Population-level effects of the national diabetes prevention programme (FIN-D2D) on the body weight, the waist circumference, and the prevalence of obesity
1 Pirkanmaa Hospital District, Tampere, Finland
2 Diabetes Prevention Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
3 Finnish Diabetes Association, Tampere, Finland
4 South Ostrobothnia Hospital District, Seinäjoki, Finland
5 Unit of Family Practice, Central Finland Hospital District, Jyväskylä, Finland
6 Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
7 Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
8 Oulu University Hospital, Northern Ostrobothnia Hospital District, Oulu, Finland
9 Department of Medicine, Kuopio University Hospital, Hospital District of Northern Savo, Kuopio, Finland
10 Department of Public Health, University of Helsinki, Helsinki, Finland
11 Research Unit, Kuopio University Hospital, Kuopio, Finland
BMC Public Health 2011, 11:350 doi:10.1186/1471-2458-11-350Published: 19 May 2011
The implementation project of the national diabetes prevention programme in Finland, FIN-D2D, was carried out in primary health care in the area of five hospital districts during 2003-2007.
The population strategy of FIN-D2D was primarily aimed at increasing the awareness of type 2 diabetes and preventing obesity. To investigate the effects of this strategy, we studied the changes in the prevalence of obesity, overweight, and central obesity among a random independent sample of individuals aged 45-74 years in the FIN-D2D area; and assessed whether they differed from a sample of individuals in the control area, which consisted of four geographical areas not participating in FIN-D2D (FINRISK study). Data was obtained for 5850/ 6406 (in the beginning/ in the end) individuals. The duration of the observation period varied from three to five years.
The mean body weight decreased from 78.7 to 78.1 kg (p = 0.041) in the FIN-D2D area, and from 78.7 to 78.0 kg (p = NS) in the control area. The prevalence of obesity (BMI ≥30 kg/m2) decreased in the FIN-D2D area (26.5% vs. 24.4%, p = 0.015), and in the control area (28.4% vs. 25.2%, p = 0.005). The prevalence of morbid obesity (BMI ≥40 kg/m2) remained unchanged in the FIN-D2D area, but increased in the control area (1.2% vs. 2.3%, p = 0.007). The mean waist circumference remained unchanged in the FIN-D2D area, but increased in the control area (92.8 vs. 94.0 cm, p = 0.005).
The prevalence of obesity may be decreasing among 45-74 year old Finns. We still need a longer time perspective and future studies to see whether this favourable trend can be sustained in Finland. The actions of this implementation project can at least partly explain the differences in the mean waist circumference and the prevalence of morbid obesity between the intervention and control areas.