Lipidemic Profile Changes over a Two-Year Intervention Period: Who Benefited Most from the Feel4Diabetes Program?

Kalliopi Karatzi,Imre Rurik,Katja Wikström,Emese Antal,Pilar De Miguel-Etayo,Jemina Kivelä,Yannis Manios,Roumyana Dimova,Itziar Lamiquiz-Moneo,George Moschonis,Greet Cardon,Stavros Liatis,Kaloyan Tsochev,Konstantinos Makrilakis,Violeta Iotova,Eirini Botsi

doi:10.3390/nu12123736

Abstract

Identification of participants’ characteristics who benefited most from large community-based intervention studies may guide future prevention initiatives in order to maximize their effectiveness. The current study aimed to examine the socio-demographic, anthropometric, and behavioral characteristics, as well as the health and eating perceptions of those who improved their lipidemic profile, in the Feel4Diabetes early screening and prevention program. In the present analyses, 1773 adults from families at high risk for developing type 2 diabetes mellitus (T2DM) were enrolled, receiving either the standard care or the more intensive intervention, and 33.3–55.2% of them improved one or more of their lipidemic indices by >5%. Women, people living in Southeastern Europe, coming from two-parent families, having higher financial security, educational level and better diet quality were associated with a 27–64% higher likelihood for benefiting from the program regarding one or more of their lipidemic profile indices. Participants who were overweight or obese (especially with central obesity), employed, with prolonged sedentary behavior, prone to emotional eating and perceiving their weight status as lower than their actual weight were 24–43% less likely to have benefited. These findings should guide future interventions, prioritizing regions in greater need, and being tailor-made to specific population characteristics in order to further improve their effectiveness.

Highlights

Dyslipidemia and insulin resistance, as well as unhealthy lifestyle behaviors have long been identified as risk factors for cardiovascular disease (CVD) development [1]
People living in Southeastern Europe, those in two-parent families, those with higher income and educational level, and having better dietary quality have a 27–64% higher probability of benefiting from the intervention
It was shown that women, those living in Southeastern Europe, two-parent families, with higher financial security and educational level and better diet quality have a higher probability of benefiting from the intervention, while employed people, those with prolonged sedentary behavior, being overweight or obese, those prone to emotional eating and those perceiving their body weight as lower than their actual weight had a lower probability of benefitting from the intervention

Summary

Introduction

Dyslipidemia and insulin resistance, as well as unhealthy lifestyle behaviors (i.e., poor diet quality, increased sedentary time, abnormal body weight, smoking) have long been identified as risk factors for cardiovascular disease (CVD) development [1]. Dyslipidemia is a major CVD risk factor for both healthy subjects and patients with type 2 diabetes mellitus (T2DM), accounting for 72–85% of diabetics, but it is very common in insulin resistant subjects who do not yet have established T2DM [2,3]. In Europe, CVD prevention has been a priority since the late 1990s and its focus has been on promotion of a heart healthy lifestyle and management of risk factors, especially in people at high risk for CVD like people with prediabetes or T2DM [5]. Large-scale randomized controlled trials (RCTs) were conducted using various lifestyle interventions in populations at high risk of developing T2DM, aiming to reduce the rate of T2DM development, as well as to ameliorate risk factors such as dyslipidemia that are associated with both T2DM and CVD morbidity and mortality [6]

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