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Rev Diabet Stud, 2010, 7(1):26-35 DOI 10.1900/RDS.2010.7.26

The Role of Diet and Lifestyle in Primary, Secondary, and Tertiary Diabetes Prevention: A Review of Meta-Analyses

Theodora Psaltopoulou1, Ioannis Ilias2, Maria Alevizaki3

1Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens, Greece
2Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou Hospital, Athens, Greece
3Endocrine Unit, Department of Clinical Therapeutics, Athens University School of Medicine, Alexandra Hospital, Athens, Greece
Address correspondence to: Theodora Psaltopoulou, e-mail:

Manuscript submitted November 10, 2009; resubmitted February 4, 2010; accepted February 7, 2010.

Keywords: type 2 diabetes, diet, lifestyle, nutrition, physical activity, weight loss, glycemic control, meta-analysis, diabetes prevention


Prevention of diabetes is crucial to lowering disease incidence, and thus minimizing the individual, familial, and public health burden. The purpose of this review is to gather current information from meta-analyses on dietary and lifestyle practices concerning reduction of risk to develop type 2 diabetes. Low glycemic index dietary patterns reduce both fasting blood glucose and glycated proteins independent of carbohydrate consumption. Diets rich in whole-grain, cereal high fiber products, and non-oil-seed pulses are beneficial. Whereas, frequent meat consumption has been shown to increase risk. Regarding non-alcoholic beverages, 4 cups/day of filtered coffee or tea are associated with a reduced diabetes risk. In contrast, the consumption of alcoholic beverages should not exceed 1-3 drinks/day. Intake of vitamin E, carotenoids, and magnesium can be increased to counteract diabetes risk. Obesity is the most important factor accounting for more than half of new diabetes' cases; even modest weight loss has a favorable effect in preventing the appearance of diabetes. Also, physical exercise with or without diet contributes to a healthier lifestyle, and is important for lowering risk. Finally, there is a positive association between smoking and risk to develop type 2 diabetes. As far as secondary and tertiary prevention is concerned, for persons already diagnosed with diabetes, there is limited evidence of the effectiveness of diet or lifestyle modification on glycemic control, but further studies are necessary.

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