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A 6-month “self-monitoring” lifestyle modification with increased sunlight exposure modestly improves vitamin D status, lipid profile and glycemic status in overweight and obese Saudi adults with varying glycemic levels

Nasser M Al-Daghri12*, Hanan Alfawaz13, Naji J Aljohani14, Yousef Al-Saleh15, Kaiser Wani12, Abdullah M Alnaami12, Mohammad Alharbi6 and Sudhesh Kumar7

Author Affiliations

1 Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, King Saud University, PO Box, 2455, Riyadh 11451, Saudi Arabia

2 Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia

3 Department of Food Science and Nutrition, College of Food Science and Agriculture King Saud University, Riyadh, Saudi Arabia

4 Specialized Diabetes and Endocrine Center, King Fahad Medical City, Faculty of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11525, Saudi Arabia

5 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11461, Saudi Arabia

6 Diabetes Centers and Units Administration, Ministry of Health, Riyadh, Saudi Arabia

7 Division of Metabolic and Vascular Health, Clinical Sciences Research Institute, University Hospitals Coventry and Warwickshire Trust, Walsgrave, Coventry CV2 2DX, UK

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Lipids in Health and Disease 2014, 13:87  doi:10.1186/1476-511X-13-87

Published: 26 May 2014

Abstract

Background

The over-all age-adjusted prevalence of diabetes mellitus type 2 (DMT2) in Saudi Arabia is unprecedented at 31%. Aggressive measures should be done to curb down increasing incidence. In this prospective 6-month study we aim to determine whether a self-monitoring, life-style modification program that includes increased sunlight exposure confer improvement in vitamin D status and health benefits among adult Saudi overweight and obese patients with varying glycemic status.

Methods

A total of 150 overweight and obese Saudi adults with varying glycemic status aged 30–60 years were included in this study. They were divided into 3 groups (Non-DMT2, Pre-diabetes and DMT2). Baseline anthropometrics and blood glucose were taken at baseline and after 6 months. Fasting blood sugar, lipid profile, calcium, albumin and phosphate were measured routinely. Serum 25(OH) vitamin D was measured using standard assays. Within the time period they were instructed to reduce total intake of fat, increased fiber intake and increase sun exposure.

Results

In all groups there was a significant improvement in vitamin D levels as well as serum triglycerides, LDL- and total cholesterol. However, a significant increase in serum glucose levels was noted in the non-DMT2 group, and a significant decrease in HDL-cholesterol in both non-DMT2 and pre-diabetes group. In the pre-diabetes group, 53.2% were able to normalize their fasting blood levels after 6 months, with 8.5% reaching the DMT2 stage and 38.3% remaining pre-diabetic. In all groups there was a significant increase in the prevalence of hypertension.

Conclusion

Improving vitamin D status with modest lifestyle modifications over a short-period translates to improvement in lipid profile except HDL-cholesterol among overweight and obese Saudi adults, but not BMI and blood pressure. Findings of the present study merit further investigation as to whether full vitamin D status correction can delay or prevent onset of DMT2.

Keywords:
Vitamin D; Self-monitoring; Diabetes mellitus; Pre-diabetes; Obesity