10 Fakultät Wirtschafts- und Sozialwissenschaften

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    Appraisal of triglyceride-related markers as early predictors of metabolic outcomes in the PREVIEW lifestyle intervention : a controlled post-hoc trial
    (2021) Navas-Carretero, Santiago; San-Cristobal, Rodrigo; Siig Vestentoft, Pia; Brand-Miller, Jennie C.; Jalo, Elli; Westerterp-Plantenga, Margriet; Simpson, Elizabeth J.; Handjieva-Darlenska, Teodora; Stratton, Gareth; Huttunen-Lenz, Maija; Lam, Tony; Muirhead, Roslyn; Poppitt, Sally; Pietiläinen, Kirsi H.; Adam, Tanja; Taylor, Moira A.; Handjiev, Svetoslav; McNarry, Melitta A.; Hansen, Sylvia; Brodie, Shannon; Silvestre, Marta P.; Macdonald, Ian A.; Boyadjieva, Nadka; Mackintosh, Kelly A.; Schlicht, Wolfgang; Liu, Amy; Larsen, Thomas M.; Fogelholm, Mikael; Raben, Anne; Martinez, J. Alfredo
    Individuals with pre-diabetes are commonly overweight and benefit from dietary and physical activity strategies aimed at decreasing body weight and hyperglycemia. Early insulin resistance can be estimated via the triglyceride glucose index {TyG = Ln [TG (mg/dl) × fasting plasma glucose (FPG) (mg/dl)/2]} and the hypertriglyceridemic-high waist phenotype (TyG-waist), based on TyG x waist circumference (WC) measurements. Both indices may be useful for implementing personalized metabolic management. In this secondary analysis of a randomized controlled trial (RCT), we aimed to determine whether the differences in baseline TyG values and TyG-waist phenotype predicted individual responses to type-2 diabetes (T2D) prevention programs. The present post-hoc analyses were conducted within the Prevention of Diabetes through Lifestyle intervention and population studies in Europe and around the world (PREVIEW) study completers (n = 899), a multi-center RCT conducted in eight countries (NCT01777893). The study aimed to reduce the incidence of T2D in a population with pre-diabetes during a 3-year randomized intervention with two sequential phases. The first phase was a 2-month weight loss intervention to achieve ≥8% weight loss. The second phase was a 34-month weight loss maintenance intervention with two diets providing different amounts of protein and different glycemic indices, and two physical activity programs with different exercise intensities in a 2 x 2 factorial design. On investigation days, we assessed anthropometrics, glucose/lipid metabolism markers, and diet and exercise questionnaires under standardized procedures. Diabetes-related markers improved during all four lifestyle interventions. Higher baseline TyG index (p < 0.001) was associated with greater reductions in body weight, fasting glucose, and triglyceride (TG), while a high TyG-waist phenotype predicted better TG responses, particularly in those randomized to physical activity (PA) of moderate intensity. Two novel indices of insulin resistance (TyG and TyG-waist) may allow for a more personalized approach to avoiding progression to T2D.
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    ItemOpen Access
    Socio-economic factors, mood, primary care utilization, and quality of life as predictors of intervention cessation and chronic stress in a type 2 diabetes prevention intervention (PREVIEW Study)
    (2023) Huttunen-Lenz, Maija; Raben, Anne; Adam, Tanja; Macdonald, Ian; Taylor, Moira A.; Stratton, Gareth; Mackintosh, Kelly; Martinez, J. Alfredo; Handjieva-Darlenska, Teodora; Bogdanov, Georgi Assenov; Poppitt, Sally D.; Silvestre, Marta P.; Fogelholm, Mikael; Jalo, Elli; Brand-Miller, Jennie; Muirhead, Roslyn; Schlicht, Wolfgang
    Background. Sedentary lifestyle and unhealthy diet combined with overweight are risk factors for type 2 diabetes (T2D). Lifestyle interventions with weight-loss are effective in T2D-prevention, but unsuccessful completion and chronic stress may hinder efficacy. Determinants of chronic stress and premature cessation at the start of the 3-year PREVIEW study were examined. Methods. Baseline Quality of Life (QoL), social support, primary care utilization, and mood were examined as predictors of intervention cessation and chronic stress for participants aged 25 to 70 with prediabetes ( n= 2,220). Moderating effects of sex and socio-economic status (SES) and independence of predictor variables of BMI were tested. Results. Participants with children, women, and higher SES quitted intervention earlier than those without children, lower SES, and men. Lower QoL, lack of family support, and primary care utilization were associated with cessation. Lower QoL and higher mood disturbances were associated with chronic stress. Predictor variables were independent ( p ≤ .001) from BMI, but moderated by sex and SES. Conclusions. Policy-based strategy in public health should consider how preventive interventions may better accommodate different individual states and life situations, which could influence intervention completion. Intervention designs should enable in-built flexibility in delivery enabling response to individual needs.