Changes in lifestyle modestly reduce the estimated cardiovascular disease risk in one-year follow-up of the Finnish diabetes prevention program (FIN-D2D).
OBJECTIVE
The purpose of this study was to assess whether changes in self-rated physical activity and diet during a type 2 diabetes (T2D) prevention program were associated with changes in estimated 10-year risk for cardiovascular disease (CVD) events and mortality in people at high risk for T2D.


METHODS
Individuals were identified and offered lifestyle counseling as part of the Finnish diabetes prevention program. Ten-year risk for estimated CVD events and mortality were calculated with Framingham Risk Score (FRS) and Systematic Coronary Risk Evaluation (SCORE) formula. FRS was available for 774 men and 1474 women and SCORE for 961 men and 1766 women.


RESULTS
During the one-year follow-up, 9.6% of the men reported both an increase in physical activity and improved dietary pattern, 4.1% an increase in physical activity, 39.3% an increase in improved dietary pattern, while 47.0% reported no lifestyle changes. Corresponding numbers for women were 14.2%, 3.8%, 39.2% and 42.7%. Estimated 10-year risk for CVD events decreased 3.5% in men and 1.5% in women reporting an increase in physical activity and improvement in diet, compared to an increase of 0.15% in men (p<0.001, between groups) and decrease of 0.43% (p=0.027, between groups) in women with no lifestyle changes after adjustment for age and baseline FRS. Numbers needed to treat to prevent one CVD event by lifestyle changes were 25 for men and 59 for women. Lifestyle changes had no effect on estimated CVD mortality risk.


CONCLUSIONS
Lifestyle counseling offered in primary health care for one year results in favorable changes in lifestyle, and lowered the estimated 10-year risk for CVD events.
Pirkanmaa Hospital District, Finland nina.rautio@oulu.fi.
Nina
N
Rautio
Institute of Health Sciences, University of Oulu, Finland Unit of General Practice, Oulu University Hospital, Finland.
Jari
J
Jokelainen
Pirkanmaa Hospital District, Finland.
Auli
A
Pölönen
Pirkanmaa Hospital District, Finland.
Heikki
H
Oksa
National Institute for Health and Welfare, Finland.
Markku
M
Peltonen
Unit of Family Practice, Central Finland Health Care District, Finland Kuopio University Hospital, Finland.
Mauno
M
Vanhala
Department of Internal Medicine, Seinäjoki Central Hospital, Finland.
Hannu
H
Puolijoki
Department of Medicine, Kuopio University Hospital, Finland.
Leena
L
Moilanen
National Institute for Health and Welfare, Finland Centre for Vascular Prevention, Danube-University Krems, Austria King Abdulaziz University, Saudi Arabia.
Jaakko
J
Tuomilehto
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland Research Unit, Kuopio University Hospital, Finland.
Matti
M
Uusitupa
Institute of Health Sciences, University of Oulu, Finland Unit of General Practice, Oulu University Hospital, Finland.
Sirkka
S
Keinänen-Kiukaanniemi
Pirkanmaa Hospital District, Finland.
Timo
T
Saaristo
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control* / Q000523:psychology; D004032:Diet; D037001:Directive Counseling; D015444:Exercise; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012307:Risk Factors; D013997:Time Factors
Cardiovascular risk; diet; physical activity; prevention; type 2 diabetes