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Journal: The lancet. Diabetes & endocrinology

71

Because of the high density of fat, high-fat diets are perceived as likely to lead to increased bodyweight, hence health-care providers are reluctant to recommend them to overweight or obese individuals. We assessed the long-term effects of ad libitum, high-fat, high-vegetable-fat Mediterranean diets on bodyweight and waist circumference in older people at risk of cardiovascular disease, most of whom were overweight or obese.

Concepts: Cancer, Nutrition, Obesity, Randomized controlled trial, Effectiveness, Adipose tissue, Dieting, Mediterranean diet

68

Diabetes is presently classified into two main forms, type 1 and type 2 diabetes, but type 2 diabetes in particular is highly heterogeneous. A refined classification could provide a powerful tool to individualise treatment regimens and identify individuals with increased risk of complications at diagnosis.

Concepts: Diabetes mellitus type 2, Diabetes mellitus, Diabetes mellitus type 1

67

Endocrine-disrupting chemicals (EDCs) contribute to disease and dysfunction and incur high associated costs (>1% of the gross domestic product [GDP] in the European Union). Exposure to EDCs varies widely between the USA and Europe because of differences in regulations and, therefore, we aimed to quantify disease burdens and related economic costs to allow comparison.

Concepts: European Union, United States, Republic of Ireland, Gross domestic product

55

Despite the increasing popularity of activity trackers, little evidence exists that they can improve health outcomes. We aimed to investigate whether use of activity trackers, alone or in combination with cash incentives or charitable donations, lead to increases in physical activity and improvements in health outcomes.

Concepts: Epidemiology, Clinical trial, Improve, Randomized controlled trial, Avicenna

50

The obesity epidemic has major public health consequences. Expert dietetic and behavioural counselling with intensive follow-up is effective, but resource requirements severely restrict widespread implementation in primary care, where most patients are managed. We aimed to estimate the effectiveness and cost-effectiveness of an internet-based behavioural intervention (POWeR+) combined with brief practice nurse support in primary care.

Concepts: Health care, Health economics, Epidemiology, Clinical trial, Nutrition, Randomized controlled trial, Effectiveness, Efficacy

41

Dementia and obesity are increasingly important public health issues. Obesity in middle age has been proposed to lead to dementia in old age. We investigated the association between BMI and risk of dementia.

Concepts: Cohort study, Public health, Epidemiology, Middle age, Middle Ages, Gerontology, Old age, Ageing

40

Statin treatment and variants in the gene encoding HMG-CoA reductase are associated with reductions in both the concentration of LDL cholesterol and the risk of coronary heart disease, but also with modest hyperglycaemia, increased bodyweight, and modestly increased risk of type 2 diabetes, which in no way offsets their substantial benefits. We sought to investigate the associations of LDL cholesterol-lowering PCSK9 variants with type 2 diabetes and related biomarkers to gauge the likely effects of PCSK9 inhibitors on diabetes risk.

Concepts: Cholesterol, Genetics, Nutrition, Myocardial infarction, Atherosclerosis, Low-density lipoprotein, Statin, Atheroma

39

Effective prevention is needed to combat the worldwide epidemic of type 2 diabetes. We investigated the long-term extent of beneficial effects of lifestyle intervention and metformin on diabetes prevention, originally shown during the 3-year Diabetes Prevention Program (DPP), and assessed whether these interventions reduced diabetes-associated microvascular complications.

Concepts: Diabetes mellitus type 2, Obesity, Insulin resistance, Sulfonylurea, Intervention

38

The metabolic effects of omega-6 polyunsaturated fatty acids (PUFAs) remain contentious, and little evidence is available regarding their potential role in primary prevention of type 2 diabetes. We aimed to assess the associations of linoleic acid and arachidonic acid biomarkers with incident type 2 diabetes.

Concepts: Nutrition, Fatty acid, Fatty acids, Essential fatty acid, Omega-6 fatty acid, Linoleic acid, Arachidonic acid, Essential fatty acid interactions

38

We assessed whether fully closed-loop insulin delivery (the so-called artificial pancreas) is safe and effective compared with standard subcutaneous insulin therapy in patients with type 2 diabetes in the general ward.

Concepts: Insulin, Diabetes mellitus type 2, Diabetes mellitus, Diabetes mellitus type 1, Obesity, Islets of Langerhans, Diabetes, Subcutaneous injection