A new long-term study underscores the importance of diet and physical activity over medication alone in preventing multiple chronic conditions among adults with prediabetes, highlighting practical steps to improve health outcomes.
Healthy eating and regular exercise remain two of the most reliable ways to reduce the risk of chronic illness, and a recent study has added weight to that view. Researchers following adults with prediabetes for more than two decades found that a structured lifestyle programme was linked to a lower long-term risk of developing multiple chronic conditions, while metformin alone was not associated with the same benefit. The trial, published in JAMA and supported by the National Institutes of Health, reinforces the idea that day-to-day habits can have effects that stretch far beyond blood sugar control.
That finding is especially relevant for people at risk of type 2 diabetes, because the study compared three approaches: lifestyle change, metformin and placebo. According to the JAMA analysis, the lifestyle arm was associated with a lower burden of multimorbidity over 21 years of follow-up. The American College of Cardiology’s review of the work said metformin did not produce a statistically significant reduction in multimorbidity risk versus placebo, underlining the limits of medicine when it is not paired with broader behaviour change.
The broader message from the nutrition literature is that weight loss alone is not the only goal. A follow-up analysis of the CENTRAL and DIRECT-PLUS trials, summarised by the American College of Cardiology and published in Circulation, found that reducing visceral fat , the fat stored deep around the organs , was associated with sustained metabolic gains, even when some weight returned later. The benefit matters because visceral fat is strongly tied to insulin resistance, fatty liver disease and cardiometabolic risk.
For that reason, doctors and dietitians often focus on waist size, food quality and physical activity rather than the bathroom scale alone. The research summaries point to a pattern: fewer refined carbohydrates, more protein and fibre, healthier fats, and consistent movement all support lower risk. A Mediterranean-style diet, adapted so that it is not overloaded with starch and sugar, is one practical route. So is a routine that includes walking after meals and keeping highly processed foods to a minimum.
Salt intake is another area where the evidence is clear. The article’s argument that excessive sodium damages blood vessels and raises the risk of high blood pressure fits with longstanding public health advice to cut back on added salt and favour fresh foods. The safest approach is to use less salt in cooking, avoid habits such as drinking salted water, and rely instead on vegetables, fruit, pulses, whole grains and unsalted nuts for flavour and nutrition. If salt is used, it should be iodised and sparing.
There is also growing interest in gut health, but the strongest advice remains straightforward: food first. Fermented dairy such as yoghurt and kefir, along with fibre-rich foods, fruit, nuts, legumes, onions and garlic, can help support a varied microbiome, according to the article’s summary of current nutrition thinking. The key takeaway from the newer studies is not that one product or supplement can prevent disease, but that sustained, practical changes to eating patterns can reduce risk over time.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
