Around 10-15% of adults aged over 40 years have pre-diabetes, which carries a high risk of progression to type 2 diabetes. Intensive lifestyle intervention reduces progression by as much as 58%. However, the cost and personnel requirements of these interventions are major obstacles to delivery in NHS primary care. AimTo assess the effectiveness of a low-cost intervention, delivered in primary care by non-NHS staff, to reduce the risk of diabetes through weight loss and physical activity. Design of studyPragmatic single-blind randomised controlled trial with researchers and statistician blinded to group allocation. SettingUK primary care. MethodOne-hundred and forty-one participants with a body mass index of 28 kg/m 2 or more, but without diabetes or heart disease, received either information leaflets or individual behavioural counselling using motivational interviewing techniques. The intervention was delivered by five counsellors recruited from the local community. The primary outcomes were the proportions of participants meeting predefined targets for weight loss (5%) and moderate physical activity (150 minutes/ week) after 6 months. ResultsUsing intention-to-treat analysis, more people in the intervention group achieved the weight-loss target (24% versus 7% for controls; odds ratio [OR] = 3.96; 95% confidence interval [CI] = 1.4 to 11.4; number needed to treat [NNT] = 6.1 (95% CI = 4 to 21). The proportion achieving the physical activity target did not increase significantly (38% versus 28% for controls; OR = 1.6; 95% CI = 0.7 to 3.8). ConclusionShort-term weight loss, at a level which, if sustained, is clinically meaningful for reducing diabetes risk, is achievable in primary care, without excessive use of NHS monetary or personnel resources.

The relationship between the frequency of short bouts (> or =4 s) of activity and health was as strong as relationships identified between longer bouts (> or =5 min) and health. This is encouraging as sporadic intermittent activity is characteristic of children's activity pattern.

Aims/hypothesis Adults with type 2 diabetes mellitus have impaired microvascular function. It has been hypothesised that microvascular function may be restored through regular exercise. The aim of this study was to investigate whether 6 months of regular aerobic exercise would improve microvascular function in adults with type 2 diabetes. Materials and methods Fifty-nine patients with type 2 diabetes (32 males, age 62.9±7.6 years, HbA 1c 6.8±0.9%) were randomised to either a 6-month aerobic exercise programme (30 min, three times a week, 70-80% of maximal heart rate) or a 'standard care' control group. Before and after the intervention period, microvascular function was assessed as the maximum skin hyperaemia to local heating and endothelial and non-endothelial responsiveness following the iontophoretic application of acetylcholine and sodium nitroprusside. Maximal oxygen uptake, as an index of aerobic fitness, was assessed using a maximal exercise test.

The sex difference in peak V˙O2 in 9- to 10-yr-old children is, in part, related to sex-specific changes in muscle O2 extraction dynamics during incremental exercise.

Aerobic fitness is significantly inversely related to VAT, but subcutaneous body fatness is the single strongest determinant of VAT in children aged 13-14 y.