Search Results (270)

Background/Objectives: Conventional ketogenic diets, although effective for weight loss, often contain high total and saturated fat intake, which leads to increased low-density lipoprotein cholesterol (LDL-C). Thus, the Healthy Ketogenic Diet (HKD) was developed to address these concerns. It emphasizes calorie restriction, limiting net carbohydrate intake to 50 g per day, prioritizing unsaturated fats, and reducing saturated fat intake. However, adherence to the HKD remains a challenge in urban, time-constrained environments. Therefore, this pilot randomized controlled trial aimed to investigate the effects of Healthy Ketogenic Diet Ready-To-Eat (HKD-RTE) meals (provided for the first month only) versus HKD alone on weight loss and metabolic parameters among overweight adults. Methods: Multi-ethnic Asian adults (n = 50) with a body mass index (BMI) ≥ 27.5 kg/m² were randomized into the HKD-RTE group (n = 24) and the HKD group (n = 26). Both groups followed the HKD for six months, with the HKD-RTE group receiving HKD-RTE meals during the first month. Five in-person workshops and mobile health coaching through the Nutritionist Buddy Keto app helped to facilitate dietary adherence. The primary outcome was the change in body weight at 6 months. Linear regression was performed on the change from baseline for each continuous outcome, adjusting for demographics and relevant covariates. Logistic regression was performed on binary weight loss ≥ 5%, adjusting for demographics and relevant covariates. Results: In the HKD group, participants’ adherence to the 50 g net carbohydrate target was 15 days, while that in the HKD-RTE group was 19 days over a period of 30 days. Participants’ adherence to calorie targets was 21 days in the HKD group and 23 days in the HKD-RTE. The average compliance with the HKD-RTE meals provided in the HKD-RTE group was 55%. The HKD-RTE group experienced a greater percentage weight loss at 1 month (−4.8 ± 3.0% vs. −1.8 ± 6.2%), although this was not statistically significant. This trend continued up to 6 months, with the HKD-RTE group showing a greater percentage weight reduction (−8.6 ± 6.8% vs. −3.9 ± 8.6%; p = 0.092). At 6 months, the HKD-RTE group had a greater reduction in total cholesterol (−0.54 ± 0.76 mmol/L vs. −0.05 ± 0.56 mmol/L; p = 0.283) and LDL-C (−0.43 ± 0.67 mmol/L vs. −0.03 ± 0.52 mmol/L; p = 0.374) compared to the HKD group. Additionally, the HKD-RTE group exhibited greater reductions in systolic blood pressure (−8.3 ± 9.7 mmHg vs. −5.3 ± 11.0 mmHg), diastolic blood pressure (−7.7 ± 8.8 mmHg vs. −2.0 ± 7.0 mmHg), and HbA1c (−0.3 ± 0.5% vs. −0.1 ± 0.4%) than the HKD group (not statistically significant for any). Conclusions: Both HKD-RTE and HKD led to weight loss and improved metabolic profiles. The HKD-RTE group tended to show more favorable outcomes. Short-term HKD-RTE meal provision may enhance initial weight loss, with sustained long-term effects. Full article

A psoriasis vulgaris flare is characterized by a rapid intensification of symptoms, which is often triggered by various factors that can worsen the condition. The risk factors for these exacerbations are numerous and include obesity, antihypertensive drugs, and psychological stress. Moreover, links have been documented between type II diabetes, hypertension, and psoriasis vulgaris. The present case report describes a 52-year-old female patient who presented at the clinic with disseminated erythematous-squamous plaques and patches covered by thick, white-pearly, easily detachable scales, along with stress, fatigue, anxiety, severe pruritus, irritability, insomnia, and decreased self-esteem. Her past medical regimen included various conventional topical options, including calcipotriol combined with betamethasone, clobetasol, betamethasone combined with salicylic acid, and betamethasone combined with gentamicin, yet the condition remained refractory, with periodic flare-ups. The integrated and personalized therapeutic approach aimed to target both the dermatological issues and the associated systemic and psychological factors contributing to the condition. The therapeutic strategy implemented in this case combined psychological counseling sessions, a very low-calorie ketogenic diet, oral supplementation with anti-inflammatory and antioxidant vitamins and minerals, topical treatments utilizing urea and Dead Sea-mineral-based formulations, and rosemary extract-based scalp care, without requiring additional conventional treatment. This comprehensive approach led to significant improvement, ultimately achieving complete remission of the patient’s psoriasis. The associated comorbidities were well controlled with the specified medication, without any further complications. Thus, the importance of alternative options was emphasized, particularly in the context of an incurable disease, along with the need for continued research to improve the ongoing therapeutic management of psoriasis vulgaris. Such approaches are essential to reducing the risk of flare-ups and to achieving better management of associated risk factors. Full article

Despite recent advances in the treatment of obesity, lifestyle medicine remains foundational to the treatment of individuals with obesity, regardless of the modality chosen by the patient with the guidance of the clinician they are working with, including in conjunction with, as appropriate, anti-obesity medications and metabolic surgery. Lifestyle medicine involves the use of diet, exercise, sleep, stress, and other lifestyle modalities in the treatment of disease. Clinicians and health systems should, after a patient-centered discussion with the patient, do their best to ensure access to lifestyle treatments. Gold standard guidelines recommend intensive, multicomponent lifestyle change programs for obesity treatments with evidence-based diet and exercise counseling and established, theoretically driven behavior change components. Clinicians treating obesity should be aware of their own biases, make efforts to reduce stigmatizing experiences in their practice, and address weight stigma in their treatment plans as needed. A variety of dietary patterns can be used to support patients with obesity, and clinicians should make evidence-based but patient-centered recommendations that aim to maximize adherence. Diet and exercise can play an important role in reducing the side effects of treatment and optimizing outcomes in weight loss, attenuating the effects of metabolic adaptation, and weight maintenance. Exercise should be increased gradually to reduce injury with a goal of 200–300 min (approximately 3.3–5 h) of moderate to vigorous intensity exercise per week to maximize weight maintenance effects with exercise prescriptions customized to patients risks. A variety of practice models can be leveraged along with the use of an interdisciplinary team to provide lifestyle medicine care for those with obesity. Full article

Westernization of traditional diets has been implicated in the rising burden of overweight/obesity and type 2 diabetes, especially in developing countries. In recent times, diet therapy is increasingly being recognized as an essential component of diabetes care. This study assessed the effect of diet therapy on body composition, antioxidant nutrient intake, and glycemic status in individuals living with type 2 diabetes (ILWT2D). In this prospective observational cohort study, 45 ILWT2D who were receiving diet therapy (personalized dietary counseling) in addition to standard medical treatment (intervention group) were compared with 45 ILWT2D receiving only standard medical treatment (comparator group). Antioxidant micronutrient intake was assessed using a 24-h dietary recall. Body composition indices, including body mass index (BMI), percentage body fat (%BF), and visceral fat (VF), were assessed. Participants’ fasting blood glucose (FBG), glycated hemoglobin (HbA1C) levels, and blood pressure (BP) were measured. All measurements were performed before and after a three-month period. There were significant improvements in BMI (27.8 ± 6.0 kg/m² vs. 26.9 ± 5.5 kg/m², p = 0.003), %BF (37.8 ± 11.9% vs. 35.5 ± 10.5%, p < 0.001), visceral fat (9.8 ± 3.4 vs. 9.1 ± 3.2, p < 0.001), systolic BP (136.9 ± 19.9 mmHg vs. 124.6 ± 13.0 mmHg, p < 0.001), FBG (8.8 ± 2.8 mmol/L vs. 6.7 ± 1.5 mmol/L, p < 0.001), and HbA1c (7.3 ± 1.0% vs. 6.4 ± 0.8%, p < 0.001) in the intervention group from baseline to endline, but not in the comparator group. In contrast, %BF increased within the comparator group (39.9 ± 7.8 vs. 40.7 ± 7.4; p = 0.029). Vitamin A intake increased significantly (227.5 ± 184.3 µg vs. 318.8 ± 274.7 µg, p = 0.038) within the intervention group but not in the comparator group (174.9 ± 154.3 µg, 193.7 ± 101.4 µg, p = 0.54). There were no significant changes in zinc, copper, selenium, and vitamin C intakes (p > 0.05) in the intervention group from the baseline to endline, unlike those in the comparator group who showed a significant increase in the intake of these nutrients. There was a significant increase in vitamin A intake among the ILWT2D who received dietary counseling as an intervention compared to those who did not. Additionally, the ILWT2D who received dietary counseling had significant improvements in their body composition (BMI, body fat, and visceral fat) and systolic blood pressure, compared to those who did not. The ILWT2D who received the intervention had significantly better glycemic control (FBG and HbA1c) than their counterparts who did not. Thus, this study suggests the potential of diet therapy as a viable non-pharmacological treatment approach for individuals living with type 2 diabetes. Full article

Background/Objectives: We evaluated the efficacy of a good lifestyle intervention on the severity of metabolic dysfunction-associated steatotic liver disease (MASLD) in children with Down syndrome (DS). Methods: This retrospective longitudinal study included 31 children with Down syndrome (DS) who were affected by MASLD and attended nutritional counseling based on a nutritional approach (e.g., Mediterranean diet and antioxidant supplements), as well as physical exercise. Clinical parameters, markers of low-grade systemic inflammation, and hepatic steatosis, as assessed by ultrasound, were evaluated at baseline (T0) and after 6 months (T1). Results: Several anthropometric and biochemical parameters, including body mass index, waist circumference, diastolic and systolic blood pressure, aspartate aminotransferase, basal insulin, insulin resistance, pro-inflammatory interleukin-1β, and anti-inflammatory interleukin-10, showed significant improvement after 6 months of a nutritional approach. This study also found a regression of at least one grade of hepatic steatosis in a significant portion of patients, especially in those who received antioxidant supplements. Conclusions: Our study further supports the hypothesis that a healthy lifestyle intervention, based on adherence to the Mediterranean diet, natural supplements with antioxidant properties, and regular physical activity, can be considered a safe therapeutic approach for reducing the risk and severity of MASLD in children with DS. Full article

Background: Obesity in adults is a growing health concern. The principal interventions used in obesity management are lifestyle-change interventions such as diet, exercise, and behavioral therapy. Although they are effective, current treatment options have not succeeded in halting the global rise in the prevalence of obesity or achieving sustained long-term weight maintenance at the population level. E-health and m-health are both integral components of digital health that focus on the use of technology to improve healthcare delivery and outcomes. The use of eHealth/mHealth might improve the management of some of these treatments. Several digital health interventions to manage obesity are currently in clinical trials. Objective: The aim of our systematic review is to evaluate whether digital health interventions (e-Health and m-Health) have effects on changes in anthropometric measures, such as weight, BMI, and waist circumference and behaviors such as energy intake, eating behaviors, and physical activity. Methods: A search was conducted for randomized controlled trials (RCTs) conducted through 4 October 2024 through three databases (Medline, Web of Science, and Scopus). Studies were included if they evaluated digital health interventions (e-Health and m-Health) compared to control groups in overweight or obese adults (BMI ≥ 25 kg/m²) and reported anthropometric or lifestyle behavioral outcomes. Study quality was assessed using the Cochrane Risk of Bias Tool (RoB 2). Meta-analyses were performed using random-effects or fixed-effects models as appropriate, with statistical significance set at p < 0.05. Results: Twenty-two RCTs involving diverse populations (obese adults, overweight individuals, postpartum women, patients with eating disorders) were included. Digital interventions included biofeedback devices, smartphone apps, e-coaching systems, web-based interventions, and mixed approaches. Only waist circumference showed a statistically significant reduction (WMD = −1.77 cm; 95% CI: −3.10 to −0.44; p = 0.009). No significant effects were observed for BMI (WMD = −0.43 kg/m²; p = 0.247), body weight (WMD = 0.42 kg; p = 0.341), or lifestyle behaviors, including physical activity (SMD = −0.01; p = 0.939) and eating behavior (SMD = −0.13; p = 0.341). Body-fat percentage showed a borderline-significant trend toward reduction (WMD = −0.79%; p = 0.068). High heterogeneity was observed across most outcomes (I² > 80%), indicating substantial variability between studies. Quality assessment revealed predominant judgments of “Some Concerns” and “High Risk” across the evaluated domains. Conclusions: Digital health interventions produce modest but significant benefits on waist circumference in overweight and obese adults, without significant effects on other anthropometric or behavioral parameters. The high heterogeneity observed underscores the need for more personalized approaches and future research focused on identifying the most effective components of digital interventions. Digital health interventions should be positioned as valuable adjuncts to, rather than replacements for, established obesity treatments. Their integration within comprehensive care models may enhance traditional interventions through continuous monitoring, real-time feedback, and improved accessibility, but interventions with proven efficacy such as behavioral counseling and clinical oversight should be maintained. Full article

Background/Objectives: The aim of this secondary analysis is to determine the baseline characteristics that are associated with a higher likelihood of weight-loss success in a personalized nutrition intervention. Methods: Data were analyzed in adults with abnormal glucose metabolism and obesity from a 6-month behavioral counseling randomized clinical trial. Participants were randomized to two calorie-restricted diets: a low-fat diet (Standardized) or a personalized nutrition diet leveraging a machine learning algorithm (Personalized). The gradient boosting machine method was used to determine the baseline variables (i.e., age, weight-loss self-efficacy) that predicted successful weight loss (≥5%) at 6 months in each study arm separately, using repeated five-fold cross-validation with 100 repetitions. Results: A total of 155 participants (Personalized: n = 84 vs. Standardized: n = 71) contributed data (mean [standard deviation]: age, 59 [10] y; 66.5% female; 56.1% White; body mass index (BMI), 33.4 [4.6] kg/m²). In both arms, higher baseline self-efficacy for weight loss was a predictor of weight-loss success. Participants with a higher BMI (p < 0.0001) in the Standardized arm and those who were older (p < 0.0001) in the Personalized arm were more likely to achieve successful weight loss. Conclusions: Future weight-loss interventions may consider providing tailored behavioral support for individuals based on weight-loss self-efficacy, BMI, and age. Full article

Infertility is a growing global phenomenon affecting millions of individuals and is characterized by multifactorial causes, including both lifestyle and environmental factors. These include smoking, chronic exposure to environmental pollutants, stress, excessive caffeine or alcohol intake, drug use, improper eating habits and physical inactivity. The potential to modify these behaviors has gained increasing interest due to its impact on reproductive health and its role in mitigating infertility. Preconception counseling has also emerged as a fundamental strategy, providing education and risk assessments to improve pregnancy outcomes. Among lifestyle factors, nutrition, body composition and physical activity significantly influence female fertility, emphasizing the strong connection between metabolism and reproductive function. Supplementation with anti-inflammatory nutrients, such as omega-3 polyunsaturated fatty acids (n-3 PUFAs), a key component of the Mediterranean diet, may offer benefits for female fertility, partially through the modulation of gene expression in reproductive tissues. However, the specific mechanisms linking diet and fertility remain unclear. The primary objective of this review is to explore how the modification of selected lifestyle factors, with particular reference to dietary habits, may positively influence the female reproductive system and improve fertility and pregnancy-related outcomes. Full article

Adolescence is a key period for the development and consolidation of habits that favour a healthy and active lifestyle. The promotion of healthy habits in this critical period of development is essential to ensure a better quality of life and the prevention of chronic diseases in the long term. This study aims to analyse how physical activity (PA) and adherence to the Mediterranean diet (MD) influence motivation towards physical education (PE) in adolescents. It also aims to explore gender differences and provide information that will allow the design of educational strategies to promote healthy lifestyle habits in schools. Method: descriptive cross-sectional quantitative study. An ad hoc socio-demographic questionnaire, the Physician-based Assessment and Counselling for Exercise, the KIDMED Mediterranean diet adherence questionnaire and the motivation in Physical Education questionnaire were administered in the school environment under direct supervision of the researchers to minimise biases in self-perception. Results: Students with higher adherence to the Mediterranean diet showed higher intrinsic motivation towards physical education (F = 5.133, p < 0.01), while those with lower adherence showed higher demotivation (F = 5.507, p < 0.01). Conclusions: The findings suggest the need to reinforce physical activity and nutrition education programmes in adolescents, promoting interdisciplinary approaches to increase adherence to healthy lifestyles. Full article

Total hip arthroplasty (THA) is the definitive treatment for end-stage hip osteoarthritis, reliably relieving pain and restoring joint function. However, patient-reported quality of life (QoL) after THA remains heterogeneous, with recovery trajectories influenced by a range of biological, psychological, and social factors. A comprehensive synthesis of these determinants is lacking, limiting our ability to optimize individualized perioperative care and long-term outcomes. This review examines the various factors impacting quality of life (QoL) before and after hip arthroplasty. An analysis of 67 studies reveals significant postoperative enhancements in physical function, pain alleviation, and overall patient satisfaction. Identified key factors encompass physical activity, mental health status (anxiety and depression), lifestyle choices (diet and weight management), and social support systems, particularly from spouses and family members. The review indicates that, although these elements positively influence recovery, it also recognizes limitations including dependence on subjective, self-reported QoL measures, possible selection biases, and inconsistencies in study design. The results indicate that a com-prehensive, patient-focused strategy—integrating organized rehabilitation, psychological assistance, and family engagement—can markedly improve recovery and long-term QoL for arthroplasty patients. Nonetheless, additional research employing standardized protocols and extended follow-up durations is essential to corroborate these findings and guide clinical practice. The early implementation of tailored, multidisciplinary perioperative pathways—including structured rehabilitation programs, routine psychological screening and intervention, nutritional counseling for weight management, and active family involvement—may optimize functional recovery, reduce complications, and maximize long-term QoL in patients undergoing THA. This review highlights the importance of a multidisciplinary approach to enhance post-surgical quality of life, thereby advancing the understanding of patient-centered recovery strategies in orthopedic care. Full article

Background/Objectives: Food allergies represent a growing public health challenge, showing an alarming increase in prevalence over the past few decades. Children with multiple food allergies face not only allergic reaction risks but also nutritional gaps, affecting diet, nutrition, and growth. This review summarizes the impact on nutrient intake and growth, highlighting key challenges and strategies to improve clinical care. Methods: The literature search was conducted using a structured search strategy in PubMed up to 31 January, using MeSH terms with Boolean operators (AND, OR) to combine searches (food hypersensitivity AND growth, food hypersensitivity AND nutrition, food hypersensitivity AND micronutrient, food hypersensitivity AND vitamin, food hypersensitivity AND trace element, and soy hypersensitivity) for human studies meeting pre-defined PICOS criteria that simultaneously assessed the reproducibility and validity. Results: Nearly 2000 studies were identified in the literature search, with 31 articles selected for full-text evaluation and 11 articles included in the final review. Dietary restrictions imposed by the need to avoid multiple allergens can lead to a reduced intake of essential nutrients, particularly proteins, calcium, iron, zinc, iodine, folate, vitamin B12, and vitamin D. Children with multiple FAs appear to be at an increased risk of impaired growth, as evidenced by the lower height-for-age, weight-for-age, head-circumference, and weight-for-length Z-scores compared to non-allergic peers. Conclusions: Evidence from the studies reviewed suggests that children with multiple FAs may be at increased risk for growth impairments and nutritional inadequacies, especially where dietary management does not adequately compensate for nutrient losses, and highlights that tailored dietary counseling is crucial. Full article

Background/Objectives: Weight management is directly linked to cancer recurrence and survival, but unfortunately, nutritional oncology counseling is not typically covered by insurance, creating a disparity for patients without nutritional education and food access. Novel ways of imparting personalized nutrition advice are needed to address this issue. Large language models (LLMs) offer a promising path toward tailoring dietary advice to individual patients. This study aimed to assess the capacity of LLMs to offer personalized dietary advice to patients with breast cancer. Methods: Thirty-one prompt templates were designed to evaluate dietary recommendations generated by ChatGPT and Gemini with variations within eight categorical variables: cancer stage, comorbidity, location, culture, age, dietary guideline, budget, and store. Seven prompts were selected for four board-certified oncology dietitians to also respond to. Responses were evaluated based on nutritional content and qualitative observations. A quantitative comparison of the calories and macronutrients of the LLM- and dietitian-generated meal plans via the Acceptable Macronutrient Distribution Ranges and United States Department of Agriculture’s estimated calorie needs was performed. Conclusions: The LLMs generated personalized grocery lists and meal plans adapting to location, culture, and budget but not age, disease stage, comorbidities, or dietary guidelines. Gemini provided more comprehensive responses, including visuals and specific prices. While the dietitian-generated diets offered more adherent total daily calorie contents to the United States Department of Agriculture’s estimated calorie needs, ChatGPT and Gemini offered more adherent macronutrient ratios to the Acceptable Macronutrient Distribution Range. Overall, the meal plans were not significantly different between the LLMs and dietitians. LLMs can provide personalized dietary advice to cancer patients who may lack access to this care. Grocery lists and meal plans generated by LLMs are applicable to patients with variable food access, socioeconomic means, and cultural preferences and can be a tool to increase health equity. Full article

Background. It is unclear if dietary education may increase adherence to the Mediterranean diet (MD). Study aim. We estimated the effect of dietary counseling on nutritional knowledge and adherence to MD in T2D adult patients. Methods. T2D patients who attended the Diabetology Center of the Grande Ospedale Metropolitano Niguarda were recruited (April to September 2019) and categorized into two groups: the intervention group (IG), receiving a 2.5-h education, and the control group (CG). The Moynihan questionnaire and the Mediterranean Diet Adherence Assessment Questionnaire (MDAAQ) were administered to estimate the overall knowledge and adherence to MD at baseline (T0), 1 week (T1), and 1 month (T2) later. Results. Seventy-two individuals (69.5 ± 8.6 years old) were included in the IG, and 52 (67.7 ± 9.2 years old) were included in the CG. All patients had sufficient dietary knowledge and intermediate adherence to MD at baseline. Those assigned to the IG showed a significant reduction in the Moynihan score from T0 (24.9 ± 2.6) to T1 (20.3 ± 1.8; p < 0.001) and T2 (20.4 ± 2.2; p < 0.001). CG had the same Moynihan score as IG individuals at T0 (24.8 ± 1.8), but their dietary knowledge was unchanged at T1 and T2 (24.9 ± 1.8). MD adherence was similar at each time in the IG, with a MDAAQ score of 4.4 ± 1.7 (T0), 5.1 ± 1.7 (T1), and 5.3 ± 1.8 (T2), and in the CG (T0: 5.1 ± 1.7; T1: 5 ± 1.5; T2: 5.1 ± 1.5). Discussion and Conclusions. The 2.5-h dietary counseling session improves dietary knowledge, but it is not enough to improve adherence to MD. Full article

Alpha-synuclein has been associated with neurodegeneration, especially in Parkinson’s disease (PD). This study aimed to review clinical, biochemical, and neuroimaging markers and management of prodromal synucleinopathies. The prodromal state of synucleinopathies can be better understood with PD pathophysiology, and it can be separated into premotor and pre-diagnostic phases. The incidence of PD in patients with prodromal phase symptoms ranges from 0.07 to 14.30, and the most frequently studied pathology is the REM behavioral disorder (RBD). Neuroimaging markers are related to dopamine denervation, brain perfusion changes, gross anatomy changes, and peripheral abnormalities. α-synuclein assays (SAA) in CSF revealed high sensitivity (up to 97%) and high specificity (up to 92%); in the last decade, there was the development of other matrices (blood, skin, and olfactory mucosa) for obtaining quantitative and qualitative α-synuclein. Other biomarkers are neurofilament light chain, DOPA decarboxylase, and multiplexed mass spectrometry assay. Regarding genetic counseling in α-synucleinopathies, it is an important topic in clinical practice to discuss with patients with high-risk individuals and should involve basic principles of autonomy, beneficence, and non-maleficence. Some of the themes that should be reviewed are the involvement of physical activity, diet (including alcohol, coffee, and vitamin supplementation), smoking, sleep, and stress in the pathophysiology of synucleinopathies. The number of trials related to prodromal symptoms is still scarce, and the number of studies evaluating intervention is even lower. Full article

Interventions for primary prevention are crucial in tackling type 2 diabetes (T2D) by offering a structured approach to implementing lifestyle modifications, such as community-based programs. The aim of this study was to demonstrate the effectiveness of primary prevention interventions in preventing or delaying the onset of T2D in the 28 EU member states (EU-28). The present systematic review is registered on PROSPERO (CRD42020219994), and it followed the PRISMA guidelines. Eligibility criteria comprised original interventional studies reporting incidence of T2D in member states of the EU-28. A total of 23,437 records were initially retrieved, of which 16 met the eligibility criteria for inclusion. These interventional studies, published between 2003 and 2021, provided data from Spain, the UK, Finland, the Netherlands, and Denmark. Thirteen studies were of low quality, two were moderate, and one was high-quality. Three studies focused solely on dietary interventions, twelve studies combined diet, physical activity, and lifestyle counseling, and one study applied repeated health checks with personalized feedback and lifestyle advice. Overall, 10 studies reported a significant reduction in T2D incidence exclusively among high-risk individuals following the interventions with HR: 0.4 (95% CI: 0.3–0.7) to 0.75 (95% CI: 0.58–0.96). Only a few studies reported that primary lifestyle interventions decreased T2D risk, thus limiting generalizability. While lifestyle improvements were noted on high-risk groups, significant risk reduction among healthy individuals was not observed. Multicomponent interventions combining dietary modifications, physical activity, and personalized lifestyle counseling were the most effective in reducing the incidence of T2D among high-risk populations in the EU-28. Full article