TY - JOUR
T1 - The PREVIEW intervention study
T2 - Results from a 3-year randomized 2 x 2 factorial multinational trial investigating the role of protein, glycaemic index and physical activity for prevention of type 2 diabetes
AU - Raben, Anne
AU - Vestentoft, Pia Siig
AU - Brand-Miller, Jennie
AU - Jalo, Elli
AU - Drummen, Mathjis
AU - Simpson, Liz
AU - Martinez, J. Alfredo
AU - Handjieva-Darlenska, Teodora
AU - Stratton, Gareth
AU - Huttunen-Lenz, Maija
AU - Lam, Tony
AU - Sundvall, Jouko
AU - Muirhead, Roslyn
AU - Poppitt, Sally
AU - Ritz, Christian
AU - Pietilainen, Kirsi H.
AU - Westerterp-Plantenga, Margriet
AU - Taylor, Moira A.
AU - Navas-Carretero, Santiago
AU - Handjiev, Svetoslav
AU - McNarry, Melitta A.
AU - Hansen, Sylvia
AU - Raman, Laura
AU - Brodie, Shannon
AU - Silvestre, Marta P.
AU - Adam, Tanja C.
AU - Macdonald, Ian A.
AU - San-Cristobal, Rodrigo
AU - Boyadjieva, Nadka
AU - Mackintosh, Kelly A.
AU - Schlicht, Wolfgang
AU - Liu, Amy
AU - Larsen, Thomas M.
AU - Fogelholm, Mikael
N1 - Funding Information:
Biotechnology and Biological Sciences Research Council (BBSRC) (UK); The Cambridge Weight Plan ©, Ltd, Northants (UK); Emil Aaltosen Säätiö; Engineering and Physical Sciences Research Council (EPSRC) (UK); EU Framework programme 7, Grant/Award Number: 312057; Finnish Diabetes Research Foundation; Government Research Funds for Helsinki University Hospital; Jenny ja Antti Wihurin Rahasto; Juho Vainio Foundation (FIN), Academy of Finland, Grant/Award Numbers: 272376, 314383, 266286, 314135; National Health and Medical Research Council ‐ EU collaborative grant, AUS 8, ID 1067711; National Institute for Health Research Biomedical Research Centre (NIHR BRC) (UK); Novo Nordisk Fonden; Nutritics (Dublin, IRE); Signe ja Ane Gyllenbergin Säätiö; Suomen Lääketieteen Säätiö; The Danish Agriculture & Food Council; The Danish Meat and Research Institute; The Glycemic Index Foundation Australia; The NZ Health Research Council (14/191) and University of Auckland Faculty Research Development Fund Funding information
Funding Information:
The PREVIEW consortium would like to thank all study participants at every intervention centre for their time and commitment and all scientists, advisors and students for their dedication and contributions to the study. Specifically, we would like to thank Louise Dye (chairman of the Scientific Advisory Board, SAB), University of Leeds, UK, Richard Atkinson (Ethical Officer of the SAB), Virginia Commonwealth University, USA, and medical expert and consultant Stephen Colagiuri (University of Sydney, Australia). The PREVIEW project was designed by AR, JB-M, MW-P, MF, WS and Edith Feskens (Wageningen University, NL).
Funding Information:
The EU framework programme 7 (FP7/2007–2013) grant agreement # 312057. National Health and Medical Research Council ‐ EU Collaborative Grant, AUS 8, ID 1067711. The Glycemic Index Foundation Australia through royalties to the University of Sydney. The NZ Health Research Council (14/191) and University of Auckland Faculty Research Development Fund. The Cambridge Weight Plan donated all products for the 8‐week LED period. The Danish Agriculture & Food Council. The Danish Meat and Research Institute. National Institute for Health Research Biomedical Research Centre (NIHR BRC) (UK). Biotechnology and Biological Sciences Research Council (BBSRC) (UK). Engineering and Physical Sciences Research Council (EPSRC) (UK). Nutritics (Dublin) donated all dietary analyses software used by UNOTT. Juho Vainio Foundation (FIN), Academy of Finland (grant numbers: 272376, 314383, 266286, 314135), Finnish Medical Foundation, Gyllenberg Foundation, Novo Nordisk Foundation, Finnish Diabetes Research Foundation, University of Helsinki, Government Research Funds for Helsinki University Hospital (FIN), Jenny and Antti Wihuri Foundation (FIN), Emil Aaltonen Foundation (FIN).
Publisher Copyright:
© 2020 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.
PY - 2021/2
Y1 - 2021/2
N2 - Aim To compare the impact of two long-term weight-maintenance diets, a high protein (HP) and low glycaemic index (GI) diet versus a moderate protein (MP) and moderate GI diet, combined with either high intensity (HI) or moderate intensity physical activity (PA), on the incidence of type 2 diabetes (T2D) after rapid weight loss.Materials and Methods A 3-year multicentre randomized trial in eight countries using a 2 x 2 diet-by-PA factorial design was conducted. Eight-week weight reduction was followed by a 3-year randomized weight-maintenance phase. In total, 2326 adults (age 25-70 years, body mass index >= 25 kg/m(2)) with prediabetes were enrolled. The primary endpoint was 3-year incidence of T2D analysed by diet treatment. Secondary outcomes included glucose, insulin, HbA1c and body weight.Results The total number of T2D cases was 62 and the cumulative incidence rate was 3.1%, with no significant differences between the two diets, PA or their combination. T2D incidence was similar across intervention centres, irrespective of attrition. Significantly fewer participants achieved normoglycaemia in the HP compared with the MP group (P <.0001). At 3 years, normoglycaemia was lowest in HP-HI (11.9%) compared with the other three groups (20.0%-21.0%, P <.05). There were no group differences in body weight change (-11% after 8-week weight reduction; -5% after 3-year weight maintenance) or in other secondary outcomes.Conclusions Three-year incidence of T2D was much lower than predicted and did not differ between diets, PA or their combination. Maintaining the target intakes of protein and GI over 3 years was difficult, but the overall protocol combining weight loss, healthy eating and PA was successful in markedly reducing the risk of T2D. This is an important clinically relevant outcome.
AB - Aim To compare the impact of two long-term weight-maintenance diets, a high protein (HP) and low glycaemic index (GI) diet versus a moderate protein (MP) and moderate GI diet, combined with either high intensity (HI) or moderate intensity physical activity (PA), on the incidence of type 2 diabetes (T2D) after rapid weight loss.Materials and Methods A 3-year multicentre randomized trial in eight countries using a 2 x 2 diet-by-PA factorial design was conducted. Eight-week weight reduction was followed by a 3-year randomized weight-maintenance phase. In total, 2326 adults (age 25-70 years, body mass index >= 25 kg/m(2)) with prediabetes were enrolled. The primary endpoint was 3-year incidence of T2D analysed by diet treatment. Secondary outcomes included glucose, insulin, HbA1c and body weight.Results The total number of T2D cases was 62 and the cumulative incidence rate was 3.1%, with no significant differences between the two diets, PA or their combination. T2D incidence was similar across intervention centres, irrespective of attrition. Significantly fewer participants achieved normoglycaemia in the HP compared with the MP group (P <.0001). At 3 years, normoglycaemia was lowest in HP-HI (11.9%) compared with the other three groups (20.0%-21.0%, P <.05). There were no group differences in body weight change (-11% after 8-week weight reduction; -5% after 3-year weight maintenance) or in other secondary outcomes.Conclusions Three-year incidence of T2D was much lower than predicted and did not differ between diets, PA or their combination. Maintaining the target intakes of protein and GI over 3 years was difficult, but the overall protocol combining weight loss, healthy eating and PA was successful in markedly reducing the risk of T2D. This is an important clinically relevant outcome.
KW - behaviour change
KW - carbohydrate
KW - dietary intervention
KW - exercise intervention
KW - glycaemic control
KW - obesity
KW - LIFE-STYLE INTERVENTION
KW - BETA-CELL FUNCTION
KW - BODY-WEIGHT LOSS
KW - DIETARY-PROTEIN
KW - URINE NITROGEN
KW - GLUCOSE
KW - RISK
KW - EXERCISE
KW - PEOPLE
KW - EUROPE
U2 - 10.1111/dom.14219
DO - 10.1111/dom.14219
M3 - Article
C2 - 33026154
SN - 1462-8902
VL - 23
SP - 324
EP - 337
JO - Diabetes Obesity & Metabolism
JF - Diabetes Obesity & Metabolism
IS - 2
ER -