Physical activity and dietary interventions to prevent Type 2 Diabetes

An evidence gap map

Resumo

Introduction: Type 2 diabetes mellitus (T2DM), one of the most prevalent chronic non-communicable diseases, remains a major global health concern. Lifestyle interventions, particularly healthy dietary patterns and regular physical activity, play a pivotal role in T2DM prevention. Objective: To develop an evidence gap map of the effectiveness of Physical Activity and Dietary Interventions for T2DM Prevention based on the high-quality systematic reviews. Methods: Following a comprehensive database search and duplicate removal [PROSPERO CRD42023422444], systematic reviews were independently screened and assessed by two reviewers. Methodological quality was appraised using AMSTAR-2. Only high-quality systematic reviews with meta-analyses of randomized controlled trials were included. Data extraction was performed using the REDCap system. Interventions were classified as dietary, physical activity, or combined, and outcomes were grouped into clinical, anthropometric, epidemiological, economic, and well-being/quality of life categories. Lastly, a visual evidence matrix was generated. Results: Over 3,500 citations were identified, but only four systematic reviews (published between 2007 and 2020) met the inclusion criteria. On average, each review analyzed eight studies (range: 3–12). The most often assessed outcomes were glycemic profile, body weight, and T2DM incidence, corresponding to the clinical, anthropometric, and epidemiological categories, respectively. Across the evidence matrix, 48 findings were identified: 13 inconclusive, 13 positive, 12 null, 8 not reported, and 3 potentially positive. Combined dietary and physical activity interventions yielded 10 positive or potentially positive effects, particularly for clinical, anthropometric, and epidemiological outcomes. Conclusion: Combined dietary and physical activity interventions demonstrate beneficial effects, most notably on anthropometric indicators, biomarker profiles, and T2DM incidence. These findings reinforce the importance of combined lifestyle interventions for individuals at elevated risk of T2DM.