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Lifestyle approach for type 2 diabetes and metabolic syndrome

Current Atherosclerosis Reports volume 10, pages 523–528 (2008)Cite this article

Abstract

Recent changes in lifestyle, including physical inactivity and unhealthy diets, are likely to have played an important role in the global epidemic of obesity, type 2 diabetes, and metabolic syndrome. Implementation of a healthier lifestyle, with an increase in physical activity and a reduction of body weight, based on the regulation of calories and fat intake, are the basis for the prevention and treatment of both type 2 diabetes and metabolic syndrome. Intervention studies based on changes in lifestyle in individuals at risk found that diabetes incidence was reduced by 42% to 63%. Similarly, intensive lifestyle changes in patients with the metabolic syndrome have been shown to reduce the prevalence of the syndrome by 20% to 48%. Reduction of body weight, improvement of the quality of diet, and promotion of physical activity are the main approaches to prevent and treat patients with type 2 diabetes or metabolic syndrome.

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References and Recommended Reading

  1. Zimmet P: Globalization, coca-colonization and the chronic disease epidemic: can the doomsday scenario be averted? J Intern Med 2000, 247:301–310.

    PubMed  Article  CAS  Google Scholar 

  2. Wild S: Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004, 27:1047–1053.

    PubMed  Article  Google Scholar 

  3. The Diabetes Control and Complications Trial Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993, 329:977–986.

    Article  Google Scholar 

  4. UK Prospective Diabetes Study Group (UKPDS): Effect of intensive blood glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 1998, 352:854–865.

    Article  Google Scholar 

  5. Khaw KT, Wareham N, Bingham S, et al.: Association of hemoglobin A 1c with cardiovascular disease and mortality in adults: the European Prospective Investigation into Cancer in Norfolk. Ann Intern Med 2004, 141:413–420.

    PubMed  CAS  Google Scholar 

  6. Ford ES, Giles WH, Dietz WH: Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002, 287:356–359.

    PubMed  Article  Google Scholar 

  7. Flegal KM, Carroll MD, Ogden CL, Johnson CL: Prevalence and trends in obesity among US adults, 1999–2000. JAMA 2002, 288:1723–1727.

    PubMed  Article  Google Scholar 

  8. Ezzati M, Lopez AD, Rodgers A, et al.; Comparative Risk Assessment Collaborating Group: Selected major risk factors and global and regional burden of disease. Lancet 2002, 360:1347–1360.

    PubMed  Article  Google Scholar 

  9. Eckel RH, Grundy SM, Zimmet PZ: The metabolic syndrome. Lancet 2005; 365:1415–1428.

    PubMed  Article  CAS  Google Scholar 

  10. Allison DB, Fontaine KR, Manson JE, et al.: Annual deaths attributable to obesity in the United States. JAMA 1999, 282:1530–1538.

    PubMed  Article  CAS  Google Scholar 

  11. Hu FB, Li TY, Colditz GA, et al.: Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA 2003, 289:1785–1791.

    PubMed  Article  Google Scholar 

  12. Hu FB, Sigal RJ, Rich-Edwards JW, et al.: Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA 1999, 282:1433–1439.

    PubMed  Article  CAS  Google Scholar 

  13. Hu FB, Leitzmann MF, Stampfer MJ, et al.: Physical activity and television watching in relation to risk for type 2 diabetes mellitus in men. Arch Intern Med 2001, 161:1542–1548.

    PubMed  Article  CAS  Google Scholar 

  14. Hu G, Lakka TA, Lakka AM, Tuomilehto J: Lifestyle management in the metabolic syndrome. Met Syn Rel Disord 2006, 4:270–286.

    Article  Google Scholar 

  15. Laaksonen DE, Lakka HM, Salonen JT, et al.: Low levels of leisure-time physical activity and cardiorespiratory fitness predict development of the metabolic syndrome. Diabetes Care 2002, 25:1612–1618.

    PubMed  Article  Google Scholar 

  16. Heidemann C, Hoffmann K, Spranger J, et al.: A dietary pattern protective against type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC): Potsdam Study cohort. Diabetologia 2005, 48:1126–1134.

    PubMed  Article  CAS  Google Scholar 

  17. Montonen J, Knekt P, Harkanen T, et al.: Dietary patterns and the incidence of type 2 diabetes. Am J Epidemiol 2005, 161:219–227.

    PubMed  Article  Google Scholar 

  18. Murtaugh MA, Jacobs DR, Jacob B, et al.: Epidemiological support for the protection of whole grains against diabetes. Proc Nutr Soc 2003, 62:143–149.

    PubMed  Article  CAS  Google Scholar 

  19. Lovejoy JC: The impact of nuts on diabetes and diabetes risk. Curr Diabetes Rep 2005, 5:379–384.

    Article  CAS  Google Scholar 

  20. Howard AA, Arnsten JH, Gourevitch MN: Effect of alcohol consumption on diabetes mellitus: a systematic review. Ann Intern Med 2004, 140:211–219.

    PubMed  Google Scholar 

  21. Fung TT, McCullough M, van Dam RM, Hu FB: A prospective study of overall diet quality and risk of type 2 diabetes in women. Diabetes Care 2007, 30:1753–1757.

    PubMed  Article  Google Scholar 

  22. Williams DE, Prevost AT, Whichelow MJ, et al.: A crosssectional study of dietary patterns with glucose intolerance and other features of the metabolic syndrome. Br J Nutr 2000, 83:257–266.

    PubMed  CAS  Google Scholar 

  23. Zhu S, St-Onge MP, Heshka S, Heymsfield SB: Lifestyle behaviours associated with lower risk of having the metabolic syndrome. Metabolism 2004, 53:1503–1511.

    PubMed  Article  CAS  Google Scholar 

  24. McKeown NM, Meigs JB, Liu S, et al.: Carbohydrate nutrition, insulin resistance, and the prevalence of the metabolic syndrome in the Framingham Offspring Cohort. Diabetes Care 2004, 27:538–546.

    PubMed  Article  Google Scholar 

  25. Millen BE, Pencina MJ, Kimokoti RW, et al.: Nutritional risk and the metabolic syndrome in women: opportunities for preventive intervention from the Framingham Nutrition Study. Am J Clin Nutr 2006, 84:434–451.

    PubMed  CAS  Google Scholar 

  26. Sigal RJ, Kenny GP, Wasserman DH, et al.: Physical activity/exercise and type 2 diabetes. Diabetes Care 2004, 27:2518–2539.

    PubMed  Article  Google Scholar 

  27. Laaksonen DE, Lindstrom J, Lakka TA, et al.: Physical activity in the prevention of type 2 diabetes: the Finnish diabetes prevention study. Diabetes 2005, 54:158–165.

    PubMed  Article  CAS  Google Scholar 

  28. Diabetes Prevention Research Group: Impact of intensive life style and metformin therapy on cardiovascular disease risk factors in the Diabetes Prevention Programme. Diabetes Care 2005, 28:888–894.

    Article  Google Scholar 

  29. Pastors JG, Warshaw H, Daly H, et al.: The evidence for the effectiveness of medical nutrition therapy in diabetes management. Diabetes Care 2002, 25:608–613.

    PubMed  Article  Google Scholar 

  30. UK Prospective Diabetes Study Group: Response of fasting plasma glucose to diet therapy in newly presenting type II diabetic patients (UKPDS 7). Metabolism 1990, 39:905–912.

    Article  Google Scholar 

  31. Pan XR, Li GW, Hu YH, et al.: Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and diabetes study. Diabetes Care 1997, 20:537–544.

    PubMed  Article  CAS  Google Scholar 

  32. Eriksson KF, Lindgärde F: Prevention of type 2 (noninsulin-dependent) diabetes mellitus by diet and physical exercise. the 6-year Malm. Diabetologia 1991, 34:891–898.

    PubMed  Article  CAS  Google Scholar 

  33. Knowler WC, Barrett-Connor E, Fowler SE, et al.: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002, 346:393–403.

    PubMed  Article  CAS  Google Scholar 

  34. Lindström J, Louheranta A, Mannelin M, et al.: The Finish Diabetes Prevention Study (DPS): lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care 2003, 26:3230–3236.

    PubMed  Article  Google Scholar 

  35. Yates T, Khunti K, Bull F, et al.: The role of physical activity in the management of impaired glucose tolerance: a systemic review. Diabetologia 2007, 50:1116–1126.

    PubMed  Article  CAS  Google Scholar 

  36. Giugliano D, Ceriello A, Esposito K: Are there specific treatments for the metabolic syndrome? Am J Clin Nutr 2008, 87:8–11.

    PubMed  CAS  Google Scholar 

  37. Esposito K, Marfella R, Ciotola M, et al.: Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 2004, 292:1440–1446.

    PubMed  Article  CAS  Google Scholar 

  38. Orchard TJ, Tempros M, Goldberg R, et al.: The effect of metformin andintensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med 2005, 142:611–619.

    PubMed  CAS  Google Scholar 

  39. Azadbakht L, Mirmiran P, Esmaillzadeh A, et al.: Beneficial effects of a dietary approaches to stop hypertension eating plan on features of the metabolic syndrome. Diabetes Care 2005, 28:2823–2831.

    PubMed  Article  CAS  Google Scholar 

  40. Franz MJ, Bantle JP, Beebe CA, et al.: Evidence based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 2002, 25:148–298.

    PubMed  Article  Google Scholar 

  41. Gæde P, Lund-Andersen H, Parving HH, Pedersen O: Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med 2008, 358:580–591.

    PubMed  Article  Google Scholar 

  42. Grundy SM, Cleeman JI, Daniels RD, et al.: Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005, 112:2735–2752.

    PubMed  Article  Google Scholar 

  43. Lichtenstein AH, Appel LJ, Brands M, et al.: Diet and lifestyle recommendations revision 2006. A scientific statement from the American Heart Association Nutrition Committee. Circulation 2006, 114:82–96.

    PubMed  Article  Google Scholar 

  44. Weinberg SL: The diet-heart hypothesis: a critique. J Am Coll Cardiol 2004, 43:731–733.

    PubMed  Article  CAS  Google Scholar 

  45. Howard BV, Manson JE, Stefanick ML, et al.: Low-fat dietary pattern and weight change over 7 years. The Women’s Health Initiative Dietary Modification Trial. JAMA 2006, 295:39–49.

    PubMed  Article  CAS  Google Scholar 

  46. Esposito K, Ciotola M, Giugliano D: Low-carbohydrate diet and coronary heart disease in women. N Engl J Med 2007, 356:750–752.

    PubMed  Article  CAS  Google Scholar 

  47. American Diabetes Association: Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 2002, 25:202–212.

    Article  Google Scholar 

  48. Giugliano D, Ceriello A, Esposito K: Diet and inflammation. Emphasis on the metabolic syndrome. J Am Coll Cardiol 2006, 48:677–685.

    PubMed  Article  CAS  Google Scholar 

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Affiliations

  1. Department of Geriatrics and Metabolic Diseases, Second University of Naples, Division of Metabolic Diseases, Piazza L. Miraglia 2, 80138, Napoli, Italy

    Katherine Esposito

Authors
  1. Katherine Esposito
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  2. Miryam Ciotola
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  3. Maria Ida Maiorino
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  4. Dario Giugliano
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Correspondence to Katherine Esposito.

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Esposito, K., Ciotola, M., Maiorino, M.I. et al. Lifestyle approach for type 2 diabetes and metabolic syndrome. Curr Atheroscler Rep 10, 523–528 (2008). https://doi.org/10.1007/s11883-008-0081-4

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  • DOI: https://doi.org/10.1007/s11883-008-0081-4

Keywords

  • Physical Activity
  • Metabolic Syndrome
  • Metformin
  • Dietary Pattern
  • Lifestyle Intervention