Implications of the diabetes prevention program and Look AHEAD clinical trials for lifestyle interventions.
The Diabetes Prevention Program (DPP) and Look AHEAD (Action for Health in Diabetes) trials are long-term randomized clinical trials that have the potential to direct diabetes care and medical nutrition therapy for obesity, prediabetes, and type 2 diabetes both now and in the future. This article summarizes and compares the important evidence-based results of these diabetes and obesity clinical trials and reviews the similarities and differences in lifestyle interventions that were designed for these trials. Although there were many similarities in the features of the DPP and Look AHEAD interventions, the Look AHEAD lifestyle intervention was more ambitious in several ways: higher individual weight-loss goals, lower calorie and fat-gram targets based on initial body weight, more intensive intervention frequency, combining closed group and individual session format, and use of more structured nutrition intervention strategies from the outset, including meal replacements, structured menus, and combined fat and calorie counting. Evidence, knowledge, and insights gained from working on these clinical trials will be very important in determining the strategies, methods, and approaches needed to make sure that the results of these trials will be fully applied in real-world practice settings for obesity, prediabetes, and type 2 diabetes.
Delahanty
Linda M
LM
MGH Diabetes Center, Massachusetts General Hospital, Boston, MA 02114, USA.
Nathan
David M
DM
D000368:Aged; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy / Q000517:prevention & control* / Q000628:therapy; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000517:prevention & control* / Q000628:therapy; D017063:Outcome Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D014481:United States