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Efficacy of interventions that include diet, aerobic and resistance training components for type 2 diabetes prevention: a systematic review with meta-analysis.

ABSTRACT: Current recommendations for the prevention of type 2 diabetes advise modification of diet and exercise behaviors including both aerobic and resistance training. However, the efficacy of multi-component interventions involving a combination of these three components has not been established. The aims of this review were to systematically review and meta-analyze the evidence on multi-component (diet?+?aerobic exercise?+?resistance training) lifestyle interventions for type 2 diabetes prevention. Eight electronic databases (Medline, Embase, SportDiscus, Web of Science, CINAHL, Informit health collection, Cochrane library and Scopus) were searched up to June 2013. Eligible studies 1) recruited prediabetic adults or individuals at risk of type 2 diabetes; 2) conducted diet and exercise [including both physical activity/aerobic and resistance training] programs; and 3) reported weight and plasma glucose outcomes. In total, 23 articles from eight studies were eligible including five randomized controlled trials, one quasi-experimental, one two-group comparison and one single-group pre-post study. Four studies had a low risk of bias (score???6/10). Median intervention length was 12 months (range 4-48 months) with a follow-up of 18 months (range 6.5-48 months). The diet and exercise interventions varied slightly in terms of their specific prescriptions. Meta-analysis favored interventions over controls for weight loss (-3.79 kg [-6.13, -1.46; 95% CI], Z?=?3.19, P?=?0.001) and fasting plasma glucose (-0.13 mmol.L?¹ [-0.24, -0.02; 95% CI], Z?=?2.42, P?=?0.02). Diabetes incidence was only reported in two studies, with reductions of 58% and 56% versus control groups. In summary, multi-component lifestyle type 2 diabetes prevention interventions that include diet and both aerobic and resistance exercise training are modestly effective in inducing weight loss and improving impaired fasting glucose, glucose tolerance, dietary and exercise outcomes in at risk and prediabetic adult populations. These results support the current exercise guidelines for the inclusion of resistance training in type 2 diabetes prevention, however there remains a need for more rigorous studies, with long-term follow-up evaluating program efficacy, muscular fitness outcomes, diabetes incidence and risk reduction.

SUBMITTER: Aguiar EJ

PROVIDER: S-EPMC3898566 | biostudies-literature | 2014 Jan

REPOSITORIES: biostudies-literature

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Efficacy of interventions that include diet, aerobic and resistance training components for type 2 diabetes prevention: a systematic review with meta-analysis.

Aguiar Elroy J EJ Morgan Philip J PJ Collins Clare E CE Plotnikoff Ronald C RC Callister Robin R

The international journal of behavioral nutrition and physical activity 20140115

Current recommendations for the prevention of type 2 diabetes advise modification of diet and exercise behaviors including both aerobic and resistance training. However, the efficacy of multi-component interventions involving a combination of these three components has not been established. The aims of this review were to systematically review and meta-analyze the evidence on multi-component (diet + aerobic exercise + resistance training) lifestyle interventions for type 2 diabetes prevention. E ...[more]

PMID: 24423095

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Project description:BackgroundAerobic exercise interventions have been shown to result in alterations to dietary intake and non-exercise physical activity (PA). To date, the ability for resistance training (RT) to influence other health-related behaviors has not been examined. This study aimed to determine if initiation and maintenance of RT is associated with spontaneous changes in dietary quality and non-RT PA in adults with prediabetes.MethodsOverweight/obese adults (n=170, BMI=32.9±3.8kg·m2, age=59.5±5.5years, 73% female) with prediabetes were enrolled in the 15-month Resist Diabetes trial. Participants completed a supervised 3-month RT initiation phase followed by a 6-month maintenance phase and a 6-month no-contact phase. Participants were not encouraged to change eating or non-RT PA behaviors. At baseline, and months 3, 9, and 15, three 24-hour diet recalls were collected to evaluate dietary intake and quality, the Aerobics Institute Longitudinal Study Questionnaire was completed to evaluate non-RT PA, and body mass, body composition (DXA), and muscular strength were measured. At months 3, 9, and 15 social cognitive theory (SCT) constructs were assessed with a RT Health Beliefs Questionnaire. Mixed effects models were used to assess changes in dietary intake and non-RT PA over the 15-month study period.ResultsEnergy and carbohydrate intake decreased with RT initiation and maintenance phases (baseline to month 9: β=-87.9, p=0.015 and β=-16.3, p<0.001, respectively). No change in overall dietary quality (Healthy Eating Index [HEI]-2010 score: β=-0.13, p=0.722) occurred, but alterations in HEI-2010 sub-scores were detected. Maintenance of RT was accompanied by an increase in MET-min/week of total non-RT PA (month 3 to month 9: β=146.2, p=0.01), which was predicted by increased self-regulation and decreased negative outcome expectancies for RT (β=83.7, p=0.014 and β=-70.0, p=0.038, respectively).ConclusionsInitiation and maintenance of RT may be a gateway behavior leading to improvements in other health-related behaviors. These results provide rationale for single-component lifestyle interventions as an alternative to multi-component interventions, when resources are limited.

Project description:ContextExercise guidelines for individuals with diabetes include both aerobic and resistance training although few studies have directly examined this exercise combination.ObjectiveTo examine the benefits of aerobic training alone, resistance training alone, and a combination of both on hemoglobin A(1c) (HbA(1c)) in individuals with type 2 diabetes.Design, setting, and participantsA randomized controlled trial in which 262 sedentary men and women in Louisiana with type 2 diabetes and HbA(1c) levels of 6.5% or higher were enrolled in the 9-month exercise program between April 2007 and August 2009.InterventionForty-one participants were assigned to the nonexercise control group, 73 to resistance training 3 days a week, 72 to aerobic exercise in which they expended 12 kcal/kg per week; and 76 to combined aerobic and resistance training in which they expended 10 kcal/kg per week and engaged in resistance training twice a week. Main Outcome Change in HbA(1c) level. Secondary outcomes included measures of anthropometry and fitness.ResultsThe study included 63.0% women and 47.3% nonwhite participants who were a mean (SD) age of 55.8 years (8.7 years) with a baseline HbA(1c) level of 7.7% (1.0%). Compared with the control group, the absolute mean change in HbA(1c) in the combination training exercise group was -0.34% (95% confidence interval [CI], -0.64% to -0.03%; P = .03). The mean changes in HbA(1c) were not statistically significant in either the resistance training (-0.16%; 95% CI, -0.46% to 0.15%; P = .32) or the aerobic (-0.24%; 95% CI, -0.55% to 0.07%; P = .14) groups compared with the control group. Only the combination exercise group improved maximum oxygen consumption (mean, 1.0 mL/kg per min; 95% CI, 0.5-1.5, P < .05) compared with the control group. All exercise groups reduced waist circumference from -1.9 to -2.8 cm compared with the control group. The resistance training group lost a mean of -1.4 kg fat mass (95% CI, -2.0 to -0.7 kg; P < .05) and combination training group lost a mean of -1.7 (-2.3 to -1.1 kg; P < .05) compared with the control group.ConclusionsAmong patients with type 2 diabetes mellitus, a combination of aerobic and resistance training compared with the nonexercise control group improved HbA(1c) levels. This was not achieved by aerobic or resistance training alone.Trial registrationclinicaltrials.gov Identifier: NCT00458133.

Project description:We evaluated ophthalmic changes in healthy individuals who underwent integrated resistance and aerobic training (iRAT) during 70-d 6° head-down tilt (HDT) bed rest (BR).Participants were selected using NASA standard screening procedures. Standardized NASA BR conditions were implemented. Subjects were randomly assigned to the iRAT protocol or no exercise during HDTBR. Weekly ophthalmic examinations were performed in the sitting (pre/post-BR only) and HDT (BR only) positions. Mixed-effects linear models compared pre- and post-HDTBR intraocular pressure (IOP), Spectralis OCT circumpapillary retinal nerve fiber layer (cpRNFL) thickness, and peripapillary retinal thickness observations between groups.Six controls and nine exercisers completed the study. There was an overall effect of BR on our outcomes. Except Goldmann IOP (mean pre/post difference in controls and exercisers: -0.47 mmHg vs. +1.14 mmHg), the magnitude of changes from baseline was not significantly different between groups. There was a +1.38 mmHg and a +1.63 mmHg iCare IOP increase during BR in controls and exercisers, respectively. Spectralis OCT detected a +1.33 μm average cpRNFL thickness increase in both groups, and a +9.77 μm and a +6.65 μm peripapillary retinal thickening post-BR in controls and exercisers, respectively. Modified Amsler grid, red dot test, confrontational visual field, color vision, and stereoscopic fundus photography were unremarkable.HDTBR for 70 d induced peripapillary retinal thickening and cpRNFL thickening without visible signs of optic disc edema. The magnitude of such changes was not different between controls and exercisers. A slight IOP increase during BR subsided post-BR. Further study should evaluate whether different physical exercise paradigms may prevent/mitigate the risk of space-related visual impairment.Taibbi G, Cromwell RL, Zanello SB, Yarbough PO, Ploutz-Snyder RJ, Godley BF, Vizzeri G. Ophthalmological evaluation of integrated resistance and aerobic training during 70-day bed rest. Aerosp Med Hum Perform. 2017; 88(7):633-640.

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Efficacy of interventions that include diet, aerobic and resistance training components for type 2 diabetes prevention: a systematic review with meta-analysis.

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Efficacy of interventions that include diet, aerobic and resistance training components for type 2 diabetes prevention: a systematic review with meta-analysis.

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