Author(s): HE, Y., YU, A., WONG, S., POON, E., Institution: THE CHINESE UNIVERSITY OF HONG KONG, Country: CHINA, Abstract-ID: 1564

INTRODUCTION:
Prediabetes is a transitional state between normal glucose levels and diabetes. Excess body weight, accompanied by dyslipidemia, can exacerbate insulin resistance, accelerating the progression from prediabetes to diabetes. Lifestyle interventions involving exercise and diet during the prediabetes stage demonstrate effectiveness in weight management, improving lipid profiles, and reducing diabetes development rates. High-intensity interval exercise (HIIE) is a time-efficient strategy to improve metabolic health, whereas a low-carbohydrate diet (LCD) has demonstrated efficacy in improving lipid levels among diabetic patients. However, their efficacy in improving lipid profiles in prediabetic populations remains limited. Therefore, identifying feasible and effective lifestyle interventions that promote prediabetes health management is of major clinical relevance. This pilot study aimed to investigate the effect of HIIE combined with LCD for physically inactive adults with prediabetes.
METHODS:
This study was a 12-week pilot randomized trial. Thirty adults aged 40 to 64 years with prediabetes were randomly allocated to the following groups: HIIE group (performing home-based HIIE 3 times/week), LCD group (targeting carbohydrate intake at least 10% but less than 26% of total calories), or combined group (COM, combined HIIE and LCD intervention). Body composition, such as body weight (BW), body fat, and waist circumference (WC) were assessed at baseline and after 12 weeks of intervention. In addition, lipid profiles, such as total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides, were assessed by venous blood after 8 hours of fasting. Generalized estimating equations analyses were used to assess the treatment of the interventions. Statistical significance was defined as a two-sided p-value < 0.05.
RESULTS:
No significant group-by-time interaction effect was observed for BW (p = 0.059). However, a significant main effect of time was found in BW (p < 0.001) and WC (p < 0.001), indicating that the reduction of BW and WC occurred over time across all three groups. A group-by-time interaction effect was found for body fat percentage (p = 0.029). The COM group showed a larger reduction than the HIIE group (mean difference [95% confidence intervals]: -2.45% [-3.96, -0.95], p = 0.001) and the LCD group (-1.68% [-3.12, -0.24], p = 0.023). No significant time-by-group effect was observed for TC (p = 0.858) and LDL-C (p = 0.651). A significant time effect was found in HDL-C (p <0.001) and triglycerides (p = 0.01).
CONCLUSION:
All three interventions had benefits in weight loss, while the COM group had an additional effect on greater reduction of body fat compared with the other two groups. In addition to weight reduction, partial improvements in lipid profiles were observed. Low-carbohydrate and HIIE may represent viable strategies for weight and metabolic management in prediabetic individuals.