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Summary: The risk of type 2 diabetes mellitus (T2DM) varies by ethnicity, but ethnic differences in response to diabetes prevention interventions remain unclear. This systematic review and meta‐analysis assessed ethnic differences in the effects of lifestyle interventions on T2DM incidence, glycemic outcomes (fasting glucose, 2‐h glucose, HbA1c), anthropometric measures (weight, BMI, waist circumference), and lifestyle behaviors (physical activity, energy intake, energy from fat, fiber intake). MEDLINE, EMBASE, and other databases were searched (to June 15, 2020) for randomized and non‐randomized controlled trials on lifestyle interventions (diet and/or physical activity) in adults at risk of T2DM. Ethnicity was categorized into European, South Asian, East and Southeast Asian, Middle Eastern, Latin American, and African groups. Forty‐four studies were included in meta‐analyses. Overall, lifestyle interventions resulted in significant improvement in T2DM incidence, glycemic outcomes, anthropometric measures, physical activity, and energy intake (all P < 0.01). Significant subgroup differences by ethnicity were found for 2‐h glucose, weight, BMI, and waist circumference (all P < 0.05) but not for T2DM incidence, fasting glucose, HbA1c, and physical activity (all P > 0.05). Few studies in non‐European groups reported dietary intake. Lifestyle interventions in different ethnic groups may have similar effects in reducing incidence of T2DM although this needs to be confirmed in further studies. [ABSTRACT FROM AUTHOR]

Summary: Weight gain prevention is a global public health priority to address escalating adiposity in adults. This review evaluates the efficacy of weight gain prevention trials targeting adults aged 18–50 years and adheres to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) protocol. Trials of any duration from inception to May 2020 that evaluated a weight gain prevention intervention (using either prescriptive diet, prescriptive physical activity, prescriptive diet, and/or physical activity or non‐prescriptive lifestyle) and included weight or body mass index (weight [kg]/height [m2]) were eligible. Twenty‐nine trials across 34 publications (participants n = 37,407) were included. Intervention resulted in less weight gain compared with controls (−1.15 kg [95% CI −1.50, −0.80 kg] p < 0.001). Subgroup analysis demonstrated greater effectiveness with prescriptive (−1.60 kg [95% CI −2.00, −1.19] p < 0.001) compared with non‐prescriptive (−0.81 kg [95% CI 1.10, −0.53] p < 0.001) intervention types. Interventions had greatest impact in healthy weight (18.5–24.9 kg/m2) (−0.82 kg [95% CI −1.5, −0.50] p < 0.001) or overweight (25.0–29.9 kg/m2) (−1.48 kg [95% CI −1.85, −1.12] p < 0.001) compared with obese populations (≥30.0 kg/m2) (−0.56 kg [95% CI −1.40, 0.27] p = 0.19). These findings demonstrate that lifestyle intervention prevents cumulative weight gain in non‐obese adults, with future research required to inform cost‐effectiveness and implementation feasibility. [ABSTRACT FROM AUTHOR]

Summary Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 10–13% of reproductive‐aged women. Lifestyle management through diet and physical activity changes can improve reproductive, metabolic, and psychological comorbidities. The aim of this systematic review is to understand the barriers and facilitators to lifestyle changes from the perspective of people with PCOS and health care professionals (HCP) using the theoretical domains framework and capability, opportunity, motivation, and behavior model. Six databases were systematically searched for qualitative, quantitative, and mixed‐methods studies to 22nd September 2022. Quantitative outcomes from quantitative and mixed‐methods studies were narratively synthesized and all studies were thematically analyzed. Sixty‐eight papers met the eligibility criteria. HCP education on lifestyle management in PCOS was viewed by all to be inadequate, impacting the quality of care and health outcomes. Lifestyle advice delivered by a multidisciplinary team, including dietitians, was identified as a key component for change. All agreed that there was a need for individualized and PCOS‐specific lifestyle advice. Weight stigma was identified as negatively impacting both those in larger and smaller bodies with PCOS, reducing the quality of care and affecting self‐perception and mental health. People with PCOS perceived that lifestyle management was overly focused on weight loss and fertility, independent of their own personal motivations and goals. Systemic changes, including increasing HCP education on lifestyle management and multidisciplinary collaboration, focusing on lifestyle advice that meets individual needs, and reducing the use of weight‐centric care are necessary for long‐term sustainable changes and improvements in health outcomes in people with PCOS. [ABSTRACT FROM AUTHOR]