The Finnish Diabetes Prevention Study (DPS): Lifestyle Intervention and 3-Year Results on Diet and Physical Activity

Jaana Lindström, MSC; Anne Louheranta, PHD; Marjo Mannelin, MSC; Merja Rastas, MSC; Virpi Salminen, MSC; Johan Eriksson, MD, PHD; Matti Uusitupa, MD, PHD; Jaakko Tuomilehto, MD, PHD

Disclosures

Diabetes Care. 2003;26(12) 

In This Article

Abstract and Introduction

Objective: To describe the 1) lifestyle intervention used in the Finnish Diabetes Prevention Study, 2) short- and long-term changes in diet and exercise behavior, and 3) effect of the intervention on glucose and lipid metabolism.
Research Design and Methods: There were 522 middle-aged, overweight subjects with impaired glucose tolerance who were randomized to either a usual care control group or an intensive lifestyle intervention group. The control group received general dietary and exercise advice at baseline and had an annual physician's examination. The subjects in the intervention group received additional individualized dietary counseling from a nutritionist. They were also offered circuit-type resistance training sessions and advised to increase overall physical activity. The intervention was the most intensive during the first year, followed by a maintenance period. The intervention goals were to reduce body weight, reduce dietary and saturated fat, and increase physical activity and dietary fiber.
Results: The intervention group showed significantly greater improvement in each intervention goal. After 1 and 3 years, weight reductions were 4.5 and 3.5 kg in the intervention group and 1.0 and 0.9 kg in the control group, respectively. Measures of glycemia and lipemia improved more in the intervention group.
Conclusions: The intensive lifestyle intervention produced long-term beneficial changes in diet, physical activity, and clinical and biochemical parameters and reduced diabetes risk. This type of intervention is a feasible option to prevent type 2 diabetes and should be implemented in the primary health care system.

The Finnish Diabetes Prevention Study (DPS) was one of the first controlled, randomized studies to show that type 2 diabetes is preventable with lifestyle intervention.[1] The risk of diabetes was reduced by 58% in the intensive lifestyle intervention group compared with the control group. These results have been reproduced by the Diabetes Prevention Program (DPP), in which lifestyle intervention, with a similar 58% risk reduction, was superior to the metformin treatment.[2] The lifestyle intervention used in the DPP was not designed to be used in community settings,[3] whereas one of the main objectives in the DPS was to test an intervention feasible in primary health care.

In this study, we describe the lifestyle intervention program used in the DPS, the changes in dietary habits and exercise behavior that were achieved during the first year and the maintenance of these changes after 3 years, and assess the efficacy of the intervention on body weight, plasma glucose, and lipids.

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