Effects of meal preparation training on body weight, glycemia, and blood pressure: results of a phase 2 trial in type 2 diabetes

Abstract

BackgroundModest reductions in weight and small increases in step- related activity (e.g., walking) can improve glycemic and blood pressure control in type 2 diabetes mellitus (DM2). We examined changes in these parameters following training in time- efficient preparation of balanced, low- energy meals combined with pedometer- based step count monitoring.MethodsSeventy- two adults with DM2 were enrolled in a 24- week program (i.e., 15 three- hour group sessions). They prepared meals under a chef’s supervision, and discussed eating behaviours/nutrition with a registered dietitian. They maintained a record of pedometer- assessed step counts. We evaluated changes from baseline to 24 weeks in terms of weight, step counts, hemoglobin A1c (HbA1c, glycemic control), blood pressure, and eating control ability (Weight Efficacy Lifestyle WEL Questionnaire). 53 participants (73.6%) completed assessments.ResultsThere were improvements in eating control (11.2 point WEL score change, 95% CI 4.7 to 17.8), step counts (mean change 869 steps/day, 95% CI 198 to 1,540), weight (mean change −2.2%; 95% CI −3.6 to −0.8), and HbA1c (mean change −0.3% HbA1c, 95% CI −0.6 to −0.1), as well as suggestion of systolic blood pressure reduction (mean change −3.5 mm Hg, 95% CI −7.8 to 0.9). Findings were not attributable to medication changes. In linear regression models (adjusted for age, sex, ethnicity, insulin use, season), a −2.5% weight change was associated with a −0.3% HbA1c change (95% CI −0.4 to −0.2) and a −3.5% systolic blood pressure change (95% CI −5.5 to −1.4).ConclusionsIn this ‘proof of concept’ study, persistence with the program led to improvements in eating and physical activity habits, glycemia reductions, and suggestion of blood pressure lowering effects. The strategy thus merits further study and development to expand the range of options for vascular risk reduction in DM2.

Effectiveness of lifestyle change plus dental care (LCDC) program on improving glycemic and periodontal status in the elderly with type 2 diabetes

“…The difference of HbA1c in the intervention and the control groups were −0.29% and +0.09%, respectively with a statistically significant difference consistent with a previous study regarding the effect of changes in diet on HbA1c for 3 months which found the difference of HbA1c in the intervention was −0.83% with a statistically significant difference [21]. In other previous studies, meal preparation training also decreased HbA1c (0.3%) after 6 month follow up [22] and lifestyle counseling in the primary care setting also decreased HbA1c [23]. However, the effect of changes in supportive telephone counseling on HbA1c for 18 months did not present a statistically significant difference between the intervention and the control groups [24].…”

Effectiveness of a Lifestyle Intervention in Patients with Type 2 Diabetes: The Physical Activity and Nutrition for Diabetes in Alberta (PANDA) Trial

“…Elsewhere, a 24-week meal preparation intervention was conducted in T2D patients. The program successfully reduced weight, A1c, and there was a trend toward lower blood pressure but sodium intake was not documented [37]. Our study showed a significant reduction in systolic blood pressure by 4.1 mm Hg and diastolic blood pressure by 1.7 mm Hg.…”

Strategies to Optimize Participation in Diabetes Prevention Programs following Gestational Diabetes: A Focus Group Study

“…With respect to item (6), as a starting point for discussion, we described an intervention approach that we have pilot tested in adults with DM2 [16] that included meal preparation training (‘cooking lessons’) combined with nutrition education and pedometer-based self-monitoring. This approach has demonstrated clinically-important improvements in glycemic control (i.e., 0.3% reduction over 6 months in hemoglobin A1C) that correlate with small weight changes.…”

“…Time-efficient, balanced meals were prepared in small groups under a chef’s supervision, with concurrent discussion with a dietitian. This was combined with pedometer-based self-monitoring [16]. Of note, neither the moderator nor co-moderator of the focus groups was involved in this latter study.…”