The long-term benefits of lifestyle interventions for prevention of diabetes

AbstractAdverse exposures during fetal life and the postnatal period influence physical, cognitive and emotional development, and predispose to an increased risk of various chronic diseases throughout the life course. Findings from large observational studies in various populations and experimental animal studies have identified different modifiable risk factors in early life. Adverse maternal lifestyle factors, including overweight, unhealthy diet, sedentary behavior, smoking, alcohol consumption and stress in the preconception period and during pregnancy, are the most common modifiable risk factors leading to a suboptimal in-utero environment for fetal development. In the postnatal period, breastfeeding, infant growth and infant dietary intake are important modifiable factors influencing long-term offspring health outcomes. Despite the large amount of findings from observational studies, translation to lifestyle interventions seems to be challenging. Currently, randomized controlled trials focused on the influence of lifestyle interventions in these critical periods on short-term and long-term maternal and offspring health outcomes are scarce, have major limitations and do not show strong effects on maternal and offspring outcomes. New and innovative approaches are needed to move from describing these causes of ill-health to start tackling them using intervention approaches. Future randomized controlled lifestyle intervention studies and innovative observational studies, using quasi-experimental designs, are needed focused on the effects of an integrated lifestyle advice from preconception onwards on pregnancy outcomes and long-term health outcomes in offspring on a population level.

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Diet and diabetes - part 2

Arbor Clinical Nutrition Updates ◽

10.1017/s1446545000000221 ◽

2007 ◽

Vol 286 ◽

pp. 1-3

Keyword(s):

Type 2 Diabetes ◽

Glucose Control ◽

Alcohol Intake ◽

Dietary Advice ◽

Lifestyle Interventions ◽

Long Term Outcomes ◽

Short Term ◽

Diet And Diabetes

In a nutshellDietary advice for diabetics has included both reducing and increasing CHO.Some short term trials show improved glucose control from lower CHO, more fibre and lower GI foods. Light alcohol intake may provide some benefit. All these require further trials on their long term outcomes. And we should remember that, of all the lifestyle interventions in type 2 diabetes, the most effective appears to be exercise.

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Telemedical Coaching Improves Long-Term Weight Loss in Overweight Persons: A Randomized Controlled Trial

International Journal of Telemedicine and Applications ◽

10.1155/2018/7530602 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 2

Author(s):

Kerstin Kempf ◽

Martin Röhling ◽

Monika Stichert ◽

Gabriele Fischer ◽

Elke Boschem ◽

...

Keyword(s):

Health Care ◽

Weight Loss ◽

Occupational Health ◽

Care Setting ◽

Health Care Setting ◽

Control Group ◽

Lifestyle Interventions ◽

Occupational Health Care ◽

Weight Losses

Background. Lifestyle interventions have shown to be effective when continuous personal support was provided. However, there is lack of knowledge whether a telemedical-approach with personal coaching contributes to long-term weight losses in overweight employees. We, therefore, tested the hypothesis that telemedical-based lifestyle interventions accompanied with telemedical coaching lead to larger weight losses in overweight persons in an occupational health care setting. Methods. Overweight employees (n=180) with a body mass index (BMI) of >27 kg/m2 were randomized into either a telemedical (TM) group (n=61), a telemedical coaching (TMC) group (n=58), or a control group (n=61). Both intervention groups were equipped with scales and pedometers automatically transferring the data into a personalized online portal, which could be monitored from participants and coaches. Participants of the TMC group received additionally one motivational care call per week by mental coaches to discuss the current data (current weight and steps) and achieving goals such as a healthy lifestyle or weight reduction. The control group remained in routine care. Clinical and anthropometric data were determined after the 12-week intervention. Additionally, weight change was followed up after 12 months. Results. Participants of TMC (-3.1 ± 4.8 kg, p<0.0001) and TM group (-1.9 ± 4.0 kg; p=0.0012) significantly reduced weight and sustained it during the 1-year follow-up, while the control group showed no change. Compared to the control group only weight loss in the TMC group was significantly different (p<0.001) after 12 months. TMC and TM group also reduced BMI, waist circumference, and LDL cholesterol. Moreover, TMC group improved additionally systolic and diastolic blood pressure, total cholesterol, HDL cholesterol, and HbA1c. Conclusions. Telemedical devices in combination with telemedical coaching lead to significant long-term weight reductions in overweight persons in an occupational health care setting. This study is registered with NCT01868763, ClinicalTrials.gov.

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Variations in long-term outcome reporting among offspring followed up after lifestyle interventions in pregnancy: a systematic review

Journal of Perinatal Medicine ◽

10.1515/jpm-2019-0302 ◽

2020 ◽

Vol 48 (2) ◽

pp. 89-95 ◽

Cited By ~ 3

Author(s):

Rocío Olmedo-Requena ◽

Carmen Amezcua-Prieto ◽

Bassel H. Al Wattar ◽

Ewelina Rogozinska ◽

Aurora Bueno-Cavanillas ◽

...

Keyword(s):

Assessment Tools ◽

Lifestyle Interventions ◽

Quality Of Reporting ◽

Long Term Outcome ◽

Outcome Reporting ◽

Secondary Outcomes ◽

In Pregnancy

AbstractBackgroundMothers and their offspring may benefit from lifestyle interventions during pregnancy. We systematically reviewed the literature to map and evaluate the quality of long-term offspring outcomes in follow-up cohorts of randomised controlled trials (RCTs).MethodsWe searched MEDLINE, EMBASE, CINAHL, Database of Abstracts of Reviews of Effects and Cochrane Central (until March 2019) for all RCTs evaluating any lifestyle (diet or exercise) intervention during pregnancy and their follow-up cohorts. Two reviews evaluated the extracted outcomes using two standardised assessment tools, one for quality of reporting (score range 0–6) and another for the variation in outcome selection. We extracted data in duplicate and reported using natural frequencies, medians, ranges, means and standard deviation (SD).ResultsWe captured 30 long-term offspring outcomes reported in six articles (four studies). Offspring anthropometric measurements were the most commonly reported outcomes. There was a large variation in the measurement tools used. The mean overall quality score for outcome reporting was 3.33 (SD 1.24), with poor reporting of secondary outcomes and limited justification for the choice of the reported outcomes. Most studies showed selective reporting for both their primary and secondary outcomes.ConclusionThe quality of reporting for long-term offspring outcomes following lifestyle interventions in pregnancy is varied with evidence of selective outcome reporting. Developing a core outcome set will help to reduce the variations in outcome reporting to optimise future research.

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