***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Low serum 25-hydroxyvitamin D ( 25(OH)D ) has been shown to correlate with increased risk of type 2 diabetes . Small , observational studies suggest an action for vitamin D in improving insulin sensitivity and /or insulin secretion . The objective of the present study was to investigate the effect of improved vitamin D status on insulin resistance ( IR ) , utilising r and omised , controlled , double-blind intervention administering 100 microg ( 4000 IU ) vitamin D(3 ) ( n 42 ) or placebo ( n 39 ) daily for 6 months to South Asian women , aged 23 - 68 years , living in Auckl and , New Zeal and . Subjects were insulin resistant - homeostasis model assessment 1 (HOMA1)>1.93 and had serum 25(OH)D concentration < 50 nmol/l . Exclusion criteria included diabetes medication and vitamin D supplementation > 25 microg ( 1000 IU)/d . The HOMA2 computer model was used to calculate outcomes . Median ( 25th , 75th percentiles ) serum 25(OH)D(3 ) increased significantly from 21 ( 11 , 40 ) to 75 ( 55 , 84 ) nmol/l with supplementation . Significant improvements were seen in insulin sensitivity and IR ( P = 0.003 and 0.02 , respectively ) , and fasting insulin decreased ( P = 0.02 ) with supplementation compared with placebo . There was no change in C-peptide with supplementation . IR was most improved when endpoint serum 25(OH)D reached > or = 80 nmol/l . Secondary outcome variables ( lipid profile and high sensitivity C-reactive protein ) were not affected by supplementation . In conclusion , improving vitamin D status in insulin resistant women result ed in improved IR and sensitivity , but no change in insulin secretion . Optimal vitamin D concentrations for reducing IR were shown to be 80 - 119 nmol/l , providing further evidence for an increase in the recommended adequate levels . Registered Trial No. ACTRN12607000642482 Abstract Aims /hypothesisThe objective of this prevention programme was to study whether combining pioglitazone with lifestyle modification would enhance the efficacy of lifestyle modification in preventing  type 2 diabetes in Asian Indians with impaired glucose tolerance . Methods In a community-based , placebo-controlled 3 year prospect i ve study , 407 participants with impaired glucose tolerance ( mean age 45.3 ± 6.2 years , mean BMI 25.9 ± 3.3 kg/m2 ) were sequentially grouped to receive either : lifestyle modification plus pioglitazone , 30 mg ( n = 204 ) or lifestyle modification plus placebo ( n = 203 ) . The participants and investigators were blinded to the assignment . The primary outcome was development of diabetes . Results At baseline , both groups had similar demographic , anthropometric and biochemical characteristics . At year 3 , the response rate was 90.2 % . The cumulative incidence of diabetes was 29.8 % with pioglitazone and 31.6 % with placebo ( unadjusted HR 1.084 [ 95 % CI 0.753–1.560 ] , p = 0.665 ) . Normoglycaemia was achieved in 40.9 % and 32.3 % of participants receiving pioglitazone and placebo , respectively ( p = 0.109 ) . In pioglitazone group , two deaths and two non-fatal hospitalisations occurred due to cardiac problems ; in the placebo group there were two occurrences of cardiac disease . Conclusions /interpretationDespite good adherence to lifestyle modification and drug therapy , no additional effect of pioglitazone was seen above that achieved with placebo . The effectiveness of the intervention in both groups was comparable with that of lifestyle modification alone , as reported from the Indian Diabetes Prevention Programme-1 . The results are at variance with studies that showed significant relative risk reduction in conversion to diabetes with pioglitazone in Americans with IGT . An ethnicity-related difference in the action of pioglitazone in non-diabetic participants may be one explanation . Trial registration : Clinical Trials.gov NCT00276497 Funding : This study was funded by the India Diabetes Research Background Expert bodies and health organisations recommend that adults undertake at least 150 min.week−1 of moderate-intensity physical activity ( MPA ) . However , the underpinning data largely emanate from studies of population s of European descent . It is unclear whether this level of activity is appropriate for other ethnic groups , particularly South Asians , who have increased cardio-metabolic disease risk compared to Europeans . The aim of this study was to explore the level of MPA required in South Asians to confer a similar cardio-metabolic risk profile to that observed in Europeans undertaking the currently recommended MPA level of 150 min.week−1 . Methods Seventy-five South Asian and 83 European men , aged 40–70 , without cardiovascular disease or diabetes had fasted blood taken , blood pressure measured , physical activity assessed objective ly ( using accelerometry ) , and anthropometric measures made .  Factor analysis was used to summarise measured risk biomarkers into underlying latent ‘ factors ’ for glycaemia , insulin resistance , lipid metabolism , blood pressure , and overall cardio-metabolic risk . Age-adjusted regression models were used to determine the equivalent level of MPA ( in bouts of ≥10 minutes ) in South Asians needed to elicit the same value in each factor as Europeans undertaking 150 min.week−1 MPA . Findings For all factors , except blood pressure , equivalent MPA values in South Asians were significantly higher than 150 min.week−1 ; the equivalent MPA value for the overall cardio-metabolic risk factor was 266 ( 95 % CI 185 - 347 ) min.week−1 . Conclusions South Asian men may need to undertake greater levels of MPA than Europeans to exhibit a similar cardio-metabolic risk profile , suggesting that a conceptual case can be made for ethnicity-specific physical activity guidance . Further study is needed to extend these findings to women and to replicate them prospect ively in a larger cohort Background — Body mass index ( BMI ) is widely used to assess risk for cardiovascular disease and type 2 diabetes . Cut points for the classification of obesity ( BMI > 30 kg/m2 ) have been developed and vali date d among people of European descent . It is unknown whether these cut points are appropriate for non-European population s. We assessed the metabolic risk associated with BMI among South Asians , Chinese , Aboriginals , and Europeans . Methods and Results — We r and omly sample d 1078 subjects from 4 ethnic groups ( 289 South Asians , 281 Chinese , 207 Aboriginals , and 301 Europeans ) from 4 regions in Canada . Principal components factor analysis was used to derive underlying latent or “ hidden ” factors associated with 14 clinical and biochemical cardiometabolic markers . Ethnic-specific BMI cut points were derived for 3 cardiometabolic factors . Three primary latent factors emerged that accounted for 56 % of the variation in markers of glucose metabolism , lipid metabolism , and blood pressure . For a given BMI , elevated levels of glucose- and lipid-related factors were more likely to be present in South Asians , Chinese , and Aboriginals compared with Europeans , and elevated levels of the blood pressure – related factor were more likely to be present among Chinese compared with Europeans . The cut point to define obesity , as defined by distribution of glucose and lipid factors , is lower by ≈6 kg/m2 among non-European groups compared with Europeans . Conclusions — Revisions may be warranted for BMI cut points to define obesity among South Asians , Chinese , and Aboriginals . Using these revised cut points would greatly increase the estimated burden of obesity-related metabolic disorders among non-European population High prevalence of type 2 diabetes ( T2D ) is seen in some immigrant groups in Western countries , particularly in those from the Indian subcontinent . Our aims were to increase the physical activity ( PA ) level  in a group of Pakistani immigrant men , and to see whether any increase was associated with reduced serum glucose and insulin concentrations . The intervention was developed in collaboration with the Pakistani community . It used a social cognitive theory framework and consisted of structured supervised group exercises , group lectures , individual counselling and telephone follow-up .  One- hundred and fifty physically inactive Pakistani immigrant men living in Oslo , Norway , were r and omised to either a control group or an intervention group . The 5-month intervention focused on increasing levels of PA  , which were assessed by use of accelerometer ( Actigraph MTI 7164 ) recordings . Risk of diabetes was assessed by serum glucose and insulin concentrations determined in a fasted state , and after an oral glucose tolerance test ( OGTT ) . ANCOVA was used to assess differences between groups . There was a mean difference in PA between the two groups of 49 counts per minute per day , representing a 15 % ( 95 % CI = 8.7–21.2 ; P = 0.01 ) higher increase in total PA level in the intervention group than in the control group . Insulin values taken 2 h after an OGTT were reduced in the intervention group by 27 % ( 95 % CI = 18.9–35.0 ; P = 0.02 ) more than those in the control group . There were no differences in fasting or postpr and ial glucose values between the groups at the follow-up test . This type of intervention can increase PA and reduce serum insulin in Pakistani immigrant men , thereby presumably reducing their risk of T2D Introduction Type 2 diabetes ( T2D ) is a major health concern among population s of South Asian ethnicity . Although dietary and physical activity interventions may reduce the risk of T2D , the effectiveness has been moderate among South Asians . This might ( in part ) be because this subgroup follows strategies that were originally developed for interventions among other population s. Therefore , this review aims to assess the evidence for the current dietary and physical activity strategies recommended in T2D prevention intervention studies and guidelines for South Asians . Methods and analysis Included will be all studies and guidelines on dietary and /or physical activity strategies to prevent T2D in adult South Asians . Two review ers will search online data bases from their start until the present date for published and unpublished experimental/quasiexperimental studies , with at least an abstract in English . References of identified articles and key review s will be screened for additional studies . Guidelines will be identified by search es in online data bases and websites of public organisations . Finally , expert consultations will be held to supplement any missing information . Trial quality will be assessed with the Quality Assessment Tool for Quantitative Studies Data , and guidelines with the Appraisal of Guidelines for Research & Evaluation II . Data on the strategies recommended , targeting and evidence on effectiveness will be extracted by two review ers and presented in tabular and narrative forms . Recommendations will be compared with the National Institute for Health and Care Excellence guidelines [ PH35 ] . Overall findings on  dietary and physical activity recommendations , as well as findings for specific subgroups ( eg , by sex ) , will be discussed . Ethics and dissemination Ethics assessment is not required . Start date : 1 January 2016 , finishing and reporting date 31 July 2016 . Results will be published in a peer- review ed scientific journal , the project report of EuroDHYAN ( www.eurodhyan.eu ) and in a PhD dissertation . Trial registration number The protocol is registered with the International Prospect i ve Register of Systematic Review s ( PROSPERO ) registration number CRD42015027067 AIMS To assess the beneficial effects of the components of lifestyle intervention in reducing incidence of diabetes in Asian Indian men with impaired glucose tolerance ( IGT ) in India . METHODS This analysis was based on a 2 year prospect i ve , r and omized controlled primary prevention trial in a cohort of Asian Indian men with IGT ( n=537 ) ( Clinical Trial No : NCT00819455 ) . Intervention and control groups were given st and ard care advice at baseline . Additionally , the intervention group received frequent , mobile phone based text message reminders on healthy lifestyle principles .  Dietary intake and physical activity habits were recorded by vali date d question naires . The lifestyle goals were : reductions in consumption of carbohydrates , oil , portion size and body mass index of at least 1 unit ( 1 kg/m(2 ) ) from baseline and maintenance of good physical activity . The association between diabetes and lifestyle goals achieved was assessed using multiple logistic regression analyses . Changes in insulin sensitivity ( Matsuda 's insulin sensitivity index ) and oral disposition index during the follow-up were assessed . RESULTS At the end of the study , 123 ( 23.8 % ) participants developed diabetes  . The mean lifestyle score was higher in the intervention group compared with control ( 2.59 ± 1.13 vs. 2.28 ± 1.17 ; P=0.002 ) . Among the 5 lifestyle variables , significant improvements in the 3 dietary goal were seen with intervention . Concomitant improvement in insulin sensitivity and oral disposition index was noted . Higher lifestyle score was associated with lower risk of developing diabetes ( odds ratio : 0.54 [ 95 % CI : 0.44 - 0.70 ] ; P 
    Output:
    
Intervention studies and guidelines did not reference evidence to support the effectiveness of components included in the intervention for South Asian population s in particular .