Strengths and limitations
weight loss
INSULIN SENSITIVITY
Key strengths of this study are the randomized controlled trial design, gold standard method for measuring whole-body insulin sensitivity, and the 6-month assessment of SB and PA by accelerometry. A limitation was that because of the nature of the intervention, blinding of the participants was not possible. Moreover, the food diaries were collected only twice, during 4 consecutive days (including one weekend day) before and at the end of the intervention. Detailed instructions were given and the diaries were checked with a portion picture booklet during a study visit to assure reliable reporting, but there is a risk for underreporting or altered dietary habits during data collection. According to the food diaries, energy intake did not change significantly in either group. However, the change in energy intake was correlated to the changes in body mass, BMI, and fasting plasma glucose. This may indicate that some participants (who either did or did not change their SB) possibly changed their diet, and this could have led to a weight loss or gain during the intervention, and also contributed to the plasma glucose levels.