Effect of intensive dietetic interventions on weight and glycaemic control in overweight men with Type II diabetes: a randomised trial

Abstract

OBJECTIVE:To investigate the effectiveness of intensive innovative methods for implementing dietary prescriptions on weight management and glycaemic control in overweight men with Type II diabetes. DESIGN: A randomised clinical trial with a 12-week intervention period F three isocaloric dietary intervention groups (intermittent energy restriction, pre-portioned meals and self-selected meals) each with weekly dietitian contact F and a followup visit after 18 months. SUBJECTS: A total of 51 men with Type II diabetes (mean age 54 y, mean body mass index (BMI) 31.7 kg/m 2 ). MEASUREMENTS: Weight, body composition, waist circumference, glycaemic control (HbA 1c ) and blood lipids. RESULTS: For all subjects, intensive diet therapy over the 12-week intervention period resulted in a mean reduction in energy intake of 236072780 kJ/day (5647665 kcal/day) and significant reductions in weight (6.474.6 kg), waist circumference (8.174.6 cm), percent body fat (1.971.5%), HbA 1c (1.071.4%) and triglyceride levels (0.370.6 mmol/l) compared to baseline levels. Intervention group did not affect clinical outcomes, with the exception of percent body fat. A total of 27 (52.9%) subjects attended the 18-month follow-up visit. At this visit, none of the improvements in clinical parameters was maintained, with all parameters returning to preintervention levels. CONCLUSIONS: A dietary prescription of 6000-7000 kJ/day (1400-1700 kcal/day) was effective in achieving a 6% weight loss and improving glycaemic control. The method of implementation made no difference to the outcomes between groups at 12 weeks or 18 months. Thus, we propose that it was the intensive weekly contact with a health professional in combination with moderate energy restriction that facilitated the successful short-term results seen.

Long-term effects of advice to consume a high-protein, low-fat diet, rather than a conventional weight-loss diet, in obese adults with Type 2 diabetes: one-year follow-up of a randomised trial

“…In contrast to our results and others [17], similar trials performed in non-diabetic, obese individuals have reported long-term weight loss principally due to reductions in fat mass [21,22]. This preferential loss of LBM in Type 2 diabetes may be due to a higher whole-body proteolytic rate associated with moderate hyperglycaemia [23].…”

“…The amount of weight lost after the initial energy restriction period was comparable to previous studies over 10 to 12 weeks in patients with Type 2 diabetes [17,18]. Consistent with other studies, both groups regained weight during follow-up, but maintained a net weight loss at Week 64 [6,19].…”

“…Other studies have reported comparable results in healthy obese [34] hyperinsulinaemic subjects [35] or people with Type 2 diabetes [17]. In particular the latter study showed increases in HDL-C despite no net loss of fat at 18 months.…”

A randomised control trial comparing lifestyle groups, individual counselling and written information in the management of weight and health outcomes over 12 months

“…27 Other studies have indicated that the effects of lifestyle interventions are often modest. 7,9 A randomised trial, which assigned 423 overweight people to a structured commercial weight loss programme or self-help programme, observed mean (7s.d.)…”

Endoscopic Treatment of Metabolic Syndrome

“…However,in previous studies, it was observed that a strict calorie restriction, as performed in the first weeks after bariatric surgery, could bring itself to a normalization of plasma glucose and insulin levels before body weight decrease [19,20].…”