Prevention of type 2 diabetes in urban American Indian/Alaskan Native communities: The Life in BALANCE pilot study

Objective: The Life in BALANCE (LIB) study is a pilot translational study modeling the Diabetes Prevention Program (DPP) intensive lifestyle coaching intervention among an underserved, high-risk population: American Indians/Alaska Natives (AI/ANs) living in a large urban setting (Las Vegas, Nevada). Research Design and Methods: A total of 22 overweight/obese AI/ANs (age, 39.6 ± 10.4 years;BMI, 34.1 ± 6.3 kg/m2) at increased risk for developing type 2 diabetes (HbA1c > 5.4 (36 mmol/mol) Results: Only 12 of the 22 participants remained?in the LIB program at the final post-program follow-up. Participants demonstrated significant decreased waist circumference and elevated HDL cholesterol. Triglycerides manifested the highest percentage change without statistical significance. No significant change was observed in blood pressure or fasting blood glucose. Conclusions: LIB participants’ improvements in BMI, waist circumference, HDL cholesterol and triglycerides suggests type 2 diabetes prevention programs aimed at urban AI/ANs show significant potential for reducing the risk of developing type 2 diabetes among this underserved and high risk community. Qualitative data suggest the main challenge for type 2 diabetes prevention specific to this population is a need for improved community outreach strategies.

F1 Offspring of (F0) Female Rats Fed a High-Saturated Fat, Prenatal/Lactation Diet Remain Insulin Resistant Despite Postnatal Diet Rich in Omega-3 Polyunsaturated Fatty Acids

Prior research has shown adult diets rich in omega-3 long-chain polyunsaturated fatty acids (omega-3 LC-PUFAs) can improve adult metabolic health. Previous studies have also shown maternal overnutrition during pregnancy/lactation adversely affects metabolic functioning in adult offspring. The purpose of the current study was to investigate the interaction of these two metabolism regulating factors by assessing the effectiveness of a postweaning diet rich in omega-3 long chain-polyunsaturated fatty acids (omega-3 LC-PUFAs) to improve metabolic function in adult offspring whose mothers were fed a high-saturated fat “Western” diet during pregnancy/lactation. We compared metabolic function between offspring of three prenatal-lactation/postweaning diet lines of Sprague-Dawley rats: 1) offspring of mothers fed a high-saturated fat “Western” diet during pregnancy-lactation, then weaned to a high omega-3 LC-PUFA diet (Western/PUFA);2) offspring of mothers fed a control diet during pregnancy-lactation, then weaned to a high omega-3 LC-PUFA diet (Control/PUFA);and 3) offspring of mothers fed a Western diet during pregnancylactation, and postweaning (Western/Western). Fasting plasma insulin, triglycerides, and insulin resistance (HOMA-IR) of Western/PUFA animals were intermediate to those of Western/Western and Control/PUFA offspring, although these differences did not reach statistical significance. This suggests the metabolic benefits of an omega-3 LC-PUFA-rich diet are insufficient to overcome the deleterious effects of a high-saturated fat prenatal-lactation diet.

The “metabolic syndrome index”: A novel, comprehensive method for evaluating the efficacy of diabetes prevention programs

A myriad of diabetes prevention programs are carried out worldwide to fight against the current type 2 diabetes (T2D) pandemic. The lack of a unified criterion for evaluating the efficacy of T2D prevention programs, however, makes the interpretation of prevention program results difficult, and hinders clear and direct comparisons of different prevention programs. Metabolic syndrome is a strong indicator for diabetes and its complications, holding great promise to become the basis of an intervention evaluation method. The Metabolic Syndrome Index (MSI), proposed here, quantifies the metabolic risk for developing T2D and its complications. The MSI is a novel scale for evaluating the efficacy of diabetes prevention programs because it is a systematic, comprehensive, and stable indicator that reflects the metabolic risk reduction for diabetes and its complications at multiple levels and dimensions.

F0 Prenatal/Lactation Diets Varying in Saturated Fat and Long-Chain Polyunsaturated Fatty Acids Alters the Insulin Sensitivity of F1 Rats Fed a High Fat Western Diet Post-weaning

Previous research has shown that prenatal diets rich in specific nutrients (e.g. taurine, omega-3 fatty acids) may provide protective cardiometabolic effects for adult offspring. The purpose of the current study was to investigate the potential of a prenatal-lactation diet rich in omega-3 long-chain polyunsaturated fatty acids (omega-3 LC PUFAs) to improve metabolic function in offspring fed a high saturated fat “Western” diet postweaning. We compared growth and metabolic biomarkers of three groups of Sprague Dawley rat offspring all weaned to a high saturated fat “Western” (Western) diet, but whose mothers were fed one of three different diets during pregnancy-lactation: 1) omega-3 “PUFA”-rich (PUFA/Western);2) control (Control/Western);and 3) high saturated fat “Western” (Western/Western). PUFA/Western offspring had significantly lower fasting insulin (P < 0.01) and HOMA-IR (P < 0.01), and lower mean plasma triglycerides than Western/ Western animals. Additionally, mean HOMA-IR, fasting plasma insulin, and triglycerides were 19%, 10% and 14% lower, respectively, than those of Control/Western animals, although these differences were not statistically significant. Western/Western adult offspring had the highest fasting plasma insulin, triglycerides, and insulin-resistance (HOMA-IR) of the three groups. Our results indicated that a maternal omega-3 PUFA-rich diet during pregnancy-lactation may provide modest protective metabolic effects for adult offspring, even when consuming a high energy and saturated fat diet.