Lifestyles matter in the prevention of type 2 diabetes.

The incidence of type 2 diabetes is rapidly increasing worldwide due to the increasing occurrence of obesity and sedentary lifestyle. Type 2 diabetes is no longer confined to middle-aged and elderly people but is increasingly common among young people and even children (1,2). Type 2 diabetes constitutes a major health problem in both developed and developing countries, and with obesity it is becoming one of the largest challenges to health care systems. Therefore, any measures to prevent or delay the development of diabetes are urgently needed. There is a great deal of evidence that both genetic and environmental factors are of importance in the pathogenesis of type 2 diabetes. While the genetic factors are still poorly understood, numerous studies have shown that obesity (central obesity in particular), physical inactivity (3), high-fat diet, and diet rich in saturated fatty acids increase the risk of diabetes (4,5). Furthermore, based mainly on epidemiological studies, low intakes of dietary fiber, low-glycemic carbohydrates, and whole grain cereals have been shown to increase the risk of type 2 diabetes (5). Type 2 diabetes is preceded by a long period of impaired glucose tolerance (IGT) or milder disturbances in glucose metabolism. These disturbances in glucose metabolism and insulin resistance syndrome or metabolic syndrome, characterized by a clustering of risk factors, are much more common than type 2 diabetes and carry an increased risk not only for type 2 diabetes but also for cardiovascular morbidity and mortality, even in early phases of impaired glucose metabolism (6,7). Therefore, the …