The DOI matches its Crossref record; 146 of the 147 references it cites were found in a registry or an index.
Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis
Open accessAbstract
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 19 , 20 , 21 , 22 , 23 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [21]
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“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]
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“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]
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“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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Cites
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Items 101–110 of 110
Jurić Petričević, S., Buljan, I., Bjelanović, D., Mrduljaš-Đujić, N., Pekez, T., Ćurković, M., Vojvodić, Ž., Pavličević, I., Marušić, M., & Marušić, A. (2022) · Figshare · doi:10.6084/m9.figshare.21366174
Wells, I., Simons, G., Davenport, C., Mallen, C. D., Raza, K., & Falahee, M. (2022) · Figshare · doi:10.6084/m9.figshare.21130022
Jurić Petričević, S., Buljan, I., Bjelanović, D., Mrduljaš-Đujić, N., Pekez, T., Ćurković, M., Vojvodić, Ž., Pavličević, I., Marušić, M., & Marušić, A. (2022) · Figshare · doi:10.6084/m9.figshare.21366180
Darvishzadehdaledari, S., Harrison, A. S., Gholami, F., & Azadnia, A. (2023) · Figshare · doi:10.6084/m9.figshare.24751218
Jurić Petričević, S., Buljan, I., Bjelanović, D., Mrduljaš-Đujić, N., Pekez, T., Ćurković, M., Vojvodić, Ž., Pavličević, I., Marušić, M., & Marušić, A. (2022) · Figshare · doi:10.6084/m9.figshare.21366177
Oliveira-Gomes, D. D., de Majo, A. M., Ardila-Delgado, A. D., Inglis, S. S., Mandras, S. A., Loro-Ferrer, J. F., & daSilva‐deAbreu, A. (2026) · Current Atherosclerosis Reports · doi:10.1007/s11883-026-01395-2
Current and emerging nutrition interventions in cardiac rehabilitation: a narrative review
Small, S. L., Iglesies‐Grau, J., Gariepy, C., Williams, J., Rishis, E., Terada, T., & Kirkham, A. (2026) · Translational Exercise Biomedicine · doi:10.1515/teb-2026-0002
Behavioral Versus Pharmacologic Strategies in Cardiovascular Prevention
Chen, Z., & Fang, L. (2026) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000001374
The critical role of endothelial cells: Complications and management – A narrative review
Ijaz, M., Shahbaz, M., Latif, F., Xu, N., Ding, H., & Tian, W. (2026) · Journal of King Saud University - Science · doi:10.25259/jksus_1708_2025
Yamasaki, S., Tokunou, T., & Horiuchi, T. (2026) · PLoS ONE · doi:10.1371/journal.pone.0358270
Metadata
- 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
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2017-05-11
- Volume
- 12
- Issue
- 5
- Pages
- e0176436
- ISSN
- 1932-6203 (ISSN-L)
- 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 › Public Health, Environmental and Occupational Health › 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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