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Predictors of lifestyle intervention outcome and dropout: the SLIM study

European Journal of Clinical Nutrition volume 65, pages 1141–1147 (2011)Cite this article

Subjects

Abstract

Background/Objectives:

To evaluate the effect of a 4.1-year (range 3–6 years) lifestyle intervention according to general public health recommendations on glucose tolerance and dropout in a Dutch population with impaired glucose tolerance (IGT).

Subjects/Methods:

In the Study on Lifestyle intervention and Impaired glucose tolerance Maastricht, 147 Caucasian IGT subjects were randomized to an intervention group (INT: n=74; 38 male, 36 female) and control group (CON: n=73; 37 male, 36 female). Annually, subjects underwent measurements of body weight, anthropometry, glucose tolerance (oral glucose tolerance test), insulin resistance (homeostasis model assessment-insulin resistance), maximal aerobic capacity (VO2 max), blood lipids and blood pressure. INT received individual advice regarding a healthy diet and physical activity.

Results:

INT decreased their saturated fat intake, increased their carbohydrate intake (P<0.05) and VO2 max (P=0.04) compared with CON. Body weight did not change significantly (P=0.20) between the groups. After an initial decrease, 2-h glucose levels overall increased in INT (+0.11 mmol/l), but significantly less than CON (+1.18 mmol/l; P=0.04). Diabetes incidence was lower in INT versus CON (30 versus 56%, P=0.04). Change in body weight was associated with change in 2-h glucose levels (β=0.399 mmol/l per kg, P=0.02). Dropouts had a lower aerobic fitness and socioeconomic status, and a higher body mass index (BMI) and 2-h glucose compared with non-dropouts.

Conclusions:

Prolonged feasible changes in diet and physical activity prevent deterioration of glucose tolerance and reduce diabetes risk. Low socioeconomic status, low aerobic fitness and high BMI and 2-h glucose are indicative of dropout to the program.

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Acknowledgements

We thank Jos Stegen, Tanja Hermans-Limpens and Marja Ockeloen-van der Hulst for their help during the oral glucose tolerance tests and with the dietary intervention. This work was supported by grants from the Dutch Diabetes Research Foundation (DFN 98.901 and 2000.00.020), the Netherlands Organization for Scientific Research (940-35-034 and 2200.0139).

Clinical trial on ClinicalTrials.gov: NCT00381186, submitted on September 25 2006.

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Authors and Affiliations

  1. Department of Human Biology, Nutrition and Toxicology Research Institute Maastricht, NUTRIM, Maastricht University, Maastricht, The Netherlands

    C Roumen, E Corpeleijn, W H M Saris & E E Blaak

  2. Department of Agrotechnology and Food Sciences, Wageningen University, Wageningen, The Netherlands

    E J M Feskens & M Mensink

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  1. C Roumen
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  2. E J M Feskens
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  3. E Corpeleijn
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  4. M Mensink
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  5. W H M Saris
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  6. E E Blaak
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Correspondence to E E Blaak.

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The authors declare no conflict of interest.

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Roumen, C., Feskens, E., Corpeleijn, E. et al. Predictors of lifestyle intervention outcome and dropout: the SLIM study. Eur J Clin Nutr 65, 1141–1147 (2011). https://doi.org/10.1038/ejcn.2011.74

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