A significant positive effect of the interventions on weight was reported by all study types .
The meta- analysis showed that lifestyle interventions achieved weight and waist circumference reductions after one year .
However , no clear effects on biochemical or clinical parameters were observed , possibly due to short follow-up periods or lack of power of the studies meta-analysed .
Changes in dietary parameters or physical activity were generally not reported .
Most studies assessing feasibility were supportive of implementation of lifestyle interventions in routine clinical care .
Conclusion Lifestyle interventions for patients at high risk of diabetes , delivered by a variety of healthcare providers in routine clinical setting s , are feasible but appear to be of limited clinical benefit one year after intervention .
Despite convincing evidence from structured intensive trials , this systematic review showed that translation into routine practice has less effect on diabetes risk reduction
Background The clinical effectiveness of intensive lifestyle interventions in preventing or delaying diabetes in people at high risk has been established from r and omised trials of structured , intensive interventions conducted in several countries over the past two decades .
The challenge is to translate them into routine clinical setting s. The objective of this review is to determine whether lifestyle interventions delivered to high-risk adult patients in routine clinical care setting s are feasible and effective in achieving reductions in risk factors for diabetes .
Long-term (5-year) effects of a reduced-fat diet intervention in individuals with glucose intolerance.
OBJECTIVE To determine whether reducing dietary fat would reduce body weight and improve long-term glycemia in people with glucose intolerance . RESEARCH DESIGN AND METHODS A 5-year Follow-up of a 1-year r and omized controlled trial of a reduced-fat ad libitum diet versus a usual diet .  Participants with glucose intolerance ( 2-h blood glucose 7.0 - 11.0 mmol/l ) were recruited from a Workforce Diabetes Survey . The group that was r and omized to a reduced-fat diet participated in monthly small-group education sessions on reduced-fat eating for 1 year . Body weight and glucose tolerance were measured in 136 participants at baseline 6 months , and 1 year ( end of intervention ) , with follow-up at 2 years ( n = l04 ) , 3 years ( n = 99 ) , and 5 years ( n = 103 ) . RESULTS Compared with the control group , weight decreased in the reduced-fat-diet group ( P < 0.0001 ) ; the greatest difference was noted at 1 year ( -3.3 kg ) , diminished at subsequent follow-up ( -3.2 kg at 2 years and -1.6 kg at 3 years ) , and was no longer present by 5 years ( 1.1 kg ) . Glucose tolerance also improved in patients on the  reduced-fat diet ; a lower proportion had type 2 diabetes or impaired glucose tolerance at 1 year ( 47 vs. 67 % , P < 0.05 ) , but in subsequent years , there were no differences between groups . However , the more compliant 50 % of the intervention group maintained lower fasting and 2-h glucose at 5 years ( P = 0.041 and P = 0.026 respectively ) compared with control subjects . CONCLUSIONS The natural history for people at high risk of developing type 2 diabetes is weight gain and deterioration in glucose tolerance . This process may be ameliorated through adherence to a reduced fat
A significant positive effect of the interventions on weight was reported by all study types .
The meta- analysis showed that lifestyle interventions achieved weight and waist circumference reductions after one year .
However , no clear effects on biochemical or clinical parameters were observed , possibly due to short follow-up periods or lack of power of the studies meta-analysed .
Changes in dietary parameters or physical activity were generally not reported .
Most studies assessing feasibility were supportive of implementation of lifestyle interventions in routine clinical care .
Conclusion Lifestyle interventions for patients at high risk of diabetes , delivered by a variety of healthcare providers in routine clinical setting s , are feasible but appear to be of limited clinical benefit one year after intervention .
Despite convincing evidence from structured intensive trials , this systematic review showed that translation into routine practice has less effect on diabetes risk reduction
Background The clinical effectiveness of intensive lifestyle interventions in preventing or delaying diabetes in people at high risk has been established from r and omised trials of structured , intensive interventions conducted in several countries over the past two decades .
The challenge is to translate them into routine clinical setting s. The objective of this review is to determine whether lifestyle interventions delivered to high-risk adult patients in routine clinical care setting s are feasible and effective in achieving reductions in risk factors for diabetes .