Predictors of lifestyle intervention outcome and dropout: The SLIM study

C Roumen, E J M Feskens, E Corpeleijn, M Mensink, W H M Saris, E E Blaak

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Abstract

BACKGROUND/OBJECTIVES: To evaluate the effect of a 4.1-year (range 3-6 years) lifestyle intervention according to general public health recommendations on glucose tolerance and dropout in a Dutch population with impaired glucose tolerance (IGT).

SUBJECTS/METHODS: In the Study on Lifestyle intervention and Impaired glucose tolerance Maastricht, 147 Caucasian IGT subjects were randomized to an intervention group (INT: n=74; 38 male, 36 female) and control group (CON: n=73; 37 male, 36 female). Annually, subjects underwent measurements of body weight, anthropometry, glucose tolerance (oral glucose tolerance test), insulin resistance (homeostasis model assessment-insulin resistance), maximal aerobic capacity (VO(2) max), blood lipids and blood pressure. INT received individual advice regarding a healthy diet and physical activity.

RESULTS: INT decreased their saturated fat intake, increased their carbohydrate intake (P<0.05) and VO(2) max (P=0.04) compared with CON. Body weight did not change significantly (P=0.20) between the groups. After an initial decrease, 2-h glucose levels overall increased in INT (+0.11 mmol/l), but significantly less than CON (+1.18 mmol/l; P=0.04). Diabetes incidence was lower in INT versus CON (30 versus 56%, P=0.04). Change in body weight was associated with change in 2-h glucose levels (β=0.399 mmol/l per kg, P=0.02). Dropouts had a lower aerobic fitness and socioeconomic status, and a higher body mass index (BMI) and 2-h glucose compared with non-dropouts.

CONCLUSIONS: Prolonged feasible changes in diet and physical activity prevent deterioration of glucose tolerance and reduce diabetes risk. Low socioeconomic status, low aerobic fitness and high BMI and 2-h glucose are indicative of dropout to the program.

Original languageEnglish
Pages (from-to)1141-1147
Number of pages7
JournalEuropean Journal of Clinical Nutrition
Volume65
DOIs
Publication statusPublished - 2011
Externally publishedYes

Keywords

  • Aged
  • Blood Glucose
  • Blood Pressure
  • Body Composition
  • Body Mass Index
  • Body Weight
  • Diabetes Mellitus, Type 2
  • Diet
  • Dietary Carbohydrates
  • Energy Intake
  • Female
  • Food, Organic
  • Glucose Intolerance
  • Glucose Tolerance Test
  • Humans
  • Life Style
  • Lipids
  • Male
  • Middle Aged
  • Motor Activity
  • Netherlands
  • Patient Dropouts
  • Risk Factors
  • Socioeconomic Factors
  • Journal Article
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

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