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

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-LenzWolfgang Schlicht, Tony Lam, Jouko Sundvall, Laura Råman, Edith Feskens, Thomas-Meinert Larssen, Angelo Tremblay, Anne Raben, Margriet Westerterp-Plantenga

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


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
Pages (from-to)1491-1498
JournalDiabetes Care
Issue number7
Early online date4 Jun 2021
Publication statusPublished - Jul 2021


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