Treatment
12
Table 4. Effect of Lifestyle Components on Metabolic
Parameters
Intervention
Glycemic/Diabetes
Effect
Blood Pressure
Effect Lipids Effect
Moderate
weight loss
≥5% of initial
weight (Rec.
3.1.1)
30–60% reduction in
diabetes incidence
1
Effect on glycemic
indices
2
:
• Reduction in HbA1c
~0.6 units
• Reduction in
fasting glucose ~0.2
mmol/L (3.6 mg/dL)
BP reduction
about 3/2
mmHg
1,2
• Reduction in TGL
1,2
:
15–16 mg/dL
(0.17–0.18 mmol/L)
• Reduction in
LDL
1,2
: 5–10 mg/dL
(0.13–0.26 mmol/L)
• Increase in HDL
1,2
:
4–31 mg/dL
(0.1–0.8 mmol/L)
Healthy
cardiovascular
dietary
patterns
(Rec. 3.1.2)
Reduction 18–40%
in diabetes incidence
(Mediterranean diet)
3
BP reduction
≤6/3 mmHg
(based on
DASH diet)
1
• Trans fat: repeatedly
associated with
adverse lipid profile
1
• DASH diet: lower
LDL and total
cholesterol
1
• Mediterranean diet:
inconsistent findings
1
Active lifestyle
(Rec. 3.1.3)
Reduction of ≤65% in
diabetes incidence
4,5
BP reduction
about 2–5/
1–4 mmHg
1,6
Reduction in LDL
about 3.0–6.0 mg/dL
(0.08–0.16 mmol/L)
1
Note: Ranges taken om systematic reviews and meta-analyses as listed below.
1
Lifestyle Work Group. Lifestyle Interventions to Reduce Cardiovascular Risk: Systematic Evidence
Review from the Lifestyle Work Group. National Heart, Lung, and Blood Institute; December
2013.
2
Zomer E, Gurusamy K, Leach R, Trimmer C, Lobstein T, Morris S, James WP, Finer N.
Interventions that cause weight loss and the impact on cardiovascular risk factors: a systematic
review and meta-analysis. Obes Rev 2016; 17(10):1001-1011.
3
Salas-Salvado J, Bullo M, Estruch R, Ros E, Covas MI, Ibarrola-Jurado N, Corella D, Aros F,
Gomez-Gracia E, Ruiz-Gutierrez V, Romaguera D, Lapetra J, Lamuela-Raventos RM, Serra-Majem
L, Pinto X, Basora J, Munoz MA, Sorli JV, Martinez-Gonzalez MA. Prevention of diabetes with
Mediterranean diets: a subgroup analysis of a randomized trial. Ann Intern Med 2014; 160(1):
1-10.
4
Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, Hu ZX, Lin J, Xiao JZ, Cao HB, Liu PA,
Jiang XG, Jiang YY, Wang JP, Zheng H, Zhang H, Bennett PH, Howard BV. Effects of diet and
exercise in preventing NIDDM in people with impaired glucose tolerance. e Da Qing IGT and
Diabetes Study. Diabetes Care 1997; 20(4):537-544.
5
Laaksonen DE, Lindstrom J, Lakka TA, Eriksson JG, Niskanen L, Wikstrom K, Aunola S,
Keinanen-Kiukaanniemi S, Laakso M, Valle TT, Ilanne-Parikka P, Louheranta A, Hamalainen
H, Rastas M, Salminen V, Cepaitis Z, Hakumaki M, Kaikkonen H, Harkonen P, Sundvall J,
Tuomilehto J, Uusitupa M. Physical activity in the prevention of type 2 diabetes: the Finnish
diabetes prevention study. Diabetes 2005; 54(1):158-165.
6
2018 Physical Activity Guidelines Advisory Committee, 2018 Physical Activity Guidelines
Advisory Committee Scien-tific Report, Washington, DC: U.S. Department of Health and
Human Services.
