and Exercise Can
Dramatically Reduce Diabetes
YORK (Reuters Health) - Eating a healthy diet and exercising have
long been thought to reduce the risk of type 2 diabetes, but new
study findings confirm that such lifestyle changes can have a
big payoff for people at risk of developing the disease.
In their study,
Finnish researchers found that diet and exercise counseling resulted
in a 58% reduction in diabetes risk among people who are prime
candidates for developing the condition, which is associated with
obesity and sedentary lifestyle.
The more lifestyle
changes people make, the better. But achieving at least some changes
is better than not trying at all. For example, weight loss does
not appear to be an absolutely essential part of the equation,
the report indicates.
modest weight loss conferred a much lower risk of diabetes, those
who participated in four hours of exercise per week--even if they
did not achieve their weight loss goal--had a reduction in diabetes
risk, the investigators found.
``It is likely
that any type of physical activity--whether sports, household
work, gardening or work-related physical activity--is similarly
beneficial in preventing diabetes,'' according to lead author
Dr. Jaakko Tuomilehto of the National Public Health Institute
in Helsinki and colleagues.
participants included 522 middle-aged, overweight adults with
impaired glucose tolerance--a harbinger of diabetes. The patients
in the intervention group met with a nutritionist seven times
in the first year and every three months afterward. They were
given one-on-one counseling aimed at reducing weight, exercising
more, eating less fatty foods and boosting intake of fiber-rich
foods such as fruits, vegetables, oatmeal and bran cereal.
A second group,
the ``control'' group, was given written information about the
benefits of eating a healthier diet and getting more exercise,
but did not participate in a specific program.
After 2 years,
the men and women in the intervention group lost nearly 8 pounds
on average, while those in the control group lost only about 2
After 3 years,
a total of 27 people (3% per year) in the intervention group and
59 people (6% per year) in the control group developed diabetes--a
risk reduction of 58% for those in the treatment group, according
to the report in the May 3rd issue of The New England Journal
habits and increasing exercise may be daunting, but the study
shows that even modest alterations in lifestyle have a clear benefit.
``It is commonly
argued that it is difficult to change the lifestyle of obese and
sedentary people, but such pessimism may not be justified,'' Tuomilehto
and colleagues write.
low dropout rate in our study also indicates that subjects with
impaired glucose tolerance are willing and able to participate
in a demanding intervention program if it is made available to
them,'' the authors conclude.
It is not
clear how long the participants could stick with their new lifestyle,
Drs. P. Antonio Tataranni and Clifton Bogardus of the National
Institutes of Health, note in an accompanying editorial.
that ``most people do not maintain their weight loss after participating
in weight-control programs.'' However, if more studies confirm
the findings, it might be reasonable to ''consider whether such
intervention programs should be routinely covered by insurance
companies and made more broadly available in primary care settings,''
the editorialists add.
Type 2 diabetes
occurs when the body loses its sensitivity to insulin, the blood
sugar-regulating hormone. When this occurs, blood sugar, or glucose,
rises to levels that can--over time--increase a person's risk
of developing heart disease, kidney failure, nerve damage and
14 million Americans are estimated to have the disease and one
third of these cases are believed to be undiagnosed, according
to the American Diabetes Association.
The New England Journal of Medicine 2001;344:1343-1350, 1390-
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