Effects of a culturally adapted lifestyle intervention on cardio-metabolic outcomes: a randomized controlled trial in Iraqi immigrants to Sweden at high risk for Type 2 diabetes.

Abstract

BACKGROUND AND AIMS:

Middle-Eastern immigrants constitute a growing proportion of the Swedish population and are at high risk for Type 2 diabetes. This calls for a more proactive preventive approach for dealing with diabetes risk in this target group. The aim was to test the effect of a culturally adapted lifestyle intervention programme on changes in lifestyle habits and cardio-metabolic outcomes comparing an intervention group with a control group receiving usual care.

METHODS:

Citizens of Malmö, Sweden born in Iraq and at high risk for Type 2 diabetes (n=636) were invited. Participation rate was 15.1%. In all, 96 participants were randomized to the intervention group (n=50) or to the control group (n=46). The intervention group was offered seven group sessions addressing healthy diet and physical activity including one cooking class. Changes in body weight, physical activity levels and cardio-metabolic outcomes were evaluated using linear mixed-effects models.

RESULTS:

The mean follow-up time was 3.9 and 3.5months in the intervention and control groups, respectively. The drop-out rate from baseline to the last visit was 30.0% in the intervention group (n=15) and 30.4% in the control group (n=14). The mean insulin sensitivity index increased significantly at follow-up in the intervention group compared to the control group (10.9% per month, p=0.005). The intervention group also reached a significant reduction in body weight (0.4% per month, p=0.004), body mass index (0.4% per month, p=0.004) and LDL-cholesterol (2.1% per month, p=0.036) compared to the control group. In total, 14.3% in the intervention group reached the goal to lose ≥5% of body weight versus none in the control group.

CONCLUSIONS:

This culturally adapted lifestyle intervention programme shows a beneficial effect on insulin action, body weight reduction, as well as LDL-cholesterol reduction, in Middle-Eastern immigrants. The programme adapted to resources in primary health care provides tools for improved primary prevention and reduced cardio-metabolic risk in this high-risk group for Type 2 diabetes.

• Authors: Faiza Siddiqui, Azra Kurbasic, Ulf Lindblad, Peter M Nilsson, Louise Bennet
• Journal: Metabolism: clinical and experimental (Metabolism) Vol. 66 Pg. 1-13 (Jan 2017) ISSN: 1532-8600 [Electronic] United States
• PMID: 27923444 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Chemical References

• Blood Glucose

Topics

• Acculturation
• Adaptation, Psychological
• Adult
• Aged
• Blood Glucose (analysis)
• Cardiovascular System (physiopathology)
• Diabetes Mellitus, Type 2 (prevention & control)
• Emigrants and Immigrants
• Exercise
• Female
• Humans
• Iraq
• Life Style
• Male
• Middle Aged
• Prediabetic State (metabolism, physiopathology, therapy)
• Risk Reduction Behavior
• Sweden
• Treatment Outcome