Weight loss is key to reduced diabetes risk.

The American Diabetes Association has just released a study showing definitively that the best strategy for preventing type 2 diabetes is weight reduction. Diabetes risk was lowered by 58% in people on the study-implemented weight loss regimen, as compared to no change for placebo subjects.

In the study, subjects randomized to the "intensive lifestyle intervention" (aka the Diabetes Prevention Program) or to a placebo group. For every kilogram of weight loss, there was a 16% reduction in risk. The study not only compared the lifestyle intervention subjects with placebo subjects, but additionally analyzed the effect of each lifestyle change within the lifestyle intervention group--weight loss, a reduced fat diet, and regular exercise--to determine which was the best predictor of reduced diabetes risk. While the actual weight lost served as the best predictor, and therefore was the key factor in type 2 diabetes prevention in the study, the researchers point out that the weight loss amounts to a highly correlated measuring tool for reduced risk, with real results grounded in the lifestyle changes that brought on the weight loss.

"Lower percent of calories from fat and increased physical activity predicted weight loss," they write. "Increased physical activity was important to help sustain weight loss. Among 495 participants not meeting the weight loss goal at year 1, those who achieved the physical activity goal had 44% lower diabetes incidence." (The weight-loss goal in the Diabetes Prevention Program was to reduce weight by 7%.) Thus, the weight loss predictor incorporates the other two predictors, making regular exercise and reduced fat diets vital to the fight against type 2 diabetes. Targeting weight loss, then, ultimately means modifying your diet to include less saturated fats, and adding regular moderate exercise to your weekly routine.

A total of 1,079 high-risk people, ages 25 to 84, participated in the study over a three-year period. Their mean age was 50 years. The mean body mass index (BMI) was 33.9 kg/[m.sup.2]. A BMI of 20 to 25 is considered healthy, with 25.1 to 30 indicating slight-to-moderate overweight, and over 30 qualifying as clinical obesity. (Visit www.bariatricedge.com to calculate your BMI.) All of the study's subjects had a compromised ability to process glucose when they began the study, but had not yet developed type 2 diabetes. On the diet, fat intake was reduced to less than 25% of total calories.

The study represents an ongoing revision in focus in the literature from managing diabetes to preventing it, and within that area of research, a de-emphasis on heredity and other risk factors, and an emphasis on proactive and definitively proven preventive techniques--namely weight management through a reduced fat diet and regular exercise.

(Diabetes Care, 2006, Vol. 29, No. 9, pp. 2102-2107; American Diabetes Association, www.diabetes.org)