Biologic and Quality-of-Life Outcomes From the Mediterranean Lifestyle Program

Abstract

OBJECTIVE -Few multiple lifestyle behavior change programs have been designed to reduce the risk of coronary heart disease in postmenopausal women with type 2 diabetes. This study tested the effectiveness of the Mediterranean Lifestyle Program (MLP), a comprehensive lifestyle self-management program (Mediterranean low-saturated fat diet, stress management training, exercise, group support, and smoking cessation), in reducing cardiovascular risk factors in postmenopausal women with type 2 diabetes.RESEARCH DESIGN AND METHODS -Postmenopausal women with type 2 diabetes (n ϭ 279) were randomized to either usual care (control) or treatment (MLP) conditions. MLP participants took part in an initial 3-day retreat, followed by 6 months of weekly meetings, to learn and practice program components. Biological end points were changes in HbA 1c , lipid profiles, BMI, blood pressure, plasma fatty acids, and flexibility. Impact on quality of life was assessed.RESULTS -Multivariate ANCOVAs revealed significantly greater improvements in the MLP condition compared with the usual care group on HbA 1c , BMI, plasma fatty acids, and quality of life at the 6-month follow-up. Patterns favoring intervention were seen in lipids, blood pressure, and flexibility but did not reach statistical significance.CONCLUSIONS -These results demonstrate that postmenopausal women with type 2 diabetes can make comprehensive lifestyle changes that may lead to clinically significant improvements in glycemic control, some coronary heart disease risk factors, and quality of life.

Effect of a nutritional intervention promoting the Mediterranean food pattern on anthropometric profile in healthy women from the Québec city metropolitan area

“…Consistent with our findings, results from a nutritional intervention, which promoted the traditional MEDdiet over a period of 24 months, reported a significant reduction in body weight (À5.1%) and waist circumference (À2.2%) (Esposito et al, 2004). Two other studies have reported similar findings in response to a nutritional intervention promoting the MEDdiet (Castagnetta et al, 2002;Toobert et al, 2003). Surprisingly, our results did not demonstrate a significant relationship between changes in caloric intake and changes in body weight or waist circumference, although mean caloric intake decreased in response to the intervention.…”

Relationship of exercise volume to improvements of quality of life with supervised exercise training in patients with type 2 diabetes in a randomised controlled trial: the Italian Diabetes and Exercise Study (IDES)

“…Strengths of this study are that it was multicentre, thus less dependent on local factors, and of larger size and longer duration than other exercise intervention trials in patients with type 2 diabetes [24][25][26][27], including those assessing QoL and well-being measures [10][11][12][13].…”

“…From a long-term perspective, lifestyle modification might be better maintained if associated with improvement in quality of life (QoL), but results from previous trials investigating the impact of structured exercise counselling or supervised training on physical and mental health and well-being in diabetic patients are inconclusive [10][11][12][13].…”

Effects of aerobic exercise, resistance exercise or both, on patient-reported health status and well-being in type 2 diabetes mellitus: a randomised trial

“…We did, however, observe benefits of resistance exercise training for the physical component. In another randomised controlled trial in 279 post-menopausal women with type 2 diabetes mellitus [30], Toobert found that after 6 months participation in a self-directed physical activity programme including moderate aerobic activity for 30 min most days of the week and ten strength-training exercises performed twice per week improvements for HbA 1c , BMI and plasma fatty acids were significantly greater in the intervention group than in the usual care group. There were no significant between-group (experimental vs usual care) differences in the physical and mental health scores of the MOS-12, a brief version of the SF-36.…”