Chapter 16. The Effectiveness of Interventions Aimed at Weight Loss, and Other Effects of Diet and Physical Activity in Achieving Control of Diabetes and Preventing Its Complications

  1. R. Williams1,
  2. W. Herman2,
  3. A.-L. Kinmonth4 and
  4. N. J. Wareham3
  1. Nicholas J. Wareham

Published Online: 9 APR 2003

DOI: 10.1002/0470846585.ch16

The Evidence Base for Diabetes Care

The Evidence Base for Diabetes Care

How to Cite

Wareham, N. J. (2002) The Effectiveness of Interventions Aimed at Weight Loss, and Other Effects of Diet and Physical Activity in Achieving Control of Diabetes and Preventing Its Complications, in The Evidence Base for Diabetes Care (eds R. Williams, W. Herman, A.-L. Kinmonth and N. J. Wareham), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846585.ch16

Editor Information

  1. 1

    Nuffield Institute for Health, University of Leeds, 71-75 Clarendon Road, Leeds LS2 9PL, UK

  2. 2

    Department of Internal Medicine and Epidemiology, 1500 East Medical Center Drive, 3920 Taubman Center, Box 0345, Ann Arbor, MI 48109, USA

  3. 3

    Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

  4. 4

    General Practice and Primary Care Research Unit, Dept. of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Author Information

  1. Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Publication History

  1. Published Online: 9 APR 2003
  2. Published Print: 27 AUG 2002

ISBN Information

Print ISBN: 9780471988762

Online ISBN: 9780470846582

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Keywords:

  • weight loss;
  • diet;
  • physical activity;
  • pharmacological intervention;
  • surgical intervention;
  • macrovascular complication;
  • carbohydrate;
  • protein;
  • monounsaturated fat

Summary

This chapter reviews the evidence of the effectiveness of interventions aimed at weight loss and other effects of changing diet and physical activity in individuals with established diabetes in diminishing the risk of diabetic complications. Many of the studies described have had to assume that the desired behavioural change has been achieved, because it has been measured poorly or not at all. One can state what the interventions were designed to affect but little can be inferred about the mechanisms by which an effect was achieved or which component of the intervention was most effective. Most of the evidence comes from short-term studies with surrogate endpoints such as weight or blood glucose rather than the key outcomes related to diabetes such as incident heart disease or retinopathy. The chapter considers possible explanations for the lack of long-term health endpoint trials of behavioural interventions.