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Lifestyle intervention improves health-related quality of life in prediabetes, metabolic syndrome
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Adults with prediabetes or metabolic syndrome assigned to an intensive 12-month lifestyle intervention program saw improvements in health-related quality of life, as well as improved clinical and behavioral outcomes vs. controls assigned to a waiting list, according to recent findings.
“These community-based lifestyle intervention programs have additional valuable benefits, beyond the improvement of risk factors for type 2 diabetes and heart disease,” Yvonne L. Eaglehouse, PhD, a postdoctoral researcher in the department of epidemiology at the University of Pittsburgh Graduate School of Public Health, said in a press release. “Our study demonstrates that these programs, delivered in diverse community settings, such as senior centers and work sites, simultaneously and significantly improved the quality of life of the participants.”
In a randomized trial, Eaglehouse and colleagues analyzed data from 223 adults with a BMI of at least 24 kg/m² and prediabetes, metabolic syndrome or both (mean age, 58 years; mean baseline weight, 208.8 lb; 62.3% women; 93.7% white; 65.9% full- or part-time workers). Adults were assigned to participation in the Group Lifestyle Balance program, a 12-month, 22-session adaptation of the Diabetes Prevention Program (DPP), either immediately (n = 138) or after a 6-month delay (n = 71; wait-controls) in a 2:1 ratio by intervention site. The program goals include increasing physical activity by at least 150 minutes weekly (median self-reported physical activity, 7.88 hours weekly) and achieving 7% weight loss. Participants were given the option of attending the first 12 weekly sessions in person or participating through individually viewed DVDs with follow-up contact from a lifestyle coach; the remaining 10 biweekly and monthly sessions were conducted in a group setting. Those assigned to the waiting list received general health information by mail and were assigned to the program after the 6-month waiting period.
Participants provided blood samples and completed a self-administered EuroQol health questionnaire at baseline and 6 and 12 months, as well as a second survey developed by the researchers assessing participants’ health state. Participants ranked current health on a visual analogue scale from 0 (“worst imaginable health state”) to 100 (“best imaginable health state”); average score for the group was 71.5 at baseline (U.S. average estimate, 79.2).
In unadjusted models, visual analogue scale scores improved for the cohort at both 6 months (mean increase, 7.38) and 12 months (mean increase, 6.73) after intervention (P < .0001 for both).
After adjusting for age, baseline score and achievement of intervention goals, the mean change in visual analogue score was an increase of 11.83 at 6 months and 11.23 at 12 months (P < .0001 for both).
Unadjusted mean changes in EQ-5D index values were minimal, with no model-estimated mean change at 6 months and a 0.01-point change at 12 months, according to researchers. After adjustment, mean change was an increase of 0.04 at 6 months and 0.05 at 12 months (P < .01 for both).
During intervention, participants also experienced improvements in waist circumference, HbA1c, total and HDL cholesterol, triglycerides and blood pressure, the researchers noted.
“These results indicate that there are additional benefits to community lifestyle-intervention programs beyond the improvement of risk factors for type 2 diabetes and cardiovascular disease, and demonstrate a considerable potential to improve public health when such programs are delivered in community settings,” the researchers wrote.
“This important benefit was most evident in those who started the intervention program having a relatively lower quality of life,” Andrea Kriska, PhD, professor in the department of epidemiology at the University of Pittsburgh Graduate School of Public Health, said in the release. “In other words, those who needed to improve the most.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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