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Background: The present study investigated the effects of a 12-month interdisciplinary standardized lifestyle program addressing physical activity and changes in dietary and lifestyle behavior in 2,227 obese prediabetic participants., Methods: Measures of obesity (BMI, waist circumference), cardiopulmonary fitness, and metabolic parameters were determined before and after the intervention period., Results: From the 2,227 participants who were initially prediabetic, 839 participants (-37.7%) did no longer show the criteria of prediabetes after the intervention and had normal HbA1c levels., Conclusion: The clinical effects are substantial, and it is likely that the applied intense and multidisciplinary lifestyle interventions could reduce the risk of developing diabetes and the prevalence of a full-blown metabolic syndrome in obese and prediabetic patients., (© 2018 The Author(s) Published by S. Karger GmbH, Freiburg.)

The important role of obesity and inactivity in the pathogenesis of cardiovascular diseases is generally accepted. In Germany, 75% of men and 59% of women at the age of 25-69 years are overweight or obese. The prevalence of inactivity in Germany is 30% for all age groups, and only 13% of the population achieves a level of physical activity known to have cardioprotective effects. Overweight and inactivity have shown to be associated with several cardiovascular risk factors such as hypertension, diabetes mellitus type 2 and dyslipoproteinemia. It has been demonstrated that obesity (body mass index > 30 kg/m2) considerably increases the risk for cardiovascular diseases (by up to 50%). Comparable findings have been observed in a meta-analysis when the effects of inactivity on cardiovascular morbidity or mortality have been investigated. Compared to regular physical activity, inactivity increased the relative risk for myocardial infarction or death by 60% and 90%, respectively. Therapeutic lifestyle changes (TLC) by increased physical activity and dietary intervention have shown to reduce cardiovascular risk factors and the incidence and prevalence of cardiovascular disease. Therefore, TLC should be the primary intervention in inactive overweight or obese subjects. This recommendation is specifically important for patients with the metabolic syndrome.

Aim: To study whether an oat bran enriched diet has a specific effect in lowering total and low-density lipoprotein cholesterols, in addition to caloric and fat restriction., Methods: We performed a randomized, controlled, parallel-group, single-centre study in which 1,994 patients from the Wehrawald Hospital (Todtmoos, Germany) were screened and 235 met the criteria male gender, hypercholesterolemia, and overweight. All patients in the Wehrawald Hospital took part in a 4-week standardized inpatient lifestyle health program consisting of dietary intervention, increased physical activity, and health education. Caloric restriction, fat modification, and oat bran supplementation were part of the nutritional regimen within the lifestyle health program. Ninety-nine patients were randomized to a fat-modified diet with caloric restriction and a daily intake of 35-50 g oat bran and 136 patients to a fat-modified, oat bran-free diet with caloric restriction. Fifty-three male overweight but normocholesterolemic subjects were selected as controls., Results: The most significant decreases in total cholesterol (-67.7 +/- 37.2 mg/dl; p < 0.01), low-density lipoprotein cholesterol (-56.3 +/- 35.1 mg/dl; p < 0.01), and apolipoprotein B (-42.4 +/- 34.1 mg/dl; p < 0.01) were found with the combination of the fat-modified and oat bran enriched food., Conclusions: Added to a fat-modified diet, oat bran within a practical range of intake significantly reduces total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B. These beneficial effects occurred independent of covariables such as physical activity or caloric and fat restriction in the diet., (Copyright 2003 S. Karger AG, Basel)