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Lifestyle strategies for weight control: experience from the Finnish Diabetes Prevention Study

Published online by Cambridge University Press:  07 March 2007

Jaana Lindström ,
Markku Peltonen  and
Jaakko Tuomilehto
Jaana Lindström*
Affiliation:
National Public Health Institute, Department of Epidemiology & Health Promotion, Diabetes & Genetic Epidemiology Unit, Mannerheimintie 166, 00300 Helsinki, Finland
Markku Peltonen
Affiliation:
National Public Health Institute, Department of Epidemiology & Health Promotion, Diabetes & Genetic Epidemiology Unit, Mannerheimintie 166, 00300 Helsinki, Finland
Jaakko Tuomilehto
Affiliation:
National Public Health Institute, Department of Epidemiology & Health Promotion, Diabetes & Genetic Epidemiology Unit, Mannerheimintie 166, 00300 Helsinki, Finland
*
* Corresponding author: Professor Jaana Lindström, fax +358 9 4744 8934, email [email protected]
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Abstract

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Currently, in many European countries more than half the adult population is overweight; it hass become ‘abnormal’ to be of ‘normal weight’. The risk of type 2 diabetes, CVD, hypertension and certain forms of cancer increase with increasing weight. Biological evolution has produced body-fat-regulating mechanisms that are more powerful in protecting against weight loss than against weight gain. The current environment offers constant availability of affordable palatable energy-rich foods, with no need to consume the energy through physical activity. The ‘obesogenic’ environment is to some extent a political issue, but it has been shown that the healthcare system can also have a role in preventing obesity-related morbidity. The Finnish Diabetes Prevention Study was the first controlled randomised study to show that individualised lifestyle counselling of individuals with high risk of developing type 2 diabetes can influence diet, physical activity and body weight, and that type 2 diabetes can be prevented, or at least postponed. Most importantly, lifestyle changes do not have to be extreme. If the population would adopt a lifestyle in line with the official nutrition recommendations, the obesity and diabetes trend could at least be stabilised.

Keywords

ObesityType 2 diabetes mellitusDiet
Type
Symposium on ‘Biology of obesity’
Information
Proceedings of the Nutrition Society , Volume 64 , Issue 1 , February 2005 , pp. 81 - 88
Copyright
Copyright © The Nutrition Society 2005

References

Almiron-Roig, E, Chen, Y & Drewnowski, A (2003) Liquid calories and the failure of satiety: how good is the evidence. Obesity Reviews 4, 201–212 CrossRefGoogle ScholarPubMed
Astrup, A, Buemann, B, Flint, A & Raben, A (2002) Low-fat diets and energy balance: how does the evidence stand in 2002. Proceedings of the Nutrition Society 61, 299–309 CrossRefGoogle ScholarPubMed
Berteus, Forslund, H, Lindroos, AK, Sjostrom, L Lissner, L (2002) Meal patterns and obesity in Swedish women–a simple instrument describing usual meal types, frequency and temporal distribution. European Journal of Clinical Nutrition 56, 740–747 CrossRefGoogle Scholar
Bray, GA, Nielsen, SJ & Popkin, BM (2004) Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. American Journal of Clinical Nutrition 79, 537–543 Google Scholar
Buchholz, AC & Schoeller, DA (2004) Is a calorie a calorie. American Journal of Clinical Nutrition 79, 899S–906S.Google Scholar
Darmon, N, Briend, A & Drewnowski, A (2004) Energy-dense diets are associated with lower diet costs: a community study of French adults. Public Health Nutrition 7, 21–27 Google Scholar
DECODE, Study Group (2003) Age- and sex-specific prevalences of diabetes and impaired glucose regulation in 13 European cohorts. Diabetes Care 26, 61–69 Google Scholar
Devitt, AA & Mattes, RD (2004) Effects of food unit size and energy density on intake in humans. Appetite 42, 213–220 CrossRefGoogle ScholarPubMed
Diliberti, N, Bordi, PL, Conklin, MT, Roe, LS & Rolls, BJ (2004) Increased portion size leads to increased energy intake in a restaurant meal. Obesity Research 12, 562–568 Google Scholar
Drummond, SE, Crombie, NE, Cursiter, MC & Kirk, TR (1998) Evidence that eating frequency is inversely related to body weight status in male, but not female, non-obese adults reporting valid dietary intakes. International Journal of Obesity and Related Metabolic Disorders 22, 105–112 CrossRefGoogle Scholar
Eisenstein, J, Roberts, SB, Dallal, G & Saltzman, E (2002) High-protein weight-loss diets: are they safe and do they work? A review of the experimental and epidemiologic data. Nutrition Reviews 60, 189–200 CrossRefGoogle Scholar
Eriksson, J, Lindström, J, Valle, T, Aunola, S, Hämäläinen, H, Ilanne-Parikka, P, et, al. (1999) Prevention of Type II diabetes in subjects with impaired glucose tolerance: the Diabetes Prevention Study (DPS) in Finland. Study design and 1-year interim report on the feasibility of the lifestyle intervention programme. Diabetologia 42, 793–801 CrossRefGoogle ScholarPubMed
Farnsworth, E, Luscombe, ND, Noakes, M, Wittert, G, Argyiou, E & Clifton, PM (2003) Effect of a high-protein, energy-restricted diet on body composition, glycemic control, and lipid concentrations in overweight and obese hyperinsulinemic men and women. American Journal of Clinical Nutrition 78, 31–39 CrossRefGoogle ScholarPubMed
Finnish Diabetes Association (2003) Programme for the prevention of type 2 diabetes in Finland. http://www.diabetes.fi/english/prevention/programme/index.html. Google Scholar
Foster, GD, Wyatt, HR, Hill, JO, McGuckin, BG, Brill, C, Mohammed, BS, Szapary, PO, Rader, DJ, Edman, JS & Klein, S (2003) A randomized trial of a low-carbohydrate diet for obesity. New England Journal of Medicine 348, 2082–2090 Google Scholar
Finnpanel, Oy (2004) Television audience measurement. TV people meter study. Finnpanel Oy – YLE audience research. http://www.finnpanel.fi/english.html Google Scholar
Fried, SK & Rao, SP (2003) Sugars, hypertriglyceridemia, and cardiovascular disease. American Journal of Clinical Nutrition 78, 873S–880S.Google Scholar
Golay, A, Allaz, AF, Morel, Y, de Tonnac, N, Tankova, S & Reaven, G (1996) Similar weight loss with low- or high-carbohydrate diets. American Journal of Clinical Nutrition 63, 174–178 Google Scholar
Guare, JC, Wing, RR & Grant, A (1995) Comparison of obese NIDDM and nondiabetic women: short- and long-term weight loss. Obesity Research 3, 329–335 Google Scholar
Helakorpi, S, Patja, K, Prättälä, R & Aro, A (2002) Suomalaison aikuisväestön turveyskäyttäybyminen ja terveys, kevät 2002 (Health Behaviour and Health among Finnish adult population, Spring 2002) Publications of the National Public Health Institute Series B12/2002. Helsinki, Finland: National Public Health Institute.Google Scholar
Heymsfield, SB, van Mierlo, CA, van der, Knaap, HC, Heo, M, Frier HI (2003) Weight management using a meal replacement strategy: meta and pooling analysis from six studies. International Journal of Obesity and Related Metabolic Disorders 27, 537–549 Google Scholar
International, Obesity, Task, Force and European, Association, for, the, Study, of Obesity (2002) Obesity in Europe. The Case for Action. London: International Association for the Study of Obesity.Google Scholar
Johnston, CS, Tjonn, SL & Swan, PD (2004) High-protein, low-fat diets are effective for weight loss and favorably alter biomarkers in healthy adults. Journal of Nutrition 134, 586–591 CrossRefGoogle ScholarPubMed
Joslin, E (1921) The prevention of diabetes mellitus. Journal of the American Medical Association 76, 79–84 Google Scholar
Kangas, T (2002) Diabeetikkojen Terveyspalvelut ja Niiden Kustannukset. Helsinkiläisten Diabeetikkojen Verrokkikontrolloitu Poikkileikkaustutkimus (Structure and Costs of Health Care of Diabetic Patients in Helsinki. A Controlled Cross-sectional Study). Helsinki, Finland: KELA.Google Scholar
Koh-Banerjee, P & Rimm, EB (2003) Whole grain consumption and weight gain: a review of the epidemiological evidence, potential mechanisms and opportunities for future research. Proceedings of the Nutrition Society 62, 25–29 Google ScholarPubMed
Laatikainen, T, Tapanainen, H, Alfthan, G, Salminen, I, Sundvall, J, Leiviskä, J, Harald, K, Jousilahti, P, Salomaa, V & & Vartiainen, E (2003) Finriski 2002. Tutkimuksen Toteutus ja Tulokset 1. Perusraportti (The National FINRISK Study. The 2002 Survey Report 1). Helsinki, Finland: National Public Health Institute.Google Scholar
Lahti-Koski, M, Vartiainen, E, Männistö, S & Pietinen, P (2000) Age, education and occupation as determinants of trends in body mass index in Finland from 1982 to 1997. International Journal of Obesity and Related Metabolic Disorders 24, 1669–1676 Google Scholar
Lichtenstein, AH, Van Horn, L (1998) Very low fat diets. Circulation 98, 935–939 Google Scholar
Lindström, J, Louheranta, A, Mannelin, M, Rastas, M, Salminen, V, Eriksson, J, Uusitupa, M & Tuomilehto, J (2003) The Finnish Diabetes Prevention Study (DPS): Lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care 26, 3230–3236 CrossRefGoogle ScholarPubMed
Lindström, J & Tuomilehto, J (2003) The Diabetes Risk Score: A practical tool to predict type 2 diabetes risk. Diabetes Care 26, 725–731 Google Scholar
Liu, S, Willett, WC, Manson, JE, Hu, FB, Rosner, B & Colditz, G (2003) Relation between changes in intakes of dietary fiber and grain products and changes in weight and development of obesity among middle-aged women. American Journal of Clinical Nutrition 78, 920–927 Google Scholar
Ludwig, DS, Pereira, MA, Kroenke, CH, Hilner, JE, Van Horn, L, Slattery, ML & Jacobs, DR (1999) Dietary fiber, weight gain, and cardiovascular disease risk factors in young adults. Journal of the American Medical Association 282, 1539–1546 CrossRefGoogle ScholarPubMed
Luscombe, ND, Clifton, PM, Noakes, M, Farnsworth, E & Wittert, G (2003) Effect of a high-protein, energy-restricted diet on weight loss and energy expenditure after weight stabilization in hyperinsulinemic subjects. International Journal of Obesity and Related Metabolic Disorders 27, 582–590 Google Scholar
Männistö, S, Ovaskainen, M & Valsta, L (2003) Finravinto 2002 Tutkimus (The National FINDIET 2002 Study) Publications of the National Public Health Institute Series. B3/2003 Helsinki, Finland National Public Health InstituteGoogle Scholar
Marmonier, C, Chapelot, D, Fantino, M, Louis-Sylvestre, J (2002) Snacks consumed in a nonhungry state have poor satiating efficiency: influence of snack composition on substrate utilization and hunger. American Journal of Clinical Nutrition 76, 518–528 CrossRefGoogle Scholar
Marti, B, Tuomilehto, J, Salomaa, V, Kartovaara, L, Korhonen, HJ & Pietinen, P (1991) Body fat distribution in the Finnish population: environmental determinants and predictive power for cardiovascular risk factor levels. Journal of Epidemiology and Community Health 45, 131–137 CrossRefGoogle ScholarPubMed
Meckling, KA, O'Sullivan, C & Saari, D (2004) Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women. Journal of Clinical Endocrinology and Metabolism 89, 2717–2723 CrossRefGoogle ScholarPubMed
National Nutrition Council (1998) Finnish Nutrition Recommendations Helsinki, Finland Ministry of Agriculture and ForestryGoogle Scholar
Nielsen, SJ & Popkin, BM (2003) Patterns and trends in food portion sizes, 1977–1998. Journal of the American Medical Association 289, 450–453 Google Scholar
Padwal, R, Li, SK & Lau, DC (2003) Long-term pharmacotherapy for overweight and obesity: a systematic review and meta-analysis of randomized controlled trials. International Journal of Obesity and Related Metabolic Disorders 27, 1437–1446 CrossRefGoogle ScholarPubMed
Parker, B, Noakes, M, Luscombe, N & Clifton, P (2002) Effect of a high-protein, high-monounsaturated fat weight loss diet on glycemic control and lipid levels in type 2 diabetes. Diabetes Care 25, 425–430 Google Scholar
Parks, EJ (2001) Effect of dietary carbohydrate on triglyceride metabolism in humans. Journal of Nutrition 131, 2772S–2774S Google Scholar
Perseghin, G (2001) Pathogenesis of obesity and diabetes mellitus: insights provided by indirect calorimetry in humans. Acta Diabetologica 38, 7–21 Google Scholar
Pietinen, P, Vartiainen, E, Seppänen, R, Aro, A & Puska, P (1996) Changes in diet in Finland from 1972 to 1992: impact on coronary heart disease risk. Preventive Medicine 25, 243–250 Google Scholar
Reddy, ST, Wang, CY, Sakhaee, K, Brinkley, L & Pak, CY (2002) Effect of low-carbohydrate high-protein diets on acid-base balance, stone-forming propensity, and calcium metabolism. American Journal of Kidney Diseases 40, 265–274 Google Scholar
Samaha, FF, Iqbal, N, Seshadri, P, Chicano, KL, Daily, DA, McGrory, J, Williams, T, Williams, M, Gracely, EJ & Stern, L (2003) A low-carbohydrate as compared with a low-fat diet in severe obesity. New England Journal of Medicine 348, 2074–2081 Google Scholar
Schwartz, MW, Woods, SC, Seeley, RJ, Barsh, GS, Baskin, DG & Leibel, RL (2003) Is the energy homeostasis system inherently biased toward weight gain. Diabetes 52, 232–238 CrossRefGoogle ScholarPubMed
Stubbs, RJ, Johnstone, AM, O'Reilly, LM, Barton, K & Reid, C (1998) The effect of covertly manipulating the energy density of mixed diets on ad libitum food intake in ‘pseudo free-living’ humans. International Journal of Obesity and Related Metabolic Disorders 22, 980–987 Google Scholar
Statistics, Finland (2004) Transport and tourism statistics. http://www.stat.fi/tk/tp/tasku/taskus_liikenne.html Google Scholar
Sturm, R & Wells, KB (2001) Does obesity contribute as much to morbidity as poverty or smoking. Public Health 115, 229–235 Google Scholar
The, Diabetes, Prevention, Program & Research, Group (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine 346, 393–403 Google Scholar
Torgerson, JS, Hauptman, J, Boldrin, MN & Sjostrom, L (2004) XENical in the Prevention of Diabetes in Obese Subjects (XENDOS) Study: A randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care 27, 155–161 Google Scholar
Tuomilehto, J, Lindström, J, Eriksson, JG, Valle, TT, Hämäläinen, H, Ilanne-Parikka, P, Keinänen-Kiukaanniemi, S, Laakso, M, Louheranta, A, Rastas, M, Salminen, V & Uusitupa, M (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. New England Journal of Medicine 344, 1343–1350 Google Scholar
Westerterp-Plantenga, MS, Lejeune, MP, Nijs, I, van Ooijen, M & Kovacs, EM (2004) High protein intake sustains weight maintenance after body weight loss in humans. International Journal of Obesity and Related Metabolic Disorders 28, 57–64 CrossRefGoogle ScholarPubMed
World Health Organization World Health Organization (2003) Diet, Nutrition and the Prevention of Chronic Diseases. Report of a Joint FAO/WHO Consultation. Geneva: WHO.Google Scholar
Yancy, WS, Jr, Olsen, MK, Guyton, JR, Bakst, RP Westman, EC (2004) A low-carbohydrate, ketogenic diet versus a low-fat diet to treat obesity and hyperlipidemia: a randomized, controlled trial. Annals of Internal Medicine 140, 769–777 CrossRefGoogle ScholarPubMed
Zemel, MB, Thompson, W, Milstead, A, Morris, K & Campbell, P (2004) Calcium and dairy acceleration of weight and fat loss during energy restriction in obese adults. Obesity Research 12, 582–590 Google Scholar