Type-2 diabetes (T2D) is a global public health crisis, growing in parallel with increased prevalence of sedentary lifestyles and overweight/obesity. Observational studies and randomized clinical trials have shown that T2D is largely preventable through diet and lifestyle modifications, however the most effective diet and exercise intervention is yet to be identified. PREVIEW - PREVention of diabetes through lifestyle Intervention and population studies in Europe and around the World – is a large scale, multicentre program, recruiting overweight and obese adults and children known to be at high risk of developing T2D in 8 countries worldwide (New Zealand, Australia, Denmark, Finland, UK, Netherlands, Spain and Bulgaria). The study aims to determine whether a higher protein lower GI diet is more effective for weight loss maintenance and diabetes prevention than current international recommendations of a higher carbohydrate, moderate GI diet and will also investigate additional effects of moderate vs. higher intensity exercise. 2,500 adults and children, overweight (BMI≥25.0kg/m2) and prediabetic will be recruited. Participants complete an 8 week weight loss program using a low energy diet (LED, 4MJ/d), and those achieving ≥8% enroll into a longterm (3 year) weight loss maintenance program. Diets are ad libitum with instructions on how to achieve the macronutrient prescription. Intensive dietary and exercise counselling takes place in groups of 8-12 individuals. Blood, urine and faecal samples are collected for assessment of markers of T2D and cardiovascular disease (CVD). Behavioral modification is assessed using questionnaires. Primary endpoint is the incidence of T2D at 3 years, based on a 75g oral glucose tolerance test (OGTT). Secondary endpoints include changes in weight, % fat, insulin sensitivity, risk factors for CVD, and changes in perceived quality of life and physical activity.
Recruitment of participants started in July 2013 and will finish in February 2015. More than 50% of prediabetic adults have now been randomized and the intervention will be completed in 2018.