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Association of Psychobehavioral Variables With HOMA-IR and BMI Differs for Men and Women With Prediabetes in the PREVIEW Lifestyle Intervention

Research output: Contribution to journalJournal articleResearchpeer-review


  • Tanja C Adam
  • Mathijs Drummen
  • Ian Macdonald
  • Elli Jalo
  • Pia Siig-Vestentoft
  • J Alfredo Martinez
  • Teodora Handjiev-Darlenska
  • Jennie Brand-Miller
  • Sally Poppitt
  • Gareth Stratton
  • Mikael Fogelholm
  • Kirsi H Pietiläinen
  • Moira Taylor
  • Santiago Navas-Carretero
  • Bjorn Winkens
  • Svetoslav Handjiev
  • Roslyn Muirhead
  • Marta Silvestre
  • Nils Swindell
  • Maija Huttunen-Lenz
  • Wolfgang Schlicht
  • Tony Lam
  • Jouko Sundvall
  • Laura Råman
  • Edith Feskens
  • Thomas-Meinert Larssen
  • Angelo Tremblay
  • Anne Raben
  • Margriet Westerterp-Plantenga
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OBJECTIVE: Stress, sleep, eating behavior, and physical activity are associated with weight change and insulin resistance (IR). The aim of this analysis was the assessment of the overall and sex-specific associations of psychobehavioral variables throughout the 3-year PREVIEW intervention using the homeostatic model assessment of IR (HOMA-IR), BMI, and length of time in the study.

RESEARCH DESIGN AND METHODS: Associations of psychobehavioral variables, including stress, mood, eating behavior, physical activity (PA), and sleep, with BMI, HOMA-IR, and time spent in the study were assessed in 2,184 participants with prediabetes and overweight/obesity (n = 706 men; n = 1,478 women) during a 3-year lifestyle intervention using linear mixed modeling and general linear modeling. The study was a randomized multicenter trial using a 2 × 2 diet-by-PA design.

RESULTS: Overall, cognitive restraint and PA increased during the intervention compared with baseline, whereas BMI, HOMA-IR, disinhibition, hunger, and sleepiness decreased (all P < 0.05). Cognitive restraint and PA were negatively, whereas disinhibition, hunger, stress, and total mood disturbance were positively, associated with both BMI and HOMA-IR. Sleep duration, low sleep quality, total mood disturbance, disinhibition, and hunger scores were positively associated with HOMA-IR for men only. Participants who dropped out at 6 months had higher stress and total mood disturbance scores at baseline and throughout their time spent in the study compared with study completers.

CONCLUSIONS: Eating behavior and PA, control of stress, mood disturbance, and sleep characteristics were associated with BMI, HOMA-IR, and time spent in the study, with different effects in men and women during the PREVIEW lifestyle intervention study.

Original languageEnglish
JournalDiabetes Care
Issue number7
Pages (from-to)1491-1498
Number of pages8
Publication statusPublished - Jul 2021

Bibliographical note

© 2021 by the American Diabetes Association.

    Research areas

  • Body Mass Index, Female, Humans, Insulin Resistance, Life Style, Male, Prediabetic State

ID: 69354548