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PLoS One. 2016 Jan 5;11(1):e0146095. doi: 10.1371/journal.pone.0146095. eCollection 2016.

Long-Term Effectiveness of a Lifestyle Intervention for the Primary Prevention of Type 2 Diabetes in a Low Socio-Economic Community--An Intervention Follow-Up Study on Reunion Island.

Fianu A1,2,3,4, Bourse L1,2, Naty N1,2, Le Moullec N5, Lepage B3,4, Lang T3,4,6, Favier F1,2.

Author information

1
Centre d'Investigation Clinique de la Réunion (CIC 1410), Institut National de la Santé et de la Recherche Médicale (Inserm), Saint-Pierre, la Réunion, France.
2
Centre d'Investigation Clinique de la Réunion (CIC 1410), Centre Hospitalier Universitaire la Réunion (CHU la Réunion), Saint-Pierre, la Réunion, France.
3
Unité Mixte de Recherche 1027 (UMR1027), Université Toulouse III Paul-Sabatier, Toulouse, France.
4
Unité Mixte de Recherche 1027 (UMR1027), Institut National de la Santé et de la Recherche Médicale (Inserm), Toulouse, France.
5
Service d'Endocrinologie, Diabétologie et de Nutrition, Centre Hospitalier Universitaire la Réunion (CHU la Réunion), Saint-Pierre, la Réunion, France.
6
Centre Hospitalo-Universitaire Toulouse, Toulouse, France.

Abstract

In type 2 diabetes (T2D) prevention research, evidence for maintenance of risk factor reduction after three years of follow-up is needed. The objective of this study was to evaluate the long-term effectiveness of a combined lifestyle intervention aiming at controlling body weight (BW) and waist circumference (WC) in non-diabetic, overweight/obese adults living in a low socio-economic community. On Reunion Island, 445 adults living in deprived areas, aged 18-40 and at high-risk for T2D, were included in an intervention versus control trial for primary prevention (2001-2002). The intervention promoted a healthy diet and moderate regular physical activity, through actions strengthening individuals or community and improving living conditions. The control group received a one-shot medical information and nutritional advices. After the end of the trial (2003), 259 of the subjects participated in a follow-up study (2010-2011). The outcomes were the nine-year changes from baseline in BW, body mass index (BMI) and WC measurements, separately. Statistical analyses were performed on an intention-to-treat basis, using available and imputed datasets. At inclusion, T2D risk factors were prevalent: family history of diabetes in first-degree relatives (42%), women with a personal history of gestational diabetes (11%), total obesity (43%, median BMI 29.1 kg/m²) and central obesity (71%). At follow-up, the adjusted effect on imputed dataset was significant for WC -2.4 cm (95% confidence interval: -4.7 to -0.0 cm, p = 0.046), non-significant for BW -2.2 kg (-4.6 to +0.2 kg, p = 0.073) and BMI -0.81 kg/m² (-1.69 to +0.08 kg/m², p = 0.074). A specific long-term effect was the increased likelihood of reduction in adiposity: BW loss, BMI reduction, and WC reduction were more frequent in the intervention group. In the context of low socio-economic communities, our data support the assumption of long-term effect of lifestyle interventions targeting total obesity and central obesity two major drivers of T2D.

PMID:
26731676
PMCID:
PMC4701421
DOI:
10.1371/journal.pone.0146095
[Indexed for MEDLINE]
Free PMC Article

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