Abstract
AimTo study 1-year effectiveness of an intensive, culturally targeted lifestyle intervention in general practice for weight status and metabolic profile of South-Asians at risk of type 2 diabetes.Methods536 South-Asians at risk of type 2 diabetes were randomized to an intervention (n = 283) or control (n = 253) group. The intervention, which was targeted culturally to the South-Asian population, consisted of individual lifestyle counselling, a family session, cooking classes, and supervised physical activity programme. All components of the intervention were carried out by professionals as part of their daily clinical practice. The control group received generic lifestyle advice. Change in weight status and metabolic profile were assessed after 1 year.ResultsAfter 1 year, 201 participants were lost to follow-up. Remaining participants in intervention (n = 177) and control (n = 158) group had similar baseline characteristics. Weight loss in the intervention group was 0.2±3.3 kg, weight gain in the control group was 0.4±3.1 kg (p = 0.08). Changes in other weight-related measurements did not differ significantly between groups. Furthermore, there were no differences between groups in changes of metabolic profile. All results remained similar after repeating analyses in a multiple imputed dataset.DiscussionAn intensive, culturally targeted, lifestyle intervention of 1 year did not improve weight status and metabolic profile of South-Asians at risk of type 2 diabetes. The laborious recruitment, high drop-out, and lack of effectiveness emphasise the difficulty of realising health benefits in practice and suggest that this strategy might not be the optimal approach for this population.Trial RegistrationNederlands Trial Register NTR1499
Highlights
The prevalence of obesity and its related diseases has grown to epidemic proportions in the last few decades; at this point, type 2 diabetes mellitus has become one of the most common chronic diseases in industrialised countries [1].Several studies have shown that the prevalence and incidence of type 2 diabetes and its associated metabolic risk factors vary between ethnic groups; in particular, people of South Asian origin living in industrialised countries are disproportionally affected [2,3,4,5,6]
Main findings We investigated the effectiveness of an intensive, culturally targeted lifestyle intervention in general practice among 18 to 60year-old Hindustani Surinamese, a population of South Asian origin with a high risk of type 2 diabetes, living in the Netherlands
We found that the lifestyle intervention did not effectively change the weight status, glucose metabolism, blood pressure, or lipid profile in the target population
Summary
Several studies have shown that the prevalence and incidence of type 2 diabetes and its associated metabolic risk factors vary between ethnic groups; in particular, people of South Asian origin living in industrialised countries are disproportionally affected [2,3,4,5,6]. Is the prevalence higher, type 2 diabetes seems to develop at an earlier age among South Asians than among populations of European origin. South Asians with type 2 diabetes have a higher risk of developing disease related complications than do people of European origin [7,8]. The prevention of new cases of type 2 diabetes and its related diseases among South Asians is imperative and could potentially lead to an important health gain in this population. The opportunity to reduce obesity and to prevent type 2 diabetes among high-risk individuals through intensive lifestyle intervention has been established in several efficacy trials [9,10,11,12]
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