title: Predictors of lifestyle intervention outcome and dropout: the SLIM study.
abstract: OBJECTIVE
  To evaluate the effect of a 4.1-year (range 3-6 years) lifestyle intervention according to general public health recommendations on glucose tolerance and dropout in a Dutch population with impaired glucose tolerance (IGT).
  
  
  METHODS
  In the Study on Lifestyle intervention and Impaired glucose tolerance Maastricht, 147 Caucasian IGT subjects were randomized to an intervention group (INT: n=74; 38 male, 36 female) and control group (CON: n=73; 37 male, 36 female). Annually, subjects underwent measurements of body weight, anthropometry, glucose tolerance (oral glucose tolerance test), insulin resistance (homeostasis model assessment-insulin resistance), maximal aerobic capacity (VO(2) max), blood lipids and blood pressure. INT received individual advice regarding a healthy diet and physical activity.
  
  
  RESULTS
  INT decreased their saturated fat intake, increased their carbohydrate intake (P<0.05) and VO(2) max (P=0.04) compared with CON. Body weight did not change significantly (P=0.20) between the groups. After an initial decrease, 2-h glucose levels overall increased in INT (+0.11 mmol/l), but significantly less than CON (+1.18 mmol/l; P=0.04). Diabetes incidence was lower in INT versus CON (30 versus 56%, P=0.04). Change in body weight was associated with change in 2-h glucose levels (β=0.399 mmol/l per kg, P=0.02). Dropouts had a lower aerobic fitness and socioeconomic status, and a higher body mass index (BMI) and 2-h glucose compared with non-dropouts.
  
  
  CONCLUSIONS
  Prolonged feasible changes in diet and physical activity prevent deterioration of glucose tolerance and reduce diabetes risk. Low socioeconomic status, low aerobic fitness and high BMI and 2-h glucose are indicative of dropout to the program.
authors.affiliation: Department of Human Biology, Nutrition and Toxicology Research Institute Maastricht, NUTRIM, Maastricht University, Maastricht, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Roumen
authors.forename: E J M
authors.initials: EJ
authors.lastname: Feskens
authors.forename: E
authors.initials: E
authors.lastname: Corpeleijn
authors.forename: M
authors.initials: M
authors.lastname: Mensink
authors.forename: W H M
authors.initials: WH
authors.lastname: Saris
authors.forename: E E
authors.initials: EE
authors.lastname: Blaak
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism; D001794:Blood Pressure; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D058870:Food, Organic; D018149:Glucose Intolerance / Q000178:diet therapy / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009426:Netherlands; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates; D008055:Lipids