American Diabetes Association
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Association of Psychobehavioral Variables With HOMA-IR and BMI Differs for Men and Women With Prediabetes in the PREVIEW Lifestyle Intervention

Version 2 2021-06-28, 22:52
Version 1 2021-06-04, 22:30
posted on 2021-06-28, 22:52 authored by Tanja C. Adam, Mathijs Drummen, Ian Macdonald, Elli Jalo, Pia Siig-Vestentoft, J. Alfredo Martinez, Teodora Handjiev-Darlenska, Jennie Brand-Miller, Sally Poppitt, Gareth Stratton, Mikael Fogelholm, Kirsi H. Pietiläinen, Moira Taylor, Santiago Navas-Carretero, Bjorn Winkens, Svetoslav Handjiev, Roslyn Muirhead, Marta Silvestre, Nils Swindell, Maija Huttunen-Lenz, Wolfgang Schlicht, Tony Lam, Jouko Sundvall, Laura Råman, Edith Feskens, Thomas-Meinert Larssen, Angelo Tremblay, Anne Raben, Margriet Westerterp-Plantenga
Objective: Stress, sleep, eating behavior and physical activity are associated with weight change and insulin resistance. The aim of the analysis was the assessment of the overall and sex specific association of psychobehavioral variables throughout the 3-y PREVIEW intervention using the Homeostatic Model Assessment of Insulin resistance (HOMA-IR), BMI, and length of time in the study.

Methods: Associations of psychobehavioral variables, including stress, mood, eating behavior physical activity (PA), and sleep with BMI, HOMA-IR and time spent in study were assessed in 2184 participants with pre-diabetes and overweight/ obesity (n=706 men; n=1478 women) during a 3-year lifestyle intervention utilizing linear mixed modelling and general linear modelling.The study was a randomized multicenter trial using a 2x2 diet-by- PA design.

Results: Overall, cognitive restraint and PA increased during the intervention compared to baseline, while BMI, HOMA-IR, disinhibition, hunger and sleepiness decreased (all p<0.05). Cognitive restraint and PA were negatively, while disinhibition, hunger, stress, total mood-disturbance were positively associated with both BMI and HOMA-IR. Sleep-duration, low sleep quality, total mood-disturbance, disinhibition and hunger scores were positively associated with HOMA-IR for men only. Drop-outs at 6 months had higher stress and total mood-disturbance scores at baseline and throughout their time spent in the study compared to study completers.

Conclusion: Eating behavior and PA, control of stress, mood-disturbance and sleep characteristics were associated with BMI, HOMA-IR and time spent in study with different effects in men and women during the PREVIEW-lifestyle intervention-study.


The EU framework programme 7 (FP7/2007-2013) grant agreement # 312057. National Health and Medical Research Council - EU Collaborative Grant, AUS 8, ID 1067711). The Glycemic Index Foundation Australia through royalties to the University of Sydney. The NZ Health Research Council (14/191) and University of Auckland Faculty Research Development Fund. The Cambridge Weight Plan© donated all products for the 8-weeks LED period. The Danish Agriculture & Food Council. The Danish Meat and Research Institute. National Institute for Health Research Biomedical Research Centre (NIHR BRC) (UK). Biotechnology and Biological Sciences Research Council (BBSRC) (UK). Engineering and Physical Sciences Research Council (EPSRC) (UK). Nutritics (Dublin) donated all dietary analyses software used by UNOTT. Juho Vainio Foundation (FIN), Academy of Finland (grant numbers: 272376, 335443, 314383, 266286, 314135), Finnish Medical Foundation, Gyllenberg Foundation, Novo Nordisk Foundation (grant numbers NNF20OC0060547, NNF17OC0027232, NNF10OC1013354), Finnish Diabetes Research Foundation, University of Helsinki, Government Research Funds for Helsinki University Hospital (FIN), Jenny and Antti Wihuri Foundation (FIN), Emil Aaltonen Foundation (FIN). Dutch Organization for Scientific Research (NWO ASPASIA granted to T. Adam (grant no. 015.010.034).


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