Diet and Lifestyle Interventions for Diabetes and Metabolic Syndrome

Dear Colleagues,

Type 1 and type 2 diabetes (T1D and T2D) management has traditionally centered on pharmacological treatment; however, growing evidence underscores the foundational need for effective diet and exercise interventions to improve glycemic control and overall metabolic health. Novel themes are in fact emerging, offering more personalized, precise, and sustainable strategies for care. Innovations such as time-restricted eating, plant-based diets, and microbiome-targeted nutrition are reshaping dietary paradigms, while advancements in wearable technology and continuous glucose monitoring are enhancing the personalization of both diet and exercise. Exercise science is also evolving, with increased focus on the timing, type, and intensity of activity, as well as on pre- or postprandial exercise to optimize glucose metabolism. Furthermore, behavioral approaches that integrate digital health tools, gamification, and mindful practices are gaining traction in improving adherence and long-term outcomes. This evolving landscape, coupled with unique mechanistic insights from circadian biology and inflammation towards glycemic control, presents exciting opportunities for researchers and clinicians to reimagine lifestyle interventions that are tailored, effective, and scalable. This Special Issue highlights several of these cutting-edge themes, aiming to inspire future inquiry and innovation in the prevention and management of diabetes through diet and exercise.

The following themes are of interest in the journal Nutrients, with a focus on diet/exercise interventions for diabetes.

1. Chrononutrition and Meal Timing
   • Impact of time-restricted eating (TRE) or intermittent fasting on glycemic control.
   • Interaction between circadian rhythms and insulin sensitivity in type 2 diabetes (T2D) patients.
2. Personalized Nutrition Interventions
   • Nutrigenomics and glycemic response to tailored diets in diabetic populations.
   • Use of continuous glucose monitoring (CGM) to adapt individualized diet plans.
3. Microbiome Modulation Through Diet and Exercise.
   • Effect of fiber-rich or fermented foods on gut microbiota and insulin resistance.
   • Synergistic effects of physical activity and prebiotic intake on microbiome diversity.
4. Plant-Based and Sustainable Diets
   • Long-term glycemic control in diabetics following vegan/plant-forward dietary patterns.
   • Role of environmental sustainability in promoting adherence to healthy diets.

Nutrition- and Exercise-Focused Innovations

5. Non-Traditional Exercise Modalities and Dietary Synergy
   • Efficacy of yoga, tai chi, or exergaming combined with personalized nutrition plans (e.g., low-glycemic-index diets) on glucose control and mental health.
   • Comparison of high-intensity interval training (HIIT) vs. moderate-intensity continuous training (MICT) paired with carbohydrate periodization in diverse diabetic cohorts.
6. Timing of Exercise and Nutrient Intake
   • Glycemic and metabolic outcomes of pre- vs. postprandial exercise in the context of meal composition (e.g., protein-rich vs. carbohydrate-rich meals).
7. Nutrition-Exercise Prescriptions for T1D vs. T2D
   • Tailored exercise and dietary regimens (e.g., insulin-sensitive macronutrient adjustments) for type 1 diabetes patients.

Mechanistic and Biomarker-Focused Topics

8. Inflammation, Immune Modulation, and Diet
   • Anti-inflammatory dietary patterns (e.g., Mediterranean, polyphenol-rich diets) combined with exercise and their synergistic effects on diabetic outcomes.
   • Role of IL-6, TNF-alpha, and CRP reduction through combined dietary (e.g., omega-3s, fiber) and physical activity interventions.
9. Metabolomics, Glycemic Variability, and Personalized Nutrition
   • Metabolic signatures linked to responsiveness to specific dietary (e.g., ketogenic, plant-based) and physical activity interventions.

Behavioral and Digital Health Approaches

10. Gamification and Digital Tools for Diet-Exercise Adherence
    • Efficacy of mHealth apps with gamified features for tracking diet–exercise synergy (e.g., real-time glucose feedback + meal logging).
    • AI-based nutrition-exercise coaching systems for diabetes self-management.
11. Mindful Eating and Exercise Interventions
    • Impact of mindful eating (e.g., portion control strategies) combined with structured exercise on emotional eating and A1C levels.
12. Culturally Tailored Diet-Exercise Programs
    • Community-based participatory research to adapt culturally relevant meal plans and exercise programs for underserved populations.

Translational and Implementation Science

13. Implementation of Diet–Exercise Counseling in Primary Care
    • Feasibility of clinician-delivered combined nutrition and exercise prescriptions in routine practice.
14. Cost-Effectiveness of Lifestyle (Diet + Exercise) vs. Pharmacological Approaches
    • Economic modeling of nutrition–exercise–first interventions in newly diagnosed diabetics.
15. Remission Studies in Early T2D Through Diet-Exercise Synergy
    • Role of low-carbohydrate diets, time-restricted eating, or protein pacing paired with exercise in achieving diabetes remission.

Prof. Dr. Sangeeta Rao Kashyap
Guest Editor

Manuscript Submission Information

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• obesity
• nutrition
• diet
• exercise
• caloric restriction
• type 2 diabetes