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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

Siddiqui, Faiza LU ; Kurbasic, Azra LU ; Lindblad, Ulf LU ; Nilsson, Peter M. LU and Bennet, Louise LU (2017) In Metabolism, Clinical and Experimental 66. p.1-13
Abstract

Background andAims 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... (More)

Background andAims 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 3.5 months 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.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Body weight, Immigrants, Insulin sensitivity, Lifestyle, Randomized controlled trial
in
Metabolism, Clinical and Experimental
volume
66
pages
1 - 13
publisher
Elsevier
external identifiers
  • scopus:84994034543
  • wos:000391156200001
ISSN
0026-0495
DOI
10.1016/j.metabol.2016.10.001
language
English
LU publication?
yes
id
79468b40-3daa-49df-83f2-06888553ec40
date added to LUP
2016-12-05 09:29:42
date last changed
2018-01-07 11:38:44
@article{79468b40-3daa-49df-83f2-06888553ec40,
  abstract     = {<p>Background andAims 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 3.5 months 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.</p>},
  author       = {Siddiqui, Faiza and Kurbasic, Azra and Lindblad, Ulf and Nilsson, Peter M. and Bennet, Louise},
  issn         = {0026-0495},
  keyword      = {Body weight,Immigrants,Insulin sensitivity,Lifestyle,Randomized controlled trial},
  language     = {eng},
  month        = {01},
  pages        = {1--13},
  publisher    = {Elsevier},
  series       = {Metabolism, Clinical and Experimental},
  title        = {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},
  url          = {http://dx.doi.org/10.1016/j.metabol.2016.10.001},
  volume       = {66},
  year         = {2017},
}