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. 2025 Jan 4;17(1):187.
doi: 10.3390/nu17010187.

The Power of Movement: Linking Physical Activity with Nutritional Health and Blood Sugar Balance in a Dalmatian Type 2 Diabetic Population

Josipa Radić  1   2 , Andrej Belančić  3 , Hana Đogaš  4 , Marijana Vučković  1 , Tina Đogaš  1 , Leida Tandara  5   6 , Marina Grubić  7 , Lucija Šolić Šegvić  1 , Ivana Novak  1 , Mislav Radić  2   8
Affiliations

The Power of Movement: Linking Physical Activity with Nutritional Health and Blood Sugar Balance in a Dalmatian Type 2 Diabetic Population

Josipa Radić et al. Nutrients. .

Abstract

Background and objectives: Regular physical activity (PA) and Mediterranean diet (MeDi) adherence independently improve glycemic control and clinical outcomes in type 2 diabetes mellitus (T2DM). This study examined the associations between PA, body composition (BC), MeDi adherence, and glycemic control in Dalmatian T2DM patients.

Materials and methods: A cross-sectional study was conducted at the University Hospital of Split (November-December 2023) during an open call for T2DM patients. Data collected included blood/urine samples, blood pressure, BC, and anthropometrics. MeDi adherence and PA were assessed via the Mediterranean Diet Service Score and the International PA Questionnaire-Short Form.

Results: Among 252 participants (median age: 67 years, IQR: 60-73; 51.6% women; median T2DM duration: 10 years, IQR: 6-20), PA levels were low (31.4%, N = 79), moderate (45.2%, N = 114), and high (23.4%, N = 59), with uniformly low MeDi adherence across groups. Low PA was associated with higher body mass index (BMI) and lower phase angle (PhA). PA negatively correlated with fat mass (FM; %) and visceral adiposity. Positive BMI predictors included FM (kg), total body water, visceral fat level, and PhA, while fat-free mass, intracellular water, and FM (%) were negative predictors. The estimated glomerular filtration rate was the only positive predictor of the total metabolic equivalent of the task score.

Conclusions: PA enhances BC and metabolic health, but inadequate MeDi adherence limits these benefits in the T2DM population. To optimize glucose control and health outcomes, public health initiatives must emphasize MeDi adherence and a combination of aerobic and resistance training.

Keywords: Mediterranean diet; body composition; physical activity; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Study participant selection protocol. Abbreviations: T2DM—type 2 diabetes mellitus, T1DM—type 1 diabetes mellitus, PA—physical activity.
Figure 2
Figure 2
Adherence to the Mediterranean diet in different levels of physical activity. Abbreviation: MDSS—Mediterranean Diet Serving Score questionnaire.
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