title: Improvement in diet habits, independent of physical activity helps to reduce incident diabetes among prediabetic Asian Indian men.
abstract: OBJECTIVE
  To assess the beneficial effects of the components of lifestyle intervention in reducing incidence of diabetes in Asian Indian men with impaired glucose tolerance (IGT) in India.
  
  
  METHODS
  This analysis was based on a 2 year prospective, randomized controlled primary prevention trial in a cohort of Asian Indian men with IGT (n=537) (Clinical Trial No: NCT00819455). Intervention and control groups were given standard care advice at baseline. Additionally, the intervention group received frequent, mobile phone based text message reminders on healthy lifestyle principles. Dietary intake and physical activity habits were recorded by validated questionnaires. The lifestyle goals were: reductions in consumption of carbohydrates, oil, portion size and body mass index of at least 1 unit (1 kg/m(2)) from baseline and maintenance of good physical activity. The association between diabetes and lifestyle goals achieved was assessed using multiple logistic regression analyses. Changes in insulin sensitivity (Matsuda's insulin sensitivity index) and oral disposition index during the follow-up were assessed.
  
  
  RESULTS
  At the end of the study, 123 (23.8%) participants developed diabetes. The mean lifestyle score was higher in the intervention group compared with control (2.59 ± 1.13 vs. 2.28 ± 1.17; P=0.002). Among the 5 lifestyle variables, significant improvements in the 3 dietary goal were seen with intervention. Concomitant improvement in insulin sensitivity and oral disposition index was noted. Higher lifestyle score was associated with lower risk of developing diabetes (odds ratio: 0.54 [95% CI: 0.44-0.70]; P<0.0001).
  
  
  CONCLUSIONS
  Beneficial effects of intervention were associated with increased compliance to lifestyle goals. The plausible mechanism is through improvement in insulin sensitivity and beta cell preservation.
authors.affiliation: India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals, Chennai 600008, India.
authors.forename: Jagannathan
authors.initials: J
authors.lastname: Ram
authors.affiliation: India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals, Chennai 600008, India.
authors.forename: Sundaram
authors.initials: S
authors.lastname: Selvam
authors.affiliation: India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals, Chennai 600008, India.
authors.forename: Chamukuttan
authors.initials: C
authors.lastname: Snehalatha
authors.affiliation: India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals, Chennai 600008, India.
authors.forename: Arun
authors.initials: A
authors.lastname: Nanditha
authors.affiliation: India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals, Chennai 600008, India.
authors.forename: Mary
authors.initials: M
authors.lastname: Simon
authors.affiliation: India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals, Chennai 600008, India.
authors.forename: Ananth Samith
authors.initials: AS
authors.lastname: Shetty
authors.affiliation: Faculties of Medicine and Engineering, Imperial College, London, United Kingdom.
authors.forename: Ian F
authors.initials: IF
authors.lastname: Godsland
authors.affiliation: Faculties of Medicine and Engineering, Imperial College, London, United Kingdom.
authors.forename: Desmond G
authors.initials: DG
authors.lastname: Johnston
authors.affiliation: India Diabetes Research Foundation & Dr. A. Ramachandran's Diabetes Hospitals, Chennai 600008, India. Electronic address: ramachandran@vsnl.com.
authors.forename: Ambady
authors.initials: A
authors.lastname: Ramachandran
mesh_terms: D001213:Asian; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000517:prevention & control*; D005247:Feeding Behavior; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000208:ethnology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011236:Prediabetic State / Q000208:ethnology / Q000517:prevention & control*; D015995:Prevalence; D011446:Prospective Studies; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: Asian Indians; Diet habits; Incident diabetes; Prediabetes; Prevention of diabetes