Professor of Health Nutrition and Sport Science, Institute of Sport Science, University of Taipei,Taipei,Taiwan, Republic of ChinaChina
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Diabetes prevalence is at an alarming level. It is predicted that one in ten adults will have the condition by 2030 compared with one in eleven at present.1 Despite several global calls for action to reverse such a trend, the number of people with diabetes and associated lifestyle diseases continues to rise leading to significant health burdens, morbidity and premature mortality.2 Such challenge makes it crucial to adopt immediate preventative policies which embed effective lifestyle diabetes interventions, especially those integrating multi-components interventions.
Keywords: preventative; behavioral, exercise and dietary
Open Journal PUBLISHERS Editorial Multi-component Lifestyle Interventions for Diabetes and Associated Non-communicable Diseases: Considerations for Future Research * Ahmad Alkhatib, PhD, MSc, RNutr, FRSM* Professor of Health Nutrition and Sport Science, Institute of Sport Science, University of Taipei,Taipei,Taiwan, Republic of China * *Corresponding author Ahmad Alkhatib, PhD, MSc, RNutr, FRSM Professor of Health Nutrition and Exercise Science, Institute of Sport Science, University of Taipei, Shilin District, 111,Taipei,Taiwan, Republic of China; Tel. +886 (0) 934089846; E-mail: drahmadalkhatib@gmail.com Article information st th th rd Received: May 1 , 2019; Received: May 16 , 2019; Accepted: May 20 , 2019; Published: May 23 , 2019 Cite this article Alkhatib A. Multi-component lifestyle interventions for diabetes and associated non-communicable diseases: Considerations for future research. Obes Res Open J. 2019; 6(1): e5-e6. doi: 10.17140/OROJ-6-e015 iabetes prevalence is at an alarming level. It is predicted that cal activity and healthy nutrition can have reciprocal favorable out- one in ten adults will have the condition by 2030 compared comes. Observational evidence has reported that amongst older D 1 with one in eleven at present. Despite several global calls for ac- adults (60-80-years-old), those who consumed a healthy diet such tion to reverse such a trend, the number of people with diabetes as the Mediterranean diet were more likely to be active in their and associated lifestyle diseases continues to rise leading to sig- lifestyle than those who consumed a western diet.6 In such, adopt- nificant health burdens, morbidity and premature mortality.2 Such ing such a dietary component with an exercise training component challenge makes it crucial to adopt immediate preventative policies provided additional vascular and cardiometabolic protective bene- 7,8 which embed effective lifestyle diabetes interventions, especially fits in high-risk individuals.7,8 On the other hand, adding an exercise those integrating multi-components interventions.3 to a multi-nutrient supplementation proved much more effective in preventing age-related decline in high-risk very old frail men and Adopting a multi-component approach which encom- women, than the supplement alone, a single intervention compo- passes changing behavioral and physical aspects is likely to be more nent.9 The latter study showed that a single component (supple- effective than a single component diabetes prevention program. mentation only) failed to slow age-related deleterious outcomes Lessons from large lifestyle interventions combining a variety of compared with favorable outcomes found when strength exercise physical activity patterns with different healthy dietary regimes was combined with the supplementation.9 In such, interventions have unequivocal evidence about their joint long-term effective- should always adopt exercise and nutrition as essential components ness compared with adopting a single component whether exer- of a lifestyle intervention strategy. Even at the screening phase, 4,5 cise, diet or medication alone.4,5 For example, the Finish diabetes assessing a combined physical activity, cardiorespiratory fitness, study was first to show a remarkable 58% reduced rates of diabe- nutritional intake alongside diabetes and associated cardiometa- tes incidence when a longitudinal multi-component intervention bolic risk factors, is likely to encourage healthy behavior change 10,11 (behavioral, exercise and dietary) was followed by individuals with in high-risk individuals. Therefore, adopting multi-component glucose intolerance.3 Similar longitudinal diabetes risk reduction prevention strategy, both at baseline assessment and throughout of 58% was found for those with pre-diabetes in the US diabetes the intervention not only augments their benefits but prevents po- prevention program when exercise and diet approaches were com- tential hazards.
bined, compared with almost half (30% reduction) found when relying on insulin-sensitizing drug Metformin.5 A fifteen-year fol- Addressing as many lifestyle components as feasible is low-up of the latter showed that medication did not elicit better also important. For example, it is now known that sedentary behav- risk-reduction benefits than a multi-component lifestyle interven- ior and sleep patterns are associated with the development of dia- tion.
betes.12 Recent research evidence has classified sedentary lifestyle behavior, such as TV watching, prolonged sitting hours or driving 12,13 Adopting healthy behaviors, particularly adopting physi- as an independent risk factor for type-II diabetes. Reported as- cc Copyright 2019 by Alkhatib A. This is an open-access article distributed under Creative Commons Attribution 4.0 International License (CC BY 4.0), which Obes Res Open J. 2019; 6(1): e5-e6. doi: 10.17140/OROJ-6-e015 sociations include higher type-2 diabetes incidents, cardiovascular terranean dietary patterns and physical activity and fitness among disease and all-cause mortality independently of leisure-time physi- Spanish older Adults. Nutrients. 2017; 9(7): pii: E704. doi: 10.3390/ cal activity.13 Since it is difficult to quantify such behaviors in physi- nu9070704 ological terms, cardiorespiratory fitness remains the gold standard for measuring physical activity or its lack, since that least cardiore- 7. Alkhatib A. Effective intervention strategies combining Medi- spiratory fit individuals suffer from significantly increased chronic terranean diet and exercise for reducing obesity, metabolic and disease risks and all cause-mortality risks.14 Therefore, sedentary cardiovascular risks in high-risk populations: Mini review. Obes Res behaviors, physical activity, and cardiovascular health can all be as- Open J. 2015; 1(1): 4-9. doi: 10.17140/OROJ-1-102 sessed through cardiorespiratory fitness as an essential vital sign,15 and so it should form an integral part of any lifestyle intervention. 8. Alkhatib A, Klonizakis M. Effects of exercise training and Mediterranean diet on vascular risk reduction in post-menopausal The scientific knowledge about the behavioral, lifestyle women. Clin Hemorheol Microcirc. 2014; 57(1): 33-47. doi: 10.3233/ and biological components is continuously evolving, which enables CH-131770 better targeting of several modifiable disease risk factors for diabe- tes and associated diseases. This also requires integrating exercise 9. Fiatarone MA, O’Neill EF, Ryan ND, et al. Exercise training science, nutrition and behavior approaches to personalize future and nutritional supplementation for physical frailty in very el- lifestyle interventions. Future studies can take forward previous derly people. N Engl J Med. 1994;330(25):1769-75. doi: 10.1056/ success stories using multi-component lifestyle interventions based NEJM199406233302501 on contemporary knowledge and recent technological advances st relevant to the 21st century.
10. Alkhatib A. Sedentary risk factors across genders and job roles within a university campus workplace: Preliminary study. J Occup