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

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• 作者：Faiza Siddiqui^a ; Azra Kurbasic^b ; Ulf Lindblad^c ; Peter M. Nilsson^a ; Louise Bennet^a ; ^d ; ^{Louise.bennet@med.lu.se}
• 关键词：Body weight ; Immigrants ; Insulin sensitivity ; Lifestyle ; Randomized controlled trial
• 刊名：Metabolism
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：66
• 期：Complete
• 页码：1-13
• 全文大小：693 K
• 卷排序：66

文摘

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.MethodsCitizens 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.ResultsThe 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.ConclusionsThis 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.