Diet, exercise changes cut diabetes risk factors

Quite small changes in lifestyle can help reduce abdominal obesity and development of the metabolic syndrome, reports Dr. Pirjo Ilanne-Parikka, of the Finnish Diabetes Association in Tampere.

A cluster of diabetes risk factors including elevated waist circumference, blood pressure, triglyceride cholesterol, and blood sugar, as well as low levels of high-density lipoproteins ("good" cholesterol) are collectively know as the metabolic syndrome.

Ilanne-Parikka and colleagues report 15 percent reductions in both the metabolic syndrome and abdominal obesity among overweight middle-age men and women following individualized diet and exercise recommendations for an average of 3.9 years.

By contrast, metabolic syndrome decreased by just 4 percent and abdominal obesity did not decrease among people receiving usual diet and exercise advice, the researchers report in Diabetes Care.

In this secondary analysis of the ongoing Finnish Diabetes Prevention Study, the investigators followed 522 men and women who, at the start of the study, were 55 years old on average, overweight (body mass index 31.2), and had impaired glucose tolerance indicative of an increased risk for diabetes.

Participants in the intervention group received regular, individualized advice aimed at reducing their weight by at least 5 percent. They were counseled to improve their dietary intake of whole-grains, vegetables, fruits, low-fat diary and meat products, and vegetable oils rich in monounsaturated fatty acids. They were also advised to spend a minimum of 30 minutes each day walking, jogging, swimming or doing aerobics, endurance exercise or weight-training.

People in the control group received general written and oral diet and exercise advice at the start of the study and during annual check-ups.

The findings highlight the importance of "individual, patient-centered counseling and regular follow-up," Ilanne-Parikka told Reuters Health.

Longer follow-up studies are needed to confirm if these reductions can be achieved and maintained in other groups with the metabolic syndrome and if such reductions might limit the risk of cardiovascular disease, the investigators note.

SOURCE: Diabetes Care, April 2008.