Integrated strategies for type 2 diabetes prevention: The role of diet and exercise

Nicola Tecce; Mattia Proganò; Davide Menafra; Annamaria Docimo; Stefano Zarrilli; Roberta Scairati; Anna Lisa Pelosi; Rosario Pivonello; Annamaria Colao; Nicola Tecce; Mattia Proganò; Davide Menafra; Annamaria Docimo; Stefano Zarrilli; Roberta Scairati; Anna Lisa Pelosi; Rosario Pivonello; Annamaria Colao

doi:10.3934/publichealth.2025024

AIMS Public Health

2025, Volume 12, Issue 2: 418-450. doi: 10.3934/publichealth.2025024

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Review Topical Sections

Integrated strategies for type 2 diabetes prevention: The role of diet and exercise

1.
Department of Clinical Medicine and Surgery, Department of Endocrinology, University Federico II of Naples, Naples, Italy
2.
Unesco Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy
These two authors contributed equally.

Received: 30 September 2024 Revised: 02 March 2025 Accepted: 17 March 2025 Published: 08 April 2025

Background
Type 2 diabetes (T2D) is a prevalent global health problem largely caused by lifestyle factors, including poor diet and physical inactivity. With the increasing incidence of T2D, effective prevention strategies are urgently needed. This review examines the role of different dietary patterns and exercise regimens in the prevention and management of T2D, focusing on their effects on glycemic control, insulin sensitivity, and cardiovascular health.
Methods
A narrative review was conducted synthesizing evidence from clinical trials, cohort studies, and meta-analyses. The review focused on the effects of low-carbohydrate diets (LCDs), Mediterranean diets (MDs), plant-based diets, high-protein diets (HPDs), and various exercise regimens, including aerobic, resistance, and high-intensity interval training (HIIT).
Results
Dietary interventions, particularly MD and plant-based diets, are associated with improved glycemic control and reduced risk of developing T2D. LCDs show short-term benefits for weight management and HbA1c reduction, although adherence remains a challenge. HPDs show mixed results, with some benefits for lipid profiles but inconsistent effects on glycemic control. Exercise programs, especially combined aerobic and resistance training, significantly improve glycemic control, insulin sensitivity, and cardiovascular risk factors. HIIT emerges as an effective option for improving metabolic health in individuals at risk for or living with T2D.
Conclusions
A combination of dietary modification and physical activity, particularly Mediterranean and plant-based diets coupled with combined aerobic and resistance exercise, appears to be the most effective strategy for the prevention and management of T2D. Future research should focus on personalized approaches that integrate both diet and exercise to tailor interventions to individual patient needs.
- type 2 diabetes,
- dietary patterns,
- exercise regimens,
- glycemic control,
- prevention strategies
Citation: Nicola Tecce, Mattia Proganò, Davide Menafra, Annamaria Docimo, Stefano Zarrilli, Roberta Scairati, Anna Lisa Pelosi, Rosario Pivonello, Annamaria Colao. Integrated strategies for type 2 diabetes prevention: The role of diet and exercise[J]. AIMS Public Health, 2025, 12(2): 418-450. doi: 10.3934/publichealth.2025024

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Abstract

Background

Type 2 diabetes (T2D) is a prevalent global health problem largely caused by lifestyle factors, including poor diet and physical inactivity. With the increasing incidence of T2D, effective prevention strategies are urgently needed. This review examines the role of different dietary patterns and exercise regimens in the prevention and management of T2D, focusing on their effects on glycemic control, insulin sensitivity, and cardiovascular health.

Methods

A narrative review was conducted synthesizing evidence from clinical trials, cohort studies, and meta-analyses. The review focused on the effects of low-carbohydrate diets (LCDs), Mediterranean diets (MDs), plant-based diets, high-protein diets (HPDs), and various exercise regimens, including aerobic, resistance, and high-intensity interval training (HIIT).

Results

Dietary interventions, particularly MD and plant-based diets, are associated with improved glycemic control and reduced risk of developing T2D. LCDs show short-term benefits for weight management and HbA1c reduction, although adherence remains a challenge. HPDs show mixed results, with some benefits for lipid profiles but inconsistent effects on glycemic control. Exercise programs, especially combined aerobic and resistance training, significantly improve glycemic control, insulin sensitivity, and cardiovascular risk factors. HIIT emerges as an effective option for improving metabolic health in individuals at risk for or living with T2D.

Conclusions

A combination of dietary modification and physical activity, particularly Mediterranean and plant-based diets coupled with combined aerobic and resistance exercise, appears to be the most effective strategy for the prevention and management of T2D. Future research should focus on personalized approaches that integrate both diet and exercise to tailor interventions to individual patient needs.

Acknowledgments

This project was funded under the National Recovery and Resilience Plan (NRRP), Mission 4, Component 2, Investment 1.3—Call for tender No. 341 of 15 March 2022 of the Italian Ministry of University and research funded by the European Union–NextGenerationEU; award number: project code PE00000003, Concession Decree No. 1550 of 11 October 2022, adopted by the Italian Ministry of University and Research, CUP C53C22000840001, project title: “ON Foods—Research and Innovation Network on Food and Nutrition Sustainability, Safety and Security—Working ON Foods”.

Authors' contribution

Nicola Tecce and Mattia Proganò contributed equally to this work and share first authorship. Annamaria Colao served as senior author and supervised the project. Davide Menafra and Annamaria Docimo contributed to the literature search and manuscript drafting. Stefano Zarrilli and Roberta Scairati participated in the data analysis and interpretation. Anna Lisa Pelosi supported the methodological review. Rosario Pivonello contributed to the critical revision of the manuscript. All authors read and approved the final version of the manuscript.

Conflict of interest

The authors declare no conflict of interest.

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