Effects of dietary quality, physical activity and weight loss on glucose homeostasis in persons with and without prediabetes in the PREMIER trial
Authors' conclusion
Our findings indicate that behavioural lifestyle interventions can substantially improve glucose metabolism in persons with and without prediabetes and that the effects of diet quality and physical activity are partly independent of weight loss.
Study context
- Population
- Adults with prehypertension or stage 1 hypertension, without diabetes; mean (SD) age 49.9 (8.8) years, mean (SD) BMI 32.9 (5.7) kg/m², 35% with prediabetes at baselinewithout diabetes
- Participants
- 685 adults
- Primary endpoint
- Association of changes in diet quality, physical activity (fitness) and weight loss with HOMA-IR and fasting glucose
- Follow-up
- 6 and 18 months
Methodological details18-month, parallel randomized, General linear models; weight, fitness (treadmill test), dietary intake (24-h recalls) and glycaemic outcomes at baseline, 6 and 18 months
- 18-month
- Parallel randomized
- General linear models; weight, fitness (treadmill test), dietary intake (24-h recalls) and glycaemic outcomes at baseline, 6 and 18 months
Primary result
As reported in the abstract
HOMA-IR and fasting glucose
- Weight loss and improvements in fitness and diet quality were each significantly associated with lower HOMA-IR and fasting glucose
- Effects of fitness and diet quality partly mediated by weight loss; significant direct effects of diet and fitness independent of weight changes
- Mediation analysis
Further findings
Insulin sensitivity and fasting glucose by prediabetes status
- Insulin sensitivity and fasting glucose improved significantly in participants with and without prediabetes
Original publication
Effects of dietary quality, physical activity and weight loss on glucose homeostasis in persons with and without prediabetes in the PREMIER trial. Diabetes Obes Metab. Published 13 June 2023. doi:10.
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