Impact of a Short-Term Naturopathic Whole-Foods-Based Nutrition Education Intervention on Dietary Behavior and Diabetes Risk Markers: A Pilot Study

Abstract

Objective: To assess the feasibility of measuring the health impacts of a 12-week naturopathic whole foods nutrition education course among adults with or at risk for prediabetes. Design: A pilot nonrandomized pre-post intervention design investigated physiological changes associated with participation in a 12-week structured naturopathic nutrition education course. Follow-up measures were assessed at 6 and 12 months from baseline. Settings/Location: Three community-based kitchens in Oregon. Subjects: Forty-five adults with or at risk for prediabetes. Intervention: Twelve weekly 90-min workshops emphasizing the health benefits of a naturopathic whole foods diet and including collective meal preparation and communal dining. Outcome measures: Changes in biomarkers of diabetes and cardiovascular disease risk, including highsensitivity C-reactive protein (hs-CRP), hemoglobin A1c, insulin, and lipids, and changes in dietary behaviors at baseline, postintervention (12 weeks), and 6-and 12-month follow-up. Changes in biomarkers and food consumption patterns were assessed using linear mixed models with random intercept, including data from all participants who completed the end-of-intervention assessment. Results: Pre-post intervention results for 45 participants showed decreases in blood glucose and hs-CRP. Food frequency questionnaire data showed decreases in daily servings of grain, dairy, and fat postintervention. Decreases in blood glucose, hs-CRP, triglycerides, cholesterol, low-density lipoprotein, very-low-density lipoprotein, and HbA1c from baseline were observed at 12-month follow-up. Both insulin and high-density lipoprotein were decreased from baseline and 12-week levels at the 6-month follow-up but increased from all earlier levels at 12 months (all p < 0.0001). Daily servings of meat, dairy, and fat remained decreased at 6-month follow-up. Reduced grain consumption observed at 12-week and at 6-month follow-up was not sustained, and increased at 12 months, although still decreased from baseline. Conclusions: Results suggest that this naturopathic nutrition education series may promote dietary behavior change with associated changes in clinical biomarkers. Larger controlled studies are needed to confirm these results.

Nutritional Strategies in Prediabetes: A Scoping Review of Recent Evidence

“…Likewise, serum insulin levels were measured with similar classifications and recorded a comparable number of significant results (42/68 studies, 61.8%) [ 17 , 19 , 21 , 23 , 25 , 28 , 33 , 36 , 41 , 50 , 53 , 58 , 59 , 62 , 63 , 64 , 68 , 71 , 73 , 74 , 76 , 77 , 78 , 79 , 81 , 85 , 86 , 87 , 89 , 90 , 92 , 93 , 94 , 95 , 98 , 99 , 101 , 103 , 105 , 107 , 109 , 110 ]. This was followed by HbA1c, with 24 (58.5%) of 41 studies showing markedly reduced levels [ 17 , 18 , 19 , 23 , 24 , 28 , 29 , 32 ,…”

“…Food type and proportion may play important roles in determining health outcomes, as suggested by a nonrandomized study by Tippens et al, where consumption of grains, dairy, meat and fat were reduced [ 90 ]. This resulted in improved serum lipid profiles and glucose-related parameters including HbA1c, insulin and hs-CRP.…”

“…Among studies with dietetic advice, education or support as the primary intervention, seven studies evaluated participants’ eating behavior or changes in dietary intake [ 22 , 27 , 34 , 65 , 88 , 90 , 106 ]. All of them found a preponderance towards healthy eating such as reduced daily caloric, fat and alcohol intake as well as increased fiber consumption.…”

“…Thirty of 52 studies (57.7%) that investigated changes in weight and/or BMI, reported significant improvement postintervention [ 17 , 22 , 24 , 26 , 27 , 29 , 31 , 32 , 33 , 40 , 43 , 58 , 59 , 61 , 65 , 71 , 74 , 77 , 84 , 87 , 88 , 90 , 93 , 98 , 99 , 101 , 102 , 109 , 110 , 111 ]. Similar proportions of statistically significant findings were observed for the waist and hip circumferences and/or waist-to-hip ratio (17/32 studies, 53.1%) [ 17 , 18 , 24 , 26 , 32 , 33 , 38 , 58 , 61 , 62 , 84 , 87 , 88 , 101 , 102 , 108 , 109 ] as well as systolic and diastolic blood pressure (16/31 studies, 51.6%) [ 17 , ...…”

“…Of 79 studies investigating plasma glucose levels, 48 (60.8%) found significant improvements in one or more of the following categories: FPG, 2hPG and area under the postprandial curve (AUC) over variable timeframes up to 180 min [ 17 , 18 , 19 , 20 , 21 , 23 , 24 , 25 , 26 , 27 , 28 , 31 , 32 , 33 , 37 , 38 , 40 , 41 , 44 , 49 , 50 , 52 , 57 , 58 , 59 , 60 , 61 , 62 , 64 , 65 , 74 , 76 , 78 , 79 , 81 , 85 , 88 , 90 , 93 , 98 , 102 , 103 , 105 , 107 , 108 , 109 , 110 , 111 ]. Likewise, serum insulin levels were measured with similar classifications and recorded a comparable number of significant results (42/68 studies, 61.8%) [ …”