-Europe trial. Multivariable linear regression was used to quantify the cross-sectional association between health status, diabetes-specific QoL and HbA1c, adjusting for age, sex, education, alcohol consumption, physical activity, BMI, intake of any glucose-lowering drugs, and trial arm. Results The mean (SD) SF-36 physical and mental health summary scores were 46.2 (10.4) and 54.6 (8.6), respectively. The median average weighted impact ADDQoL score was -0.32 (IQR -0.89 to -0.06), indicating an overall negative impact of diabetes on QoL. Individuals who reported a negative impact of diabetes on their QoL had higher HbA1c levels at five years after diagnosis compared with those who reported a positive or no impact of diabetes (b-coefficient [95% CI]: b = 0.2 [0.1, 0.3]). Physical and mental health summary SF-36 scores were not significantly associated with HbA1c in multivariable analysis. Conclusions Diabetes-specific QoL but not health status was independently associated with HbA1c. Practitioners should take account of the complex relationship between diabetes-specific QoL and glucose, particularly with regard to dietary behaviour. Future research should attempt to elucidate via which pathways this association might act.
    Diabetes research and clinical practice 05/2014; 104(2). DOI:10.1016/j.diabres.2013.12.029 · 2.54 Impact Factor
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    • "The prevalence of type 2 diabetes (T2D) is increasing at alarming rates in the US and worldwide (Chen et al., 2011; Zabetian et al., 2013). In addition to well-known diabetic risk factors such as diet, obesity, physical inactivity, age, race, and a family history of T2D (Psaltopoulou et al., 2010; Venables and Jeukendrup, 2009), recent studies have suggested a role of emotional stress in the etiology of T2D (Kato et al., 2009; Pouwer et al., 2010; Rod et al., 2009). The epidemiological studies support the concept that different forms of emotional stress, particularly depression, general emotional stress, anxiety, anger, hostility and sleeping problems (Pouwer et al., 2010), contribute to an elevated risk of T2D. "
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    ABSTRACT: Emotional stress may be a risk factor for type 2 diabetes (T2D), but the relation between phobic anxiety symptom scores and risk of T2D is uncertain. To evaluate prospectively the association between phobic anxiety symptom scores and incident T2D in three cohorts of US men and women. We followed 30,830 men in the Health Professional's Follow-Up Study (HPFS) (1988-2008), 69,336 women in the Nurses' Health Study (NHS) (1988-2008), and 80,120 women in the Nurses' Health Study II (NHS II) (1993-2011). Phobic anxiety symptom scores, as measured by the Crown-Crisp index (CCI), calculated from 8 questions, was administered at baseline and updated in 2004 for NHS, in 2005 for NHS II, and in 2000 for HPFS. Incident T2D was confirmed by a validated supplementary questionnaire. We used Cox proportional hazards analysis to evaluate associations with incident T2D. During 3,110,248 person-years of follow-up, we documented 12,876 incident T2D cases. In multivariable Cox regression models with adjustment for major lifestyle and dietary risk factors,the HRs of T2D across categories of increasing levels ofCCI (scores= 2-<3, 3-<4, 4-<6, ⩾6), compared with a score of <2, were increased significantly by 6%, 10%, 11% and 13% (Ptrend =0.0005) for NHS; and by 19%, 11%, 22%, and 29% (Ptrend <0.0001) for NHS II. Each score increment in CCI was associated with 3% higher risk of T2D in NHS (HRs, 1.03, 95%CI:1.02-1.04) and 4% higher risk of T2D in NHS II (HRs, 1.04, 95%CI:1.03-1.05). Further adjustment for self-reported depression and antidepressant use did not change the results. In HPFS, the association between CCI and T2D was not significant after adjusting for lifestyle variables. Our results suggest that higher phobic anxiety symptom scores are associated with an increased risk of T2D in women.
    Brain Behavior and Immunity 10/2013; 36. DOI:10.1016/j.bbi.2013.10.025 · 5.89 Impact Factor
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    • "Indeed, removing meat from the diet tends to lower HDL-cholesterol [13] and may result in a loss of lean body mass [14,15]. While some data indicate that meat consumption is directly related to an increased risk for disease [16], the quality of the meat (i.e., lean meat versus high-fat meat) needs to be considered when determining the potential impact on blood lipids and disease [17-19]. For example, diets that include moderate consumption of lean beef and chicken [20,21], as well as lean fish [22], are associated with modest increases in HDL-cholesterol and an overall improvement in the lipid profile. "
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    ABSTRACT: The Daniel Fast involves dietary modification similar to a purified vegan diet. Although improvements in several health-specific biomarkers have been noted with this plan, the removal of animal products results in a significant reduction in both dietary protein and saturated fatty acid intake, which results in a loss of lean body mass and a reduction in HDL-cholesterol. We assigned 29 men and women to either a traditional or modified Daniel Fast for 21 days and measured anthropometric and biochemical markers of health pre and post intervention. The modified Daniel Fast was otherwise identical to the traditional plan but included one serving per day of lean meat and dairy (skim milk), providing approximately 30 grams per day of additional protein. Compared to baseline, both plans resulted in similar and significant improvements in blood lipids, as well as a reduction in inflammation. Modification of dietary intake in accordance with either a traditional or modified Daniel Fast may improve risk factors for cardiovascular and metabolic disease.
    Lipids in Health and Disease 07/2013; 12(1):114. DOI:10.1186/1476-511X-12-114 · 2.22 Impact Factor
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