title: Anti-inflammatory effect of lifestyle changes in the Finnish Diabetes Prevention Study.
abstract: OBJECTIVE
  Subclinical inflammation confers an increased risk of type 2 diabetes, cardiovascular disease, neurodegenerative disorders and other age-related chronic diseases. Physical activity and diet can attenuate systemic immune activation, but it is not known which individual components of a comprehensive lifestyle intervention are most effective in targeting subclinical inflammation.
  
  
  METHODS
  We used data from the baseline examination and the 1 year follow-up of a subsample of 406 of 522 participants of the Finnish Diabetes Prevention Study (DPS) to estimate the effect of individual components of lifestyle intervention on C-reactive protein (CRP) and IL-6 levels, which represent the best characterised proinflammatory risk factors for type 2 diabetes. Changes in metabolic markers, dietary patterns and exercise were analysed to determine which were most strongly associated with the anti-inflammatory effect of lifestyle changes.
  
  
  RESULTS
  Lifestyle intervention reduced circulating levels of CRP (p < 0.001) and IL-6 (p = 0.060). Increases in fibre intake and moderate to vigorous leisure time physical activity (LTPA), but not total LTPA, predicted decreases in CRP and/or IL-6 and remained associated even after adjustment for baseline BMI or changes in BMI during the first year of the study. Changes in carbohydrate or fat intake were either weakly or not linked to reductions in CRP and IL-6.
  
  
  CONCLUSIONS
  The present study assessed the individual effects of dietary and physical activity measures on low-grade inflammation in individuals at high cardiometabolic risk. Our results underline the importance of moderate to vigorous LTPA and a diet rich in natural fibre, and this should be emphasised in lifestyle recommendations.
authors.affiliation: Institute for Clinical Diabetology, German Diabetes Centre, Leibniz Centre at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Herder
authors.forename: M
authors.initials: M
authors.lastname: Peltonen
authors.forename: W
authors.initials: W
authors.lastname: Koenig
authors.forename: K
authors.initials: K
authors.lastname: Sütfels
authors.forename: J
authors.initials: J
authors.lastname: Lindström
authors.forename: S
authors.initials: S
authors.lastname: Martin
authors.forename: P
authors.initials: P
authors.lastname: Ilanne-Parikka
authors.forename: J G
authors.initials: JG
authors.lastname: Eriksson
authors.forename: S
authors.initials: S
authors.lastname: Aunola
authors.forename: S
authors.initials: S
authors.lastname: Keinänen-Kiukaanniemi
authors.forename: T T
authors.initials: TT
authors.lastname: Valle
authors.forename: M
authors.initials: M
authors.lastname: Uusitupa
authors.forename: H
authors.initials: H
authors.lastname: Kolb
authors.forename: J
authors.initials: J
authors.lastname: Tuomilehto
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D002097:C-Reactive Protein / Q000378:metabolism; D002151:Calorimetry; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D004043:Dietary Fiber; D002149:Energy Intake; D015444:Exercise; D005387:Finland; D018149:Glucose Intolerance / Q000517:prevention & control; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000517:prevention & control*; D007328:Insulin / Q000097:blood; D007899:Leisure Activities; D008019:Life Style; D008875:Middle Aged; D010353:Patient Education as Topic; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D004043:Dietary Fiber; D007328:Insulin; D002097:C-Reactive Protein