4. Discussion
T2D, eating behavior
A group and web portal-based lifestyle counseling intervention was very well welcomed by the participants based on their activity in participating in the group sessions, returning the food records, recording body weight and physical activity, and completing the tasks during the second and third years of the study, as well as through the login details on the website designed for the study.The combination of dietary modification and physical activity has been shown to be an effective combination for T2D prevention [In the present study, the main emphasis was on both the quality of the diet and physical activity. In addition, healthy body weight, eating behavior, and alcohol intake were discussed in the group sessions. Zhang and coworkers [There are only a few studies reporting the results of a group-based intervention aimed at lifestyle changes. Pletsch-Borba and coworkers [One issue to be considered in dietary counseling is the profession of the healthcare professionals in charge of counseling. In the present study, clinical nutritionists designed the information provided in group sessions and via the web portal, as well as the tasks provided during the intervention. In an SRMA by Möller at al. [New approaches for the prevention of T2D are needed to manage the huge burden the healthcare system is facing due to the increasing number of individuals at risk for T2D. In addition to the high-risk strategy, population-based strategies are also warranted for the prevention of T2D. Distant counseling approaches might be useful also for lower income countries due to their lesser demand for financial resources. The approach used in the T2D-GENE trial retained the activity level among the majority of participants during the whole 3-year intervention and provided ideas for less resource-demanding actions for the healthcare system to meet the challenge of preventing T2D.