Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis

Zhang, Xuanping; Devlin, Heather M.; Smith, Bryce; Imperatore, Giuseppina; Thomas, William; Lobelo, Felipe; Ali, Mohammed K.; Norris, Keri; Gruss, Stephanie; Bardenheier, Barbara; Cho, Pyone; Garcia de Quevedo, Isabel; Mudaliar, Uma; Jones, Christopher D.; Durthaler, Jeffrey M.; Saaddine, Jinan; Geiss, Linda S.; Gregg, Edward W.

doi:10.1371/journal.pone.0176436

Cited by 110Diabetes, Cardiovascular Risks, and LipoproteinsPhysical Activity and HealthCardiovascular Health and Risk Factors

Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis

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Zhang, Xuanping, Devlin, Heather M., Smith, Bryce, Imperatore, Giuseppina, Thomas, William, Lobelo, Felipe, Ali, Mohammed K., Norris, Keri +10 more·2017·PLOS ONE

DOI 10.1371/journal.pone.0176436PMC PMC5426619

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Abstract

Structured lifestyle interventions can reduce diabetes incidence and cardiovascular disease (CVD) risk among persons with impaired glucose tolerance (IGT), but it is unclear whether they should be implemented among persons without IGT. We conducted a systematic review and meta-analyses to assess the effectiveness of lifestyle interventions on CVD risk among adults without IGT or diabetes. We systematically searched MEDLINE, EMBASE, CINAHL, Web of Science, the Cochrane Library, and PsychInfo databases, from inception to May 4, 2016. We selected randomized controlled trials of lifestyle interventions, involving physical activity (PA), dietary (D), or combined strategies (PA+D) with follow-up duration ≥12 months. We excluded all studies that included individuals with IGT, confirmed by 2-hours oral glucose tolerance test (75g), but included all other studies recruiting populations with different glycemic levels. We stratified studies by baseline glycemic levels: (1) low-range group with mean fasting plasma glucose (FPG) <5.5mmol/L or glycated hemoglobin (A1C) <5.5%, and (2) high-range group with FPG ≥5.5mmol/L or A1C ≥5.5%, and synthesized data using random-effects models. Primary outcomes in this review included systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG). Totally 79 studies met inclusion criteria. Compared to usual care (UC), lifestyle interventions achieved significant improvements in SBP (-2.16mmHg[95%CI, -2.93, -1.39]), DBP (-1.83mmHg[-2.34, -1.31]), TC (-0.10mmol/L[-0.15, -0.05]), LDL-C (-0.09mmol/L[-0.13, -0.04]), HDL-C (0.03mmol/L[0.01, 0.04]), and TG (-0.08mmol/L[-0.14, -0.03]). Similar effects were observed among both low-and high-range study groups except for TC and TG. Similar effects also appeared in SBP and DBP categories regardless of follow-up duration. PA+D interventions had larger improvement effects on CVD risk factors than PA alone interventions. In adults without IGT or diabetes, lifestyle interventions resulted in significant improvements in SBP, DBP, TC, LDL-C, HDL-C, and TG, and might further reduce CVD risk.

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An increased animal fat (saturated fatty acid [SFA]) intake has been shown to be associated with the risk of diabetes.
“an increased animal fat (saturated fatty acid [SFA]) intake has been shown to be associated with the risk of diabetes 19 , 20 , 21 , 22 , 23 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [21]
DPP-4 inhibitors are not associated with an increased risk of macroangiopathy.
“They are not associated with an increased risk of macroangiopathy 21 , 22 , 23 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [21]
DPP-4 inhibitors appear to have a favorable safety profile.
“Thus, at present, DPP‐4 inhibitors appear to have a favorable safety profile 19 , 20 , 21 , 22 , while attention needs to be given to the potential onset of acute pancreatitis and bullous pemphigoid with these agents.”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [21]
Protein restriction is likely effective in inhibiting the progression of diabetic nephropathy in patients with overt or more advanced nephropathy.
“While protein restriction is thought likely to be effective in inhibiting the progression of diabetic nephropathy in patients with overt or more advanced nephropathy, there is a paucity of clinical evidence to support its implementation 21 , 22 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [21]

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2020 ESC guidelines on sports cardiology and exercise in patients with cardiovascular disease
Pelliccia, A., Sharma, S., Gati, S., Bäck, M., Börjesson, M., Caselli, S., Collet, J.-P., Corrado, D., Drezner, J. A., Halle, M., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehaa605 · Cited by 1,958 · see citing works
Japanese clinical practice guideline for diabetes 2019
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Global Updates on Cardiovascular Disease Mortality Trends and Attribution of Traditional Risk Factors
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Japanese Clinical Practice Guideline for Diabetes 2019
Araki, E., Goto, A., Kondo, T., Noda, M., Noto, H., Origasa, H., Osawa, H., Taguchi, A., Tanizawa, Y., Tobe, K., et al. (2020) · Journal of Diabetes Investigation · doi:10.1111/jdi.13306 · Cited by 346 · see citing works
Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022
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The metabolic syndrome – What is it and how should it be managed?
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Exercise prevents high fat diet-induced bone loss, marrow adiposity and dysbiosis in male mice
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The Potential Benefit of Monitoring Oxidative Stress and Inflammation in the Prevention of Non-Communicable Diseases (NCDs)
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Effect of a lifestyle intervention in obese infertile women on cardiometabolic health and quality of life: A randomized controlled trial
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Fructose metabolism, cardiometabolic risk, and the epidemic of coronary artery disease
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WHO HEARTS: A Global Program to Reduce Cardiovascular Disease Burden: Experience Implementing in the Americas and Opportunities in Canada
Campbell, N. R. C., Ordúñez, P., Giraldo, G., Morales, Y. A. R., Lombardi, C., Khan, T., Padwal, R. S., Tsuyuki, R. T., & Varghese, C. V. (2020) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2020.12.004 · Cited by 93 · see citing works
Ideal Cardiovascular Health and Incident Cardiovascular Disease Among Adults: A Systematic Review and Meta-analysis
Ramírez‐Vélez, R., Saavedra, J. M., Lobelo, F., Celis-Morales, C. A., Cruz, B. D. P., & García‐Hermoso, A. (2018) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2018.05.035 · Cited by 78 · see citing works
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Effects of 20-year infancy-onset dietary counselling on cardiometabolic risk factors in the Special Turku Coronary Risk Factor Intervention Project (STRIP): 6-year post-intervention follow-up
Pahkala, K., Laitinen, T. T., Niinikoski, H., Kartiosuo, N., Rovio, S., Lagström, H., Loo, B.-M., Salo, P., Jokinen, E. V., Magnussen, C. G., et al. (2020) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(20)30059-6 · Cited by 78 · see citing works
Declining Rates of Hospitalization for Selected Cardiovascular Disease Conditions Among Adults Aged ≥35 Years With Diagnosed Diabetes, U.S., 1998–2014
Burrows, N. R., Li, Y., Gregg, E. W., & Geiss, L. S. (2017) · Diabetes Care · doi:10.2337/dc17-1259 · Cited by 68 · see citing works
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Effectiveness of technology-assisted cardiac rehabilitation: A systematic review and meta-analysis
Chong, M. S., Sit, J. W. H., Karthijekan, K., & Chair, S. Y. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.104087 · Cited by 63 · see citing works
Community-Based Interventions for Cardiovascular Disease Prevention in Low-and Middle-Income Countries: A Systematic Review
Ndejjo, R., Hassen, H. Y., Wanyenze, R. K., Musoke, D., Nuwaha, F., Abrams, S., Bastiaens, H., & Musinguzi, G. (2021) · Public health reviews · doi:10.3389/phrs.2021.1604018 · Cited by 56 · see citing works
2020 ESC Guidelines on Sports Cardiology and Exercise in Patients with Cardiovascular Disease
Pelliccia, A., Sharma, S., Gati, S., Bäck, M., Börjesson, M., Caselli, S., Collet, J., Corrado, D., Drezner, J. A., Halle, M., et al. (2021) · Revista Española de Cardiología (English Edition) · doi:10.1016/j.rec.2021.05.003 · Cited by 53 · see citing works
JCS 2023 Guideline on the Primary Prevention of Coronary Artery Disease
Fujiyoshi, A., Kohsaka, S., Hata, J., Hara, M., Kai, H., Masuda, D., Miyamatsu, N., Nishio, Y., Ogura, M., Sata, M., et al. (2024) · Circulation Journal · doi:10.1253/circj.cj-23-0285 · Cited by 47 · see citing works
Two decades of diabetes prevention efforts: A call to innovate and revitalize our approach to lifestyle change
Golovaty, I., Ritchie, N. D., Tuomilehto, J. O., Mohan, V., Ali, M. K., Gregg, E. W., Bergman, M., & Moin, T. (2022) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2022.110195 · Cited by 50 · see citing works
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The Effect of Helicobacter pylori Eradication on Lipid Levels: A Meta-Analysis
Watanabe, J., Hamasaki, M., & Kotani, K. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10050904 · Cited by 42 · see citing works
Health Literacy as a Major Contributor to Health-Promoting Behaviors among Korean Teachers
Bae, E. J., & Yoon, J. Y. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18063304 · Cited by 39 · see citing works
Cost-effectiveness of a lifestyle intervention in high-risk individuals for diabetes in a low- and middle-income setting: Trial-based analysis of the Kerala Diabetes Prevention Program
Sathish, T., Oldenburg, B. F., Thankappan, K. R., Absetz, P., Shaw, J. E., Tapp, R. J., Zimmet, P., Balachandran, S., Shetty, S. S., Aziz, Z., et al. (2020) · BMC Medicine · doi:10.1186/s12916-020-01704-9 · Cited by 38 · see citing works
A case study of using the He Pikinga Waiora Implementation Framework: challenges and successes in implementing a twelve-week lifestyle intervention to reduce weight in Māori men at risk of diabetes, cardiovascular disease and obesity
OETZEL, J. G., Rarere, M., Wihapi, R., Manuel, C., & Tapsell, J. (2020) · International Journal for Equity in Health · doi:10.1186/s12939-020-01222-3 · Cited by 32 · see citing works
Which Physical Exercise Interventions Increase HDL-Cholesterol Levels? A Systematic Review of Meta-analyses of Randomized Controlled Trials
Palazón-Bru, A., Hernández-Lozano, D., & Gil-Guillén, V. (2020) · Sports Medicine · doi:10.1007/s40279-020-01364-y · Cited by 28 · see citing works
Effects of lifestyle interventions on cardiovascular risk factors in South Asians: a systematic review and meta-analysis
Limbachia, J., Ajmeri, M. S., Keating, B. J., de Souza, R. J., & Anand, S. S. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-059666 · Cited by 31 · see citing works
Reducing cardiometabolic risk in adults with a low socioeconomic position: protocol of the Supreme Nudge parallel cluster-randomised controlled supermarket trial
Stuber, J., Mackenbach, J., de Boer, F. D., de Bruijn, G., Gillebaart, M., Harbers, M. C., Hoenink, J., Klein, M., Middel, C. N. H., van der Schouw, Y., et al. (2020) · Nutrix Journal · doi:10.1186/s12937-020-00562-8 · Cited by 24 · see citing works
Enhanced motivational interviewing for reducing weight and increasing physical activity in adults with high cardiovascular risk: the MOVE IT three-arm RCT
Ismail, K., Stahl, D. R., Bayley, A., Twist, K., Stewart, K., Ridge, K., Britneff, E., Ashworth, M. J., de Zoysa, N., Rundle, J., et al. (2019) · Health Technology Assessment · doi:10.3310/hta23690 · Cited by 28 · see citing works
Guía ESC 2020 sobre cardiología del deporte y el ejercicio en pacientes con enfermedad cardiovascular
Pelliccia, A., Sharma, S., Gati, S., Bäck, M., Börjesson, M., Caselli, S., Collet, J., Corrado, D., Drezner, J. A., Halle, M., et al. (2021) · Revista Española de Cardiología · doi:10.1016/j.recesp.2020.11.026 · Cited by 28 · see citing works
Survival and incidence of cardiovascular diseases in participants in a long-distance ski race (Vasaloppet, Sweden) compared with the background population
Hållmarker, U., Lindbäck, J., Michaëlsson, K., Ärnlöv, J., Åsberg, S., Wester, P. O., Hellberg, D., Lagerqvist, B., & James, S. K. (2018) · European Heart Journal - Quality of Care and Clinical Outcomes · doi:10.1093/ehjqcco/qcy005 · Cited by 26 · see citing works
Reduced 10-year risk of developing cardiovascular disease after participating in a lifestyle programme in primary care
Lönnberg, L., Ekblom‐Bak, E., & Damberg, M. (2020) · Upsala Journal of Medical Sciences · doi:10.1080/03009734.2020.1726533 · Cited by 26 · see citing works
Integrating Sleep, Physical Activity, and Diet Quality to Estimate All-Cause Mortality Risk: A Combined Compositional Clustering and Survival Analysis of the National Health and Nutrition Examination Survey 2005–2006 Cycle
Cruz, B. D. P., McGregor, D. E., Cruz, J. D. P., Buman, M. P., Palarea‐Albaladejo, J., Alfonso‐Rosa, R. M., & CHASTIN, S. F. M. (2020) · American Journal of Epidemiology · doi:10.1093/aje/kwaa057 · Cited by 26 · see citing works
Dietary polyphenols, metabolic syndrome and cardiometabolic risk factors: An observational study based on the DCH-NG subcohort
Lanuza, F., Zamora‐Ros, R., Bondonno, N. P., Meroño, T., Rostgaard‐Hansen, A. L., Riccardi, G., Tjønneland, A. M., Landberg, R., Halkjær, J., & Andrés‐Lacueva, C. (2023) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2023.02.022 · Cited by 21 · see citing works
Epidemiological Trends in Cardiovascular Disease Mortality Attributable to Modifiable Risk Factors and Its Association with Sociodemographic Transitions across BRICS-Plus Countries
Nawsherwan, N., Mubarik, S., Wang, B., Zhang, L., Sang, M., Yijun, L., Zheng, J., & Wang, Y. (2023) · Nutrients · doi:10.3390/nu15173757 · Cited by 21 · see citing works
Current understanding of structural and molecular changes in diabetic cardiomyopathy
Akhtar, M. S., Alavudeen, S. S., Raza, A., Imam, M. T., Almalki, Z. S., Tabassum, F., & Iqbal, M. J. (2023) · Life Sciences · doi:10.1016/j.lfs.2023.122087 · Cited by 23 · see citing works
Physical activity and all-cause mortality in Korean older adults
Cho, J., Lee, I., Park, S. H., Jin, Y., Kim, D., Kim, S., & Kang, H. (2018) · Annals of Human Biology · doi:10.1080/03014460.2018.1478448 · Cited by 19 · see citing works
Cardiometabolic Risk Reduction Through Recreational Group Sport Interventions in Adults: A Systematic Review and Meta-analysis
Bellissimo, M. P., Galaviz, K. I., Paskert, M. C., & Lobelo, F. (2018) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2018.03.014 · Cited by 20 · see citing works
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Increasing Nitrate-Rich Vegetable Intake Lowers Ambulatory Blood Pressure in (pre)Hypertensive Middle-Aged and Older Adults: A 12-Wk Randomized Controlled Trial
van der Avoort, C. M. T., ten Haaf, D. S. M., Bongers, C. C. W. G., van Oorschot, F., Verdijk, L. B., van Loon, L. J. C., & Hopman, M. T. E. (2021) · Journal of Nutrition · doi:10.1093/jn/nxab157 · Cited by 18 · see citing works
The Evolving Epidemiology of Atherosclerotic Cardiovascular Disease in People with Diabetes
Pasquel, F. J., Gregg, E. W., & Ali, M. K. (2018) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2017.11.001 · Cited by 19 · see citing works
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Findings from Community-Based Screenings for Type 2 Diabetes Mellitus in at Risk Communities in Cape Town, South Africa: A Pilot Study
Hill, J., Peer, N., Jonathan, D., Mayige, M. T., Sobngwi, E., & Kengne, A. P. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17082876 · Cited by 19 · see citing works
Primary and secondary cardiovascular disease prevention interventions targeting lifestyle risk factors in women: A systematic review and meta-analysis
Slater, K., Colyvas, K., Taylor, R., Collins, C. E., & Hutchesson, M. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.1010528 · Cited by 18 · see citing works
Projected impact of treatment intensification with statin, ezetimibe, and statin plus ezetimibe fixed-dose combination on MACE across six countries
Farnier, M., Santos, R. D., Cosı́n-Sales, J., Владиславович, Е. М., Liu, J., Granados, D., Santoni, S., Khan, I., & Catapano, A. L. (2022) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwac214 · Cited by 17 · see citing works
Interventions to Reduce the Risk of Cardiovascular Disease among Workers: A Systematic Review and Meta-Analysis
Hwang, W. J., & Kang, S. J. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17072267 · Cited by 16 · see citing works
Digital health intervention in patients undergoing cardiac rehabilitation: systematic review and meta-analysis
Harbi, A. S., Soh, K. G., Yubbu, P., & Soh, K. G. (2024) · F1000Research · doi:10.12688/f1000research.152315.1 · Cited by 15 · see citing works
The Cost-Effectiveness of Lifestyle Interventions for Preventing Diabetes in a Health Resource-Limited Setting
Ma, J., Wan, X., & Wu, B. (2020) · Journal of Diabetes Research · doi:10.1155/2020/7410797 · Cited by 13 · see citing works
Implementing a Novel Machine Learning System for Nutrition Education in Diabetes Mellitus Nutritional Clinic: Predicting 1-Year Blood Glucose Control
Liu, M., Liu, C., Lin, T.-C., & Ma, Y. (2023) · Bioengineering · doi:10.3390/bioengineering10101139 · Cited by 15 · see citing works
Fitness, Strength and Body Composition during Weight Loss in Women with Clinically Severe Obesity: A Randomised Clinical Trial
Miller, C. T., Fraser, S. F., Selig, S., Rice, T., Grima, M. T., van den Hoek, D., Sari, C. I., Lambert, G. W., & Dixon, J. B. (2020) · Obesity Facts · doi:10.1159/000506643 · Cited by 14 · see citing works
Asociación de un índice de estilos de vida saludable con factores de riesgo cardiovascular en población chilena
Leiva, A. M., Petermann-Rocha, F. E., Martínez-Sangüinetti, M. A., Troncoso-Pantoja, C., Concha, Y., Garrido-Méndez, Á., Díaz-Martínez, X., Lanuza, F., Natalia Ulloa, M., Martorell, M., et al. (2018) · Revista médica de Chile · doi:10.4067/s0034-98872018001201405 · Cited by 13 · see citing works
Low Awareness of Cardiovascular Risk Factor Among Patients Admitted in Cardiac Rehabilitation Unit
Conte, M., Rozza, F., Fucile, I., D’Avino, G., Sorvillo, G., LUCA, N. D., & Mancusi, C. (2021) · High Blood Pressure & Cardiovascular Prevention · doi:10.1007/s40292-021-00444-y · Cited by 13 · see citing works
Dietary n-3 polyunsaturated fatty acids alter the number, fatty acid profile and coagulatory activity of circulating and platelet-derived extracellular vesicles: a randomized, controlled crossover trial
Bozbaş, E., Zhou, R., Soyama, S., Allen‐Redpath, K., Mitchell, J. L., Fisk, H. L., Calder, P. C., Jones, C. I., Gibbins, J. M., Fischer, R., et al. (2024) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2024.03.008 · Cited by 12 · see citing works
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Effects of a digital diabetes prevention program on cardiovascular risk among individuals with prediabetes
Michaud, T. L., Almeida, F. A., Porter, G. C., Kittel, C., Schwab, R. J., Brito, F. A., Wilson, K. E., Katula, J. A., Castro, C. M., Estabrooks, P. A., et al. (2023) · Primary care diabetes · doi:10.1016/j.pcd.2023.01.007 · Cited by 12 · see citing works
A culturally adapted, social support-based, diabetes group visit model for Bangladeshi adults in the USA: a feasibility study
Shah, M. K., Naing, S., Kurra, N., Weber, M. B., Islam, N. S., Ali, M. K., & Narayan, K. M. V. (2022) · Pilot and Feasibility Studies · doi:10.1186/s40814-022-00974-9 · Cited by 11 · see citing works
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Cardiometabolic Health in Relation to Lifestyle and Body Weight Changes 3–8 Years Earlier
van Elten, T. V., van Poppel, M. V., Gemke, R., Groen, H., Hoek, A., Mol, B., & Roseboom, T. (2018) · Nutrients · doi:10.3390/nu10121953 · Cited by 9 · see citing works
Lifestyle Interventions to Promote Healthy Nutrition and Physical Activity in Middle-Age (40-60 Years) Adults: A Randomized Controlled Trial in the North of Iran.
Mouodi, S., Hosseini, S. R., Ghadimi, R., Cumming, R. G., Bijani, A., Mouodi, M., & Pasha, Y. Z. (2019) · PubMed Central · Cited by 11 · see citing works
How lifestyle factors can contribute to cardiovascular disease incidence; a review study
Jafari, N., Alivand, S., Molaee, H., Rabori, V. S., Asadian, A., Abbasian, S., & Faramarzzadeh, R. (2023) · Journal of Preventive Epidemiology · doi:10.34172/jpe.2023.35232 · Cited by 10 · see citing works
The effectiveness of lifestyle interventions in reducing cardiovascular risk and risk factors in people with prediabetes: A systematic review and meta-analysis
Demissie, G. D., Birungi, J., Shrestha, A., Haregu, T., Sathish, T., & Oldenburg, B. F. (2025) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2025.104130 · Cited by 10 · see citing works
Examining the effectiveness of home-based cardiac rehabilitation programs for heart failure patients with reduced ejection fraction: a critical review
Darvishzadehdaledari, S., Harrison, A. S., Gholami, F., & Azadnia, A. (2023) · BMC Cardiovascular Disorders · doi:10.1186/s12872-023-03640-x · Cited by 9 · see citing works
Lifestyle Interventions Reduce the Risk of Type II Diabetes and Cardiovascular Diseases Development among Pre-diabetic Adults
Nguyen, S. N., Tran, V. D., Le, T. T. M., Nga, H. T., & Tho, N. T. T. (2021) · International Journal Of Pharmaceutical Research And Allied Sciences · doi:10.51847/8rpisivjrg · Cited by 9 · see citing works
New USPSTF Recommendations for Screening for Prediabetes and Type 2 Diabetes: An Opportunity to Create National Momentum
Gregg, E. W., & Moin, T. (2021) · JAMA · doi:10.1001/jama.2021.12559 · Cited by 9 · see citing works
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An Infancy-Onset 20-Year Dietary Counselling Intervention and Gut Microbiota Composition in Adulthood
Keskitalo, A., Munukka, E., Aatsinki, A., Saleem, W., Kartiosuo, N., Lahti, L., Huovinen, P., Elo, L. L., Pietilä, S., Rovio, S., et al. (2022) · Nutrients · doi:10.3390/nu14132667 · Cited by 8 · see citing works
A Proactive Intervention Study in Metabolic Syndrome High-Risk Populations Using Phenome-Based Actionable P4 Medicine Strategy
Huang, Q., Hu, Z., Zheng, Q., Mao, X., Lv, W., Wu, F., Fu, D., Lu, C., Zeng, C., Wang, F., et al. (2024) · Phenomics · doi:10.1007/s43657-023-00115-z · Cited by 8 · see citing works
Relationship between Cardiometabolic Factors and the Response of Blood Pressure to a One-Year Primary Care Lifestyle Intervention in Metabolic Syndrome Patients
Marin‐Couture, É., Filion, M.-J., Boukari, R., Jeejeebhoy, K. N., Dhaliwal, R., Brauer, P. M., Royall, D., Mutch, D. M., Klein, D., Tremblay, A., et al. (2022) · Metabolites · doi:10.3390/metabo12090861 · Cited by 8 · see citing works
Selective prevention of cardiovascular disease using integrated lifestyle intervention in primary care: protocol of the Healthy Heart stepped-wedge trial
Bonten, T. N., Verkleij, S., van der Kleij, R., Busch, K., van den Hout, W. B., Chavannes, N. H., & Numans, M. E. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-043829 · Cited by 7 · see citing works
Effects of a lifestyle intervention on cardiovascular risk factors in systemic lupus erythematosus patients: The study “Living well with lupus”
Sieczkowska, S. M., Mazzolani, B. C., Smaira, F. I., Romero, M., Pasoto, S. G., Pinto, A. L. D. S., Lima, F. R., Oliveira, V. R. D., Ueda, S., Benatti, F. B., et al. (2024) · Clinical Rheumatology · doi:10.1007/s10067-024-06870-2 · Cited by 7 · see citing works
Sex Differences in Physiological Stress Induced by a Long-Lasting Adventure Race: A Prospective Observational Analytical Study
Silva, R. P. M., Vilaça, A., Guerra, F. D., Mundim, A. V., de Agostini, G. G., de Abreu, L. C., Zhiguo, Z., Sorpreso, I. C. E., Valenti, V. E., & Penha‐Silva, N. (2019) · Sportverletzung · Sportschaden · doi:10.1055/a-0928-0990 · Cited by 7 · see citing works
Lipoprotein Subclass Profile after Progressive Energy Deficits Induced by Calorie Restriction or Exercise
Chooi, Y. C., Ding, C., Chan, Z., Lo, J., Choo, J., Ding, B. T. K., Leow, M. K., & Magkos, F. (2018) · Nutrients · doi:10.3390/nu10111814 · Cited by 6 · see citing works
Effectiveness of a Singaporean Community-Based Physical Activity and Nutrition Intervention: A Cluster Randomized Controlled Trial
Wong, E. Y.-S., James, A. P., Lee, A. H., & Jancey, J. M. (2020) · Asia Pacific Journal of Public Health · doi:10.1177/1010539520977311 · Cited by 6 · see citing works
First Report on the Co-Occurrence and Clustering Profiles of Cardiovascular Lifestyle Risk Factors among Adults in Burkina Faso
Cissé, K., Samadoulougou, S., Coppieters, Y., Bonnechère, B., Zabsonré, P., Kirakoya‐Samadoulougou, F., & Kouanda, S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19148225 · Cited by 5 · see citing works
Composite health behaviour classifier as the basis for targeted interventions and global comparisons in men’s health
Flannigan, R. K., Oliffe, J. L., McCreary, D. R., Punjani, N., Kasabwala, K., Black, N., Rachert, J., & Goldenberg, L. S. (2018) · Canadian Urological Association Journal · doi:10.5489/cuaj.5454 · Cited by 5 · see citing works
Developing a synthetic control group using electronic health records: Application to a single-arm lifestyle intervention study
Ko, Y., Chen, Z., Liu, C., Hu, Y., Quyyumi, A. A., Waller, L. A., Higgins, M. K., Ziegler, T. R., Brigham, K. L., & Martin, G. S. (2021) · Preventive Medicine Reports · doi:10.1016/j.pmedr.2021.101572 · Cited by 5 · see citing works
Performance of Stepwise Screening Methods in Identifying Individuals at High Risk of Type 2 Diabetes in an Iranian Population
Lotfaliany, M., Hadaegh, F., Mansournia, M. A., Azizi, F., Oldenburg, B. F., & Khalili, D. (2021) · International Journal of Health Policy and Management · doi:10.34172/ijhpm.2021.22 · Cited by 5 · see citing works
Dietitian‐supported dietary intervention leads to favorable dietary changes in patients with type 2 diabetes: A randomized controlled trial
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Additional file 1 of Acceptability of predictive testing for ischemic heart disease in those with a family history and the impact of results on behavioural intention and behaviour change: a systematic review
Wells, I., Simons, G., Davenport, C., Mallen, C. D., Raza, K., & Falahee, M. (2022) · Figshare · doi:10.6084/m9.figshare.21130020
Additional file 1 of A culturally adapted, social support-based, diabetes group visit model for Bangladeshi adults in the USA: a feasibility study
Shah, M. K., Naing, S., Kurra, N., Weber, M. B., Islam, N., Ali, M. K., & Narayan, K. M. V. (2022) · Figshare · doi:10.6084/m9.figshare.19028984
Self-citation
Additional file 2 of Acceptability of predictive testing for ischemic heart disease in those with a family history and the impact of results on behavioural intention and behaviour change: a systematic review
Wells, I., Simons, G., Davenport, C., Mallen, C. D., Raza, K., & Falahee, M. (2022) · Figshare · doi:10.6084/m9.figshare.21130021

Effect of lifestyle interventions on glucose regulation among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis
Zhang, X., Imperatore, G., Thomas, W., Cheng, Y. J., Lobelo, F., Norris, K. L., Devlin, H. M., Ali, M. K., Gruss, S. M., Bardenheier, B. H., et al. (2016) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2016.11.020 · Cited by 61 · see citing works
Self-citation
Lifestyle interventions in the prevention of diabetes in patients with impaired glucose tolerance:a Meta-analysis
Song, G. (2014) · Modern Medical Journal
Relationship between lifestyle interventions and glycemic level in adults with impaired glucose tolerance: A systematic review and meta-analysis
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The Research of Lifestyle Intervention and IGT
Wu, T. (2010) · Medical Recapitulate
Effects of lifestyle interventions on glucose regulation and diabetes risk in adults with impaired glucose tolerance or prediabetes: a meta-analysis
Jiang, Q., Li, J., Sun, P., Wang, L.-L., Sun, L.-Z., & Pang, S. (2022) · Archives of Endocrinology and Metabolism · doi:10.20945/2359-3997000000441 · Cited by 28 · see citing works

Authors: Zhang, X., Devlin, H. M., Smith, B., Imperatore, G., Thomas, W., Lobelo, F., Ali, M. K., Norris, K., Gruss, S., Bardenheier, B., Cho, P., Garcia de Quevedo, I., Mudaliar, U., Jones, C. D., Durthaler, J. M., Saaddine, J., Geiss, L. S., & Gregg, E. W.
Affiliations: Centers for Disease Control and Prevention (US)
Emory University (US)
Corresponding author: Zhang, Xuanping
ORCID: Zhang, Xuanping
Devlin, Heather M.
Smith, Bryce
Imperatore, Giuseppina
Lobelo, Felipe
Ali, Mohammed K.
Norris, Keri
Bardenheier, Barbara
Mudaliar, Uma
Durthaler, Jeffrey M.
Saaddine, Jinan
Geiss, Linda S.
Gregg, Edward W.
Venue: PLOS ONE
Publisher: Public Library of Science (PLoS)
Published: 2017-05-11
Volume: 12
Issue: 5
Pages: e0176436
ISSN: 1932-6203 (ISSN-L)
DOI: 10.1371/journal.pone.0176436
PMC: PMC5426619
OpenAlex: W2613978613
Cited by: 110
References: 147
Citations by year: 2026: 6 · 2025: 2 · 2024: 10 · 2023: 16 · 2022: 20 · 2021: 16 · 2020: 18 · 2019: 8 · 2018: 12 · 2017: 2
FWCI: 1.59
Type: journal article
Language: en
Open access: gold
doi.org
Licence: public-domain
creativecommons.org/publicdomain/zero/1.0/ (vor)
Locations: PLoS ONE (publishedVersion, public-domain)
Europe PMC (PubMed Central) (publishedVersion, public-domain)
PubMed Central (publishedVersion, public-domain)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Spiral (Imperial College London) (submittedVersion, public-domain)
Funders: Centers for Disease Control and Prevention
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Physiology › Physical Activity and Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
Keywords: lifestyle intervention, cardiovascular risk factors, physical activity, dietary intervention, blood pressure, lipid profile, impaired glucose tolerance, prediabetes, glycemic status, cardiovascular disease prevention, adults without diabetes, usual care comparison, triglycerides, HDL cholesterol, LDL cholesterol, total cholesterol, systolic and diastolic blood pressure, follow-up duration
MeSH terms: Blood Glucose, Cardiovascular Diseases, Cholesterol, Diabetes Mellitus, Glycated Hemoglobin, Humans, Life Style, Cholesterol, HDL, Cholesterol, LDL, Risk Factors, Triglycerides, Exercise, Randomized Controlled Trials as Topic, Glucose Intolerance

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Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis

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