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Diabetes Care 26:3230-3236, 2003
© 2003 by the American Diabetes Association, Inc.

Epidemiology/Health Services/Psychosocial Research
Original Article

The Finnish Diabetes Prevention Study (DPS)

Lifestyle intervention and 3-year results on diet and physical activity

Jaana Lindström, MSC1, Anne Louheranta, PHD2, Marjo Mannelin, MSC3, Merja Rastas, MSC4, Virpi Salminen, MSC5, Johan Eriksson, MD, PHD1, Matti Uusitupa, MD, PHD2 and Jaakko Tuomilehto, MD, PHD1,6 for the Finnish Diabetes Prevention Study Group

1 Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
2 Department of Clinical Nutrition, University of Kuopio, Kuopio, Finland
3 Department of Sport Medicine, Oulu Deaconess Institute, Oulu, Finland
4 Research and Development Centre, Social Insurance Institution, Turku, Finland
5 Institute of Nursing and Health Care, Tampere, Finland
6 Department of Public Health, University of Helsinki, Helsinki, Finland

Address correspondence and reprint requests to Jaana Lindström, National Public Health Institute, Mannerheimintie 166, 00300 Helsinki, Finland. E-mail: jaana.lindstrom{at}ktl.fi

OBJECTIVE—To describe the 1) lifestyle intervention used in the Finnish Diabetes Prevention Study, 2) short- and long-term changes in diet and exercise behavior, and 3) effect of the intervention on glucose and lipid metabolism.

RESEARCH DESIGN AND METHODS—There were 522 middle-aged, overweight subjects with impaired glucose tolerance who were randomized to either a usual care control group or an intensive lifestyle intervention group. The control group received general dietary and exercise advice at baseline and had an annual physician’s examination. The subjects in the intervention group received additional individualized dietary counseling from a nutritionist. They were also offered circuit-type resistance training sessions and advised to increase overall physical activity. The intervention was the most intensive during the first year, followed by a maintenance period. The intervention goals were to reduce body weight, reduce dietary and saturated fat, and increase physical activity and dietary fiber.

RESULTS—The intervention group showed significantly greater improvement in each intervention goal. After 1 and 3 years, weight reductions were 4.5 and 3.5 kg in the intervention group and 1.0 and 0.9 kg in the control group, respectively. Measures of glycemia and lipemia improved more in the intervention group.

CONCLUSIONS—The intensive lifestyle intervention produced long-term beneficial changes in diet, physical activity, and clinical and biochemical parameters and reduced diabetes risk. This type of intervention is a feasible option to prevent type 2 diabetes and should be implemented in the primary health care system.

Abbreviations: DPP, Diabetes Prevention Program • DPS, Diabetes Prevention Study • E%, proportion of total energy • OGTT, oral glucose tolerance test • LTPA, leisure-time physical activity • VLCD, very-low-calorie diet


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