Effect of a lifestyle intervention on weight change in south Asian individuals in the UK at high risk of type 2 diabetes: a family-cluster randomised controlled trial

Bhopal, Raj S; Douglas, Anne; Wallia, Sunita; Forbes, John F; Lean, Michael E J; Gill, Jason M R; McKnight, John A; Sattar, Naveed; Sheikh, Aziz; Wild, Sarah H; Tuomilehto, Jaakko; Sharma, Anu; Bhopal, Ruby; Smith, Joel B E; Butcher, Isabella; Murray, Gordon D

doi:10.1016/s2213-8587(13)70204-3

Cited by 149Diabetes, Cardiovascular Risks, and LipoproteinsObesity, Physical Activity, DietPhysical Activity and Health

Effect of a lifestyle intervention on weight change in south Asian individuals in the UK at high risk of type 2 diabetes: a family-cluster randomised controlled trial

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Bhopal, Raj S, Douglas, Anne, Wallia, Sunita, Forbes, John F, Lean, Michael E J, Gill, Jason M R, McKnight, John A, Sattar, Naveed +8 more·2014·The Lancet Diabetes & Endocrinology

DOI 10.1016/s2213-8587(13)70204-3

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Abstract

BACKGROUND: The susceptibility to type 2 diabetes of people of south Asian descent is established, but there is little trial-based evidence for interventions to tackle this problem. We assessed a weight control and physical activity intervention in south Asian individuals in the UK. METHODS: We did this non-blinded trial in two National Health Service (NHS) regions in Scotland (UK). Between July 1, 2007, and Oct 31, 2009, we recruited men and women of Indian and Pakistani origin, aged 35 years or older, with waist circumference 90 cm or greater in men or 80 cm or greater in women, and with impaired glucose tolerance or impaired fasting glucose determined by oral glucose tolerance test. Families were randomised (using a random number generator program, with permuted blocks of random size, stratified by location [Edinburgh or Glasgow], ethnic group [Indian or Pakistani], and number of participants in the family [one vs more than one]) to intervention or control. Participants in the same family were not randomised separately. The intervention group received 15 visits from a dietitian over 3 years and the control group received four visits in the same period. The primary outcome was weight change at 3 years. Analysis was by modified intention to treat, excluding participants who died or were lost to follow-up. We used linear regression models to provide mean differences in baseline-adjusted weight at 3 years. This trial is registered, number ISRCTN25729565. FINDINGS: Of 1319 people who were screened with an oral glucose tolerance test, 196 (15%) had impaired glucose tolerance or impaired fasting glucose and 171 entered the trial. Participants were in 156 family clusters that were randomised (78 families with 85 participants were allocated to intervention; 78 families with 86 participants were allocated to control). 167 (98%) participants in 152 families completed the trial. Mean weight loss in the intervention group was 1.13 kg (SD 4.12), compared with a mean weight gain of 0.51 kg (3.65) in the control group, an adjusted mean difference of -1.64 kg (95% CI -2.83 to -0.44). INTERPRETATION: Modest, medium-term changes in weight are achievable as a component of lifestyle-change strategies, which might control or prevent adiposity-related diseases. FUNDING: National Prevention Research Initiative, NHS Research and Development; NHS National Services Scotland; NHS Health Scotland.

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In a lifestyle intervention on weight change in British South Asian people at high risk of type 2 diabetes, families rather than individuals were randomized in the trial.
“In a lifestyle intervention on weight change in British South Asian people at high risk of T2D, families rather than individuals were randomized in the trial.”
From British South Asian Patients’ Perspectives on the Relevance and Acceptability of Mobile Health Text Messaging to Support Medication Adherence for Type 2 Diabetes: Qualitative Study (2020) · cites this paper as [64]
Researchers working on the family-cluster lifestyle intervention trial were unable to recruit family volunteers for many families, concluding that the added value of family involvement remains to be explored.
“However, researchers working on the trial were unable to recruit family volunteers for many families, concluding that the added value of family involvement remains to be explored [64].”
From British South Asian Patients’ Perspectives on the Relevance and Acceptability of Mobile Health Text Messaging to Support Medication Adherence for Type 2 Diabetes: Qualitative Study (2020) · cites this paper as [64]

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Authors: Bhopal, R. S., Douglas, A., Wallia, S., Forbes, J. F., Lean, M. E. J., Gill, J. M. R., McKnight, J. A., Sattar, N., Sheikh, A., Wild, S. H., Tuomilehto, J., Sharma, A., Bhopal, R., Smith, J. B. E., Butcher, I., & Murray, G. D.
Affiliations: University of Edinburgh (GB)
University of Glasgow (GB)
Western General Hospital (GB)
Brigham and Women's Hospital (US)
Universität für Weiterbildung Krems (AT)
ORCID: Bhopal, Raj S
Lean, Michael E J
Gill, Jason M R
McKnight, John A
Sattar, Naveed
Sheikh, Aziz
Wild, Sarah H
Sharma, Anu
Smith, Joel B E
Murray, Gordon D
Venue: The Lancet Diabetes & Endocrinology
Publisher: Elsevier BV
Published: 2014-03
Volume: 2
Issue: 3
Pages: 218-227
ISSN: 2213-8587 (ISSN-L)
DOI: 10.1016/s2213-8587(13)70204-3
OpenAlex: W2130756888
Cited by: 149
References: 39
Citations by year: 2026: 3 · 2025: 11 · 2024: 16 · 2023: 11 · 2022: 17 · 2021: 14 · 2020: 10 · 2019: 14 · 2018: 10 · 2017: 14 · 2016: 13 · 2015: 10 · 2014: 4 · 2013: 1
FWCI: 7.36
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
creativecommons.org/licenses/by/3.0/ (vor)
Locations: The Lancet Diabetes & Endocrinology (publishedVersion, cc-by)
PubMed (publishedVersion)
Arrow@dit (Dublin Institute of Technology) (acceptedVersion)
ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
University of Limerick Institutional Repository (University of Limerick) (acceptedVersion, cc-by-nc-sa)
Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
University of Limerick Institutional Repository (University of Limerick) (submittedVersion, cc-by-nc-sa)
STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
University of Limerick Institutional Repository (University of Limerick)
Funders: National Prevention Research Initiative (G0501310)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords: lifestyle intervention, weight loss, South Asian populations, impaired glucose tolerance, impaired fasting glucose, family intervention, dietitian support, physical activity, waist circumference, adiposity
MeSH terms: Adult, Body Weight, Diabetes Mellitus, Type 2, Female, Glucose Tolerance Test, United Kingdom, Humans, India, Male, Middle Aged, Pakistan, Treatment Outcome, Risk Reduction Behavior

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Effect of a lifestyle intervention on weight change in south Asian individuals in the UK at high risk of type 2 diabetes: a family-cluster randomised controlled trial

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