10 Fakultät Wirtschafts- und Sozialwissenschaften
Permanent URI for this collectionhttps://elib.uni-stuttgart.de/handle/11682/11
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Item Open Access 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. AlfredoIndividuals 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.Item Open Access PREVIEW behavior modification intervention toolbox (PREMIT): a study protocol for a psychological element of a multicenter project(2016) Kahlert, Daniela; Unyi-Reicherz, Annelie; Stratton, Gareth; Meinert Larsen, Thomas; Fogelholm, Mikael; Raben, Anne; Schlicht, WolfgangBackground: Losing excess body weight and preventing weight regain by changing lifestyle is a challenging but promising task to prevent the incidence of type-2 diabetes. To be successful, it is necessary to use evidence-based and theory-driven interventions, which also contribute to the science of behavior modification by providing a deeper understanding of successful intervention components. Objective: To develop a physical activity and dietary behavior modification intervention toolbox (PREMIT) that fulfills current requirements of being theory-driven and evidence-based, comprehensively described and feasible to evaluate. PREMIT is part of an intervention trial, which aims to prevent the onset of type-2 diabetes in pre-diabetics in eight clinical centers across the world by guiding them in changing their physical activity and dietary behavior through a group counseling approach. Methods: The program development took five progressive steps, in line with the Public Health Action Cycle: (1) Summing-up the intervention goal(s), target group and the setting, (2) uncovering the generative psychological mechanisms, (3) identifying behavior change techniques and tools, (4) preparing for evaluation and (5) implementing the intervention and assuring quality. Results: PREMIT is based on a trans-theoretical approach referring to valid behavior modification theories, models and approaches. A major “product” of PREMIT is a matrix, constructed for use by onsite-instructors. The matrix includes objectives, tasks and activities ordered by periods. PREMIT is constructed to help instructors guide participants' behavior change. To ensure high fidelity and adherence of program-implementation across the eight intervention centers standardized operational procedures were defined and “train-the-trainer” workshops were held. In summary PREMIT is a theory-driven, evidence-based program carefully developed to change physical activity and dietary behaviors in pre-diabetic people.Item Open Access A high-protein, low glycemic index diet suppresses hunger but not weight regain after weight loss : results from a large, 3-years randomized trial (PREVIEW)(2021) Zhu, Ruixin; Fogelholm, Mikael; Larsen, Thomas M.; Poppitt, Sally D.; Silvestre, Marta P.; Vestentoft, Pia S.; Jalo, Elli; Navas-Carretero, Santiago; Huttunen-Lenz, Maija; Taylor, Moira A.; Stratton, Gareth; Swindell, Nils; Kaartinen, Niina E.; Lam, Tony; Handjieva-Darlenska, Teodora; Handjiev, Svetoslav; Schlicht, Wolfgang; Martinez, J. Alfredo; Seimon, Radhika V.; Sainsbury, Amanda; Macdonald, Ian A.; Westerterp-Plantenga, Margriet S.; Brand-Miller, Jennie; Raben, AnnePrevious studies have shown an increase in hunger during weight-loss maintenance (WLM) after diet-induced weight loss. Whether a combination of a higher protein, lower glycemic index (GI) diet and physical activity (PA) can counteract this change remains unclear. To compare the long-term effects of two diets [high protein (HP)-low GI vs. moderate protein (MP)-moderate GI] and two PA programs [high intensity (HI) vs. moderate intensity (MI)] on subjective appetite sensations during WLM after ≥8% weight loss (WL). Data derived from the 3-years PREVIEW randomized intervention study. An 8-weeks WL phase using a low-energy diet was followed by a 148-weeks randomized WLM phase. For the WLM phase, participants were assigned to one of the four groups: HP-MI, HP-HI, MP-MI, and MP-HI. Available data from 2,223 participants with overweight or obesity (68% women; BMI ≥ 25 kg/m2). Appetite sensations including satiety, hunger, desire to eat, and desire to eat something sweet during the two phases (at 0, 8 weeks and 26, 52, 104, and 156 weeks) were assessed based on the recall of feelings during the previous week using visual analogue scales. Differences in changes in appetite sensations from baseline between the groups were determined using linear mixed models with repeated measures. There was no significant diet × PA interaction. From 52 weeks onwards, decreases in hunger were significantly greater in HP-low GI than MP-moderate GI (Ptime × diet = 0.018, Pdietgroup = 0.021). Although there was no difference in weight regain between the diet groups (Ptime × diet = 0.630), hunger and satiety ratings correlated with changes in body weight at most timepoints. There were no significant differences in appetite sensations between the two PA groups. Decreases in hunger ratings were greater at 52 and 104 weeks in HP-HI vs. MP-HI, and greater at 104 and 156 weeks in HP-HI vs. MP-MI. This is the first long-term, large-scale randomized intervention to report that a HP-low GI diet was superior in preventing an increase in hunger, but not weight regain, during 3-years WLM compared with a MP-moderate GI diet. Similarly, HP-HI outperformed MP-HI in suppressing hunger. The role of exercise intensity requires further investigation. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT01777893.Item Open 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, WolfgangBackground. 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.