Background andAims Middle-Eastern immigrants constitute a growing proportion of the Swedish population and are at high risk for Type 2 diabetes. This calls for a more proactive preventive approach for dealing with diabetes risk in this target group. The aim was to test the effect of a culturally adapted lifestyle intervention programme on changes in lifestyle habits and cardio-metabolic outcomes comparing an intervention group with a control group receiving usual care. Methods Citizens of Malmö, Sweden born in Iraq and at high risk for Type 2 diabetes (n = 636) were invited. Participation rate was 15.1%. In all, 96 participants were randomized to the intervention group (n = 50) or to the control group (n = 46). The intervention group was offered seven group sessions addressing healthy diet and physical activity including one cooking class. Changes in body weight, physical activity levels and cardio-metabolic outcomes were evaluated using linear mixed-effects models. Results The mean follow-up time was 3.9 and 3.5 months in the intervention and control groups, respectively. The drop-out rate from baseline to the last visit was 30.0% in the intervention group (n = 15) and 30.4% in the control group (n = 14). The mean insulin sensitivity index increased significantly at follow-up in the intervention group compared to the control group (10.9% per month, p = 0.005). The intervention group also reached a significant reduction in body weight (0.4% per month, p = 0.004), body mass index (0.4% per month, p = 0.004) and LDL-cholesterol (2.1% per month, p = 0.036) compared to the control group. In total, 14.3% in the intervention group reached the goal to lose ≥ 5% of body weight versus none in the control group. Conclusions This culturally adapted lifestyle intervention programme shows a beneficial effect on insulin action, body weight reduction, as well as LDL-cholesterol reduction, in Middle-Eastern immigrants. The programme adapted to resources in primary health care provides tools for improved primary prevention and reduced cardio-metabolic risk in this high-risk group for Type 2 diabetes. © 2016 The Authors

Body weight immigrants Randomized controlled trial insulin sensitivity Lifestyle

physical activity Blood Glucose lifestyle immigrant Life Style Iraqi analysis metabolism exercise low density lipoprotein cholesterol non insulin dependent diabetes mellitus follow up Diabetes Mellitus, Type 2 human middle aged controlled study Iraq coping behavior priority journal diet Adaptation, Psychological Aged randomized controlled trial insulin sensitivity Risk Reduction Behavior cardiometabolic risk insulin Sweden cross-sectional study migrant Humans Treatment Outcome male Emigrants and Immigrants Acculturation clinical evaluation female cultural factor Article glucose blood level major clinical study lifestyle modification adult Prediabetic State body weight outcome assessment cardiovascular system body mass risk reduction pathophysiology