Lifestyle education program helps increase moderate-to-vigorous intensity physical activity

D-CLIP, a lifestyle education program to prevent diabetes in South Asians with prediabetes, increased moderate-to-vigorous intensity physical activity (MVPA) by up to nearly an hour a week, researchers at the Rush Institute for Healthy Aging have found.

The results of their study were published online Feb. 28 in the medical journal Diabetes Research and Clinical Practice and will be featured in the journal's April print edition.

The D-CLIP trial, that included 573 individuals with prediabetes from Chennai, India, aimed to implement and evaluate the effectiveness, cost-effectiveness and sustainability of a culturally appropriate, low-cost lifestyle intervention for the prevention of type 2 diabetes mellitus in India.

These lifestyle interventions included training on improving diet quality and reducing dietary intake through keeping weekly food diaries, adhering to individual goals for total fat intake, reducing portion sizes, and increasing intake of fiber-rich foods. In addition, a lifestyle modification team, including a health coach, a fitness instructor and a community volunteer peer leader worked with each participant.

Using data from this trial, an abbreviation for Diabetes Community Lifestyle Improvement Program, the Rush investigators examined if the program's intervention increased MVPA. MVPA was measured with a questionnaire given to study participants at six, 12, 18, 24, 30 and 36 months after the program began.

South Asians are thought to be at particularly high risk of developing diabetes. India has the second highest burden of diabetes, after China, but is expected to become the global leader in diabetes by 2030."

Christopher Ford, PhD, Study Lead Author and Researcher, Rush Institute for Healthy Aging

Rush investigators used a methodology called random effects models to examine the relationship between the group participating in D-CLIP and odds of reporting more than 150 weekly minutes of MVPA, as compared to a control group.

They also examined the impact of intervention on weekly MVPA. Random effects research models enable the assessment of an entire sample of data for subgroup differences without need to split the data into subgroups.

The researchers found that D-CLIP increased the average amount of weekly MVPA by an additional 56.7 after six months and 34.3, 23.6 and 24.3 minutes a week at 12, 18, and 24 months, respectively.

"We found that the intervention significantly increased physical activity by increasing walking, the duration of exercise and number of workout sessions per week," Ford explained. "Findings from this study show that lifestyle interventions to prevent diabetes in South Asians at high risk of diabetes can significantly increase physical activity."

Studying the data found in the D-CLIP trial could have a major impact that extends beyond how to prevent diabetes in South Asians.

"Studying diabetes in South Asians could inform national recommendations to prevent diabetes in India and also could have implications for the treatment and prevention of diabetes globally," Ford says. "Findings from this study may be important to global health policy makers."