Efficacy Of Lifestyle Interventions On Reducing Insulin Resistance And Dyslipidemia In Obese Adults: A Comparative Study
Abstract
Objective: This study evaluates the efficacy of lifestyle interventions, including dietary modifications and physical exercise, on insulin resistance (IR) and lipid profiles in obese adults. It compares the outcomes of different intervention strategies such as low-carbohydrate diets, Mediterranean diets, and aerobic versus resistance training on metabolic health.
Materials and Methods: A randomized controlled trial (RCT) was conducted at Index Medical College, Hospital and Research Center, Indore – (M.P.), among 180 obese adults. Participants were randomized into three dietary intervention groups: a low-carbohydrate diet, a Mediterranean diet, and a standard low-fat diet. In addition, participants were further divided into aerobic exercise and resistance training subgroups. Insulin resistance was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and lipid profiles were measured over 12 weeks.
Results: Both the low-carbohydrate and Mediterranean diets significantly reduced HOMA-IR (p < 0.001) compared to the low-fat diet. Aerobic exercise, when combined with the Mediterranean diet, resulted in a more significant reduction in triglycerides (TG) (p < 0.01) and an increase in high-density lipoprotein cholesterol (HDL-C) (p < 0.01) compared to resistance training.
Conclusion: Lifestyle interventions, particularly the Mediterranean diet combined with aerobic exercise, show greater improvements in reducing insulin resistance and dyslipidemia in obese adults. These findings suggest that personalized intervention strategies based on individual metabolic profiles can lead to better outcomes in managing obesity-related metabolic disorders.
References
2. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017;390(10113):2627-42.
3. Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol. 2008;28(4):629-36.
4. Petersen KF, Shulman GI. Pathogenesis of skeletal muscle insulin resistance in type 2 diabetes mellitus. Am J Cardiol. 2002 Feb 20;90(5):11-8.
5. Jakicic JM, et al. Effect of exercise on 24-month weight loss maintenance in overweight women. Arch Intern Med. 2008;168(14):1550-1559.
6. Esposito K, et al. Effects of weight loss and lifestyle changes on vascular inflammatory markers in obese women: a randomized trial. JAMA. 2003;289(14):1799-804.
7. Estruch R, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279-1290.
8. Sofi F, et al. Adherence to Mediterranean diet and health status: meta-analysis. BMJ. 2008;337.
9. Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008;359(3):229-41.
10. Thompson PD, et al. Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease. Circulation. 2003;107(24):3109-16.
11. Slentz CA, et al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity. Arch Intern Med. 2004;164(1):31-39.
12. Martínez-González MA, et al. Mediterranean diet and cardiovascular health: teachings of the PREDIMED study. Adv Nutr. 2016;7(1).
13. Esposito K, et al. Mediterranean diet and metabolic syndrome: the randomized controlled trial. Diabetes Care. 2004;27(5):1401-1406.
14. Knowler WC, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
15. Bazzano LA, et al. Effects of low-carbohydrate and low-fat diets: a randomized trial. Ann Intern Med. 2014;161(5):309-318.
16. Ebbeling CB, et al. Effects of dietary composition on energy expenditure during weight-loss maintenance. JAMA. 2018;319(3):247-262.
17. Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008;93(11 Suppl 1).
18. Hawley JA, et al. Integrative biology of exercise. Cell. 2015;159(4):738-749.
19. Look AHEAD Research Group. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013;369(2):145-154.
20. Paddon-Jones D, et al. Role of dietary protein in the sarcopenia of aging. Am J Clin Nutr. 2008;87(5):1562S-1566S.
21. Esposito K, et al. Effects of a Mediterranean-style diet on the need for antihyperglycemic drug therapy in patients with newly diagnosed type 2 diabetes: a randomized trial. Ann Intern Med. 2009;151(5):306-314.
22. Hession M, et al. Systematic review of randomized controlled trials of low-carbohydrate vs low-fat/low-calorie diets in the management of obesity and its comorbidities. Obes Rev. 2009;10(1):36-50.
23. Jakicic JM, et al. Effect of exercise on 24-month weight loss maintenance in overweight women. Arch Intern Med. 2008;168(14):1550-1559.
24. Slentz CA, et al. Effects of the amount of exercise on body weight, body composition, and measures of central obesity. Arch Intern Med. 2004;164(1):31-39.
25. Hawley JA, et al. Integrative biology of exercise. Cell. 2015;159(4):738-749.