A 21-year JAMA study found diet changes, weight loss and weekly exercise reduced long-term multimorbidity risk more effectively than metformin in adults with prediabetes.
By yourNEWS Media Newsroom
Adults with prediabetes who lost weight, improved their diets and exercised regularly developed fewer chronic health problems over two decades than those who received metformin or placebo, according to a 21-year study published in JAMA.
The research found that an intensive lifestyle program reduced the risk of developing multiple chronic conditions by 21% compared with placebo. Participants in the lifestyle group followed a reduced-calorie, low-fat diet, completed at least 150 minutes of physical activity each week and aimed to lose 7% of their starting body weight.
At follow-up, participants in the lifestyle group had a median of four chronic conditions. Participants in both the metformin and placebo groups had a median of five.
The findings came from the Diabetes Prevention Program and its Outcomes Study, known as DPP and DPPOS. The analysis included 1,173 adults with prediabetes who were randomly assigned to one of three groups: intensive lifestyle intervention, metformin at 850 milligrams twice daily, or placebo.
Researchers concluded that lifestyle intervention was more effective than metformin at slowing the long-term accumulation of chronic diseases. Metformin did not show a statistically significant difference from placebo in reducing multimorbidity risk.
The study adds to evidence that diet, physical activity and weight management remain central tools in preventing chronic disease, particularly for people with elevated blood sugar who have not yet developed type 2 diabetes.
Prediabetes is a widespread condition in the United States. The Centers for Disease Control and Prevention reports that more than 2 in 5 U.S. adults have prediabetes. A Mercola.com article citing CDC data said more than 114 million American adults live with diabetes or prediabetes, while diabetes ranks as the seventh leading cause of death in the United States.
Prediabetes raises the risk of type 2 diabetes and is also linked to other chronic conditions, including hypertension, high cholesterol and heart disease.
The JAMA study focused on multimorbidity, which means having two or more chronic health conditions. The problem is especially common among older adults, affecting up to 95% of primary care patients age 65 and older, according to the study authors.
Researchers said people with prediabetes are at elevated risk because several chronic conditions can develop at the same time, including diabetes, hypertension, hyperlipidemia and cardiovascular disease.
The participants had a median age of 51 and a median body mass index of 32.1, placing them in the obese category. The cohort was 56% non-Hispanic white, nearly one-quarter non-Hispanic Black, with the remainder Hispanic, Asian or Pacific Islander, and Native American.
The lifestyle intervention began with 16 individual sessions, followed by monthly sessions for about two years. Participants later received booster sessions twice a year. The program aimed for less than 25% of calories from fat, at least 150 minutes of moderate physical activity weekly and a 7% reduction in body weight.
The metformin and placebo groups received their assigned tablets and standard lifestyle advice four times each year.
After 21 years, 85% of all participants had developed multimorbidity. The most common conditions across the study population were hyperlipidemia, affecting 76%; hypertension, affecting 75%; and diabetes, affecting 67%.
The lifestyle group had fewer accumulated chronic conditions than the other groups. While 81% of those in the placebo and metformin groups had more than three chronic conditions, that figure was 72% in the lifestyle group.
The results align with prior research showing long-term benefits from lifestyle changes. Research compiled in “Nutrition and Diabetes” by Emmanuel C. Opara and Sam Dagogo Jack has emphasized that diabetes-prevention benefits from lifestyle intervention can last up to 20 years, while medication effects have not shown the same long-term durability. The Finnish Diabetes Prevention Study also found a 43% reduction in diabetes incidence years after intervention completion, according to “Lifestyle Medicine” by James M. Rippe.
Thomas M. Holland, a physician scientist at the RUSH Institute for Healthy Aging, said the study shifts attention from preventing one disease to supporting long-term health across multiple systems. He said lifestyle habits can affect inflammation, insulin sensitivity, vascular health and muscle preservation at the same time.
David Cutler, a board-certified family medicine physician at Providence Saint John’s Health Center, said diet and exercise are powerful tools for longevity and healthy aging, though medications remain necessary for some patients.
Both experts said the same habits that help prevent diabetes can also support heart health, brain health and quality of life.
A NaturalNews.com review also noted that reducing refined carbohydrates may help stabilize blood sugar and improve cholesterol without relying entirely on pharmaceuticals.
Experts said people should focus on sustainable changes, including daily walking, improved food quality, stress management and gradual weight loss when needed.
The JAMA findings suggest that early lifestyle intervention in prediabetes may reduce not only diabetes risk, but the broader burden of chronic disease over time. Researchers said the results support making diet and exercise a larger part of prevention strategies for adults at risk of metabolic disease.
Source: Natural News
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