1. Long-term effectiveness of a lifestyle intervention on the prevention of type 2 diabetes in a middle-income country
- Author
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Davood Khalili, Brian Oldenburg, Mojtaba Lotfaliany, Fereidoun Azizi, Arash Ghanbarian, Farzad Hadaegh, Neda Zafari, M A Mansournia, and Parvin Mirmiran
- Subjects
Male ,0301 basic medicine ,Health Knowledge, Attitudes, Practice ,Urban Population ,lcsh:Medicine ,Type 2 diabetes ,Iran ,0302 clinical medicine ,Residence Characteristics ,Risk Factors ,lcsh:Science ,Health Education ,education.field_of_study ,Multidisciplinary ,Anthropometry ,Incidence ,Incidence (epidemiology) ,Smoking ,Middle Aged ,Income ,Educational Status ,Female ,Adult ,medicine.medical_specialty ,Dietary Approaches To Stop Hypertension ,Concordance ,Population ,Middle income country ,Article ,Young Adult ,03 medical and health sciences ,Intervention (counseling) ,Dash ,Lifestyle intervention ,medicine ,Humans ,education ,Life Style ,Aged ,Family Health ,business.industry ,lcsh:R ,Feeding Behavior ,medicine.disease ,Cross-Sectional Studies ,030104 developmental biology ,Diabetes Mellitus, Type 2 ,Physical therapy ,lcsh:Q ,Sedentary Behavior ,business ,030217 neurology & neurosurgery ,Follow-Up Studies ,Program Evaluation - Abstract
This study aims to assess the effects of a community-based lifestyle intervention program on the incidence of type 2 diabetes (T2D). For this purpose, three communities in Tehran were chosen; one community received a face-to-face educational session embedded in a long-term community-wide lifestyle intervention aimed at supporting lifestyle changes. We followed up 9,204 participants (control: 5,739, intervention: 3,465) triennially from 1999 to 2015 (Waves 1–5). After a median follow-up of 3.5 years (wave 2), the risk of T2D was 30% lower in the intervention community as compared with two control communities by (Hazard-ratio: 0.70 [95% CI 0.53; 0.91]); however, the difference was not statistically significant in the following waves. After a median follow-up of 11.9 years (wave 5), there was a non-significant 6% reduction in the incidence of T2D in the intervention group as compared to the control group (Hazard-ratio: 0.94 [0.81, 1.08]). Moreover, after 11.9 years of follow-up, the intervention significantly improved the diet quality measured by the Dietary Approaches to Stop Hypertension concordance (DASH) score. Mean difference in DASH score in the intervention group versus control group was 0.2 [95% CI 0.1; 0.3]. In conclusion, the intervention prevented T2D by 30% in the short-term (3.5 years) but not long-term; however, effects on improvement of the diet maintained in the long-term.Registration: This study is registered at IRCT, a WHO primary registry (https://irct.ir). The registration date 39 is 2008-10-29 and the IRCT registration number is IRCT138705301058N1.
- Published
- 2020
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