Effect of a nutrition education programme on the metabolic syndrome in type 2 diabetes mellitus patients at a level 5 Hospital in Kenya: “a randomized controlled trial”

Abstract

Background Type 2 diabetes mellitus (T2D), is a life-threatening condition of global public health concern. It worsens in the presence of the metabolic syndrome (MetS), a complex disorder characterized by co-occurrence of at least three of such factors as hypertension, obesity, dyslipidemia and insulin resistance. However, lifestyle interventions reduce the risk of both MetS and T2D, and nutrition education can empower individuals on the appropriate, lifestyle changes. The aim of the current study was to evaluate the effect of a nutrition education programme, with and without inclusion of peer to peer support, on MetS in T2D patients. Methods This was a randomized controlled trial with two intervention groups and one control. One of the intervention groups involved a nutrition education programme with peer-to-peer support (NEP); the other involved only the education program, while the control received standard care. Each group had 51 participants. The nutrition education programme was conducted for 2 h per week for 8 weeks. In addition, the NEP had weekly peer-to-peer interactions for 8 weeks. All groups had follow-up sessions for 6 months. Data on MetS risk factors as well as food intake patterns and physical activity levels were taken at baseline and at different time points during the study. Analysis of Co-variance and regression were used in the analysis. Results The MetS prevalence improved in the NEP (90 to 52%) and NE (86 to 69%), while it worsened in C (88 to 91%). There was improvement in the mean values of the anthropometric parameters in the NEP and NE which worsened in the control group. There was a general improvement in mean values of blood lipids, fasting blood glucose and HbA1c in all the groups, with NEP showing the greatest improvements, followed by NE, except for triglycerides and HDL where the control group had better improvement than the NE. Changes in the anthropometric and metabolic indicators mirrored the changes in food intake patterns and physical activity, where the greatest improvements occurred in the NEP. Conclusions Nutrition education with inclusion of peer to peer support was of clinical benefit in improving metabolic outcomes and reducing MetS in T2DM patients. Trial registration The study has been registered retrospectively by Pan African Clinical Trial Registry; Registration No: PACTR201910518676391 .

Individual Diet Modification Reduces the Metabolic Syndrome in Patients Before Pharmacological Treatment

“…Nutrition education programs conducted in other countries have shown the effectiveness of this method in reducing some MetS risk factors [ 43 , 44 ]. In our study, lower waist circumference, fat mass, fasting glucose, total cholesterol, and LDL-cholesterol and higher HDL-cholesterol showed post-intervention in the INEG.…”

“…A longer study period is recommended to demonstrate long-term effects. However, the study period of 2–3 months is typical for this type of study [ 36 , 43 ].…”

Low Reported Adherence to the 2019 American Diabetes Association Nutrition Recommendations among Patients with Type 2 Diabetes Mellitus, Indicating the Need for Improved Nutrition Education and Diet Care

“…Previous studies in Greece have revealed suboptimal nutrition knowledge among patients with DM [24][25][26], highlighting the need for an integrated approach to patient education. In parallel, randomized controlled trials (RCTs) have unanimously revealed improvements in glycemic control and disease prognosis following the implementation of nutrition education sessions [27,28]. In a study conducted in the USA [29] (Table 4), patients with T1DM and T2DM were educated on nutritional issues by an RDN and set individual goals based on the ADA/Morrison Health Care (MHC) recommendations.…”

Group-Based Lifestyle Intervention Strategies for Metabolic Syndrome: A Scoping Review and Strategic Framework for Future Research

“…Most studies were randomised controlled trials (RCTs) [16][17][18][19][20][21][22][23][24][25], followed by pre-post design [26][27][28][29][30][31][32] (Table 1). Five interventions were conducted in the United States [17,18,26,[29][30][31][32].…”

“…Seven studies were conducted among adults with MetS or at risk for the syndrome without other medical conditions [16][17][18]24,27,28,30,33]. Three studies were conducted among adults with other medical issues and increased risk for MetS [25,29,31,32], while two interventions were conducted among obese adults [19,20,23]. National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III (NCEP ATP III) criteria were the most commonly used MetS definition for patient inclusion [16,[21][22][23]26], followed by International Diabetes Federation (IDF) [17][18][19][20] and Joint Interim Societies (JIS) Harmonised criteria [27,28].…”