title: A 6-month "self-monitoring" lifestyle modification with increased sunlight exposure modestly improves vitamin D status, lipid profile and glycemic status in overweight and obese Saudi adults with varying glycemic levels.
abstract: BACKGROUND
  The over-all age-adjusted prevalence of diabetes mellitus type 2 (DMT2) in Saudi Arabia is unprecedented at 31%. Aggressive measures should be done to curb down increasing incidence. In this prospective 6-month study we aim to determine whether a self-monitoring, life-style modification program that includes increased sunlight exposure confer improvement in vitamin D status and health benefits among adult Saudi overweight and obese patients with varying glycemic status.
  
  
  METHODS
  A total of 150 overweight and obese Saudi adults with varying glycemic status aged 30-60 years were included in this study. They were divided into 3 groups (Non-DMT2, Pre-diabetes and DMT2). Baseline anthropometrics and blood glucose were taken at baseline and after 6 months. Fasting blood sugar, lipid profile, calcium, albumin and phosphate were measured routinely. Serum 25(OH) vitamin D was measured using standard assays. Within the time period they were instructed to reduce total intake of fat, increased fiber intake and increase sun exposure.
  
  
  RESULTS
  In all groups there was a significant improvement in vitamin D levels as well as serum triglycerides, LDL- and total cholesterol. However, a significant increase in serum glucose levels was noted in the non-DMT2 group, and a significant decrease in HDL-cholesterol in both non-DMT2 and pre-diabetes group. In the pre-diabetes group, 53.2% were able to normalize their fasting blood levels after 6 months, with 8.5% reaching the DMT2 stage and 38.3% remaining pre-diabetic. In all groups there was a significant increase in the prevalence of hypertension.
  
  
  CONCLUSIONS
  Improving vitamin D status with modest lifestyle modifications over a short-period translates to improvement in lipid profile except HDL-cholesterol among overweight and obese Saudi adults, but not BMI and blood pressure. Findings of the present study merit further investigation as to whether full vitamin D status correction can delay or prevent onset of DMT2.
authors.affiliation: Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, King Saud University, PO Box, 2455, Riyadh 11451, Saudi Arabia. aldaghri2011@gmail.com.
authors.forename: Nasser M
authors.initials: NM
authors.lastname: Al-Daghri
authors.forename: Hanan
authors.initials: H
authors.lastname: Alfawaz
authors.forename: Naji J
authors.initials: NJ
authors.lastname: Aljohani
authors.forename: Yousef
authors.initials: Y
authors.lastname: Al-Saleh
authors.forename: Kaiser
authors.initials: K
authors.lastname: Wani
authors.forename: Abdullah M
authors.initials: AM
authors.lastname: Alnaami
authors.forename: Mohammad
authors.initials: M
authors.lastname: Alharbi
authors.forename: Sudhesh
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood*; D050177:Overweight / Q000097:blood*; D011446:Prospective Studies; D012529:Saudi Arabia; D013472:Sunlight; D014807:Vitamin D / Q000097:blood*
chemical_list: D001786:Blood Glucose; D014807:Vitamin D