Randomized Controlled Trial of a New Dietary Education Program to Prevent Type 2 Diabetes in a High-Risk Group of Japanese Male Workers

Watanabe, Miki; Yamaoka, Kazue; Yokotsuka, Masako; Tango, Toshiro

doi:10.2337/diacare.26.12.3209

Cited by 54 publications

(69 citation statements)

References 14 publications

(10 reference statements)

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“…Information was obtained by use of the semiquantitative food-frequency questionnaire (FFQW65) [23,24]. FFQW65 consists of 65 food items for each meal with colored illustrations showing portion sizes.…”

Section: Dietary Intakementioning

confidence: 99%

Common risk factors for changes in body weight and psychological well-being in Japanese male middle-aged workers

Sagara

Hitomi

Kambayashi

et al. 2009

Environ Health Prev Med

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Objectives Overweight and poor psychological wellbeing are becoming serious health issues in the Japanese workplace. Concurrence of those physical and mental conditions has been pointed out, especially in middle-aged workers. Therefore, we tried to determine common risk factors for body weight gain and the deterioration of psychological well-being in male middle-aged office workers using a five-year follow-up study. Methods We administered General Health Questionnaire-12 (GHQ-12) as an indicator of psychological well-being to 110 male workers with ages ranging from 40-59 years, and analyzed the influence of several psychological factors, namely sense of coherence (SOC), health locus of control (HLC), and lifestyle variables such as exercise frequency, alcohol intake, smoking status, and dietary intake on changes of body mass index and GHQ-12 score. ResultsMcNemar's chi-squared test showed significant concurrence of weight gain and deterioration of psychological well-being after five-year follow-up. Low-SOC score, low frequency of exercise, and high-dietary intake at supper were significantly associated with both weight gain and poorer psychological well-being in workers, results which were supported by multiple regression analysis. Conclusions These results suggest that exercise and calorie restriction seem to prevent weight gain and promote psychological well-being in workers. Low SOC, which implies difficulty in coping with stress, may be an important risk factor not only for deterioration of psychological well-being but also for becoming overweight. These assumptions must be confirmed by conducting future intervention studies on SOC and lifestyle including exercise and eating behavior.

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Section: Dietary Intakementioning

confidence: 99%

Common risk factors for changes in body weight and psychological well-being in Japanese male middle-aged workers

Sagara

Hitomi

Kambayashi

et al. 2009

Environ Health Prev Med

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“…Em relação aos valores de glicemia, com exceção dos estudos que avaliaram a redução da incidência do diabetes mellitus tipo 2 com maior tempo de seguimento, apenas no estudo japonês 17 houve uma redução estatisticamente significante na glicemia duas horas após sobrecarga de glicose em período relativamente curto de tempo. Esses resultados sugerem a necessidade de um maior tempo de seguimento para a detecção de diferenças nos valores de glicemia em estudos epidemiológicos.…”

Section: Discussionunclassified

“…Um ensaio clínico aleatorizado controlado conduzido no Japão entre 173 homens adultos portadores de TGD avaliou o impacto de um programa educacional de estilo de vida saudá-vel na redução de glicemia plasmática após um ano de acompanhamento 17 . Os voluntários foram selecionados entre trabalhadores residentes na área metropolitana de Tóquio que apresentaram valores de glicemia duas horas após sobrecarga de glicose entre 180 e 200mg/dl.…”

Section: Recentemente Dois Grandes Ensaios Clínicos Aleatorizados Counclassified

“…Os autores observaram redução percentual média (DP) na glicemia após sobrecarga de glicose maior entre os indivíduos do grupo intervenção [-8,2 (1,9)%] em relação ao observado no grupo controle [+11,2 (3,0)%] após um ano de seguimento (p < 0,05, ANCOVA). Os autores não relataram as alterações de peso ou perfil lipídico após o período de intervenção 17 .…”

Section: Recentemente Dois Grandes Ensaios Clínicos Aleatorizados Counclassified

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Intervenção nutricional e prevenção primária do diabetes mellitus tipo 2: uma revisão sistemática

2006

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IntroduçãoEm muitos países do mundo, a prevalência do diabetes mellitus tipo 2 tem se elevado vertiginosamente, e se espera um incremento ainda maior. Nos países em desenvolvimento, há uma tendência de aumento na freqüência em todas as faixas etárias, especialmente nas mais jovens, cujo impacto negativo sobre a qualidade de vida e a carga da doença aos sistemas de saúde é imensurável 1 .O controle metabólico de indivíduos com a doença em evolução consiste em um dos maiores desafios dos serviços de saúde pública americanos e do Brasil 2,3,4 . Por isso, o desenvolvimento de programas eficazes e viáveis aos serviços públicos de saúde para a prevenção primária de diabetes mellitus tipo 2 em população de risco é necessário tanto para o controle de incidência de diabetes mellitus tipo 2 como também para a prevenção secundária de suas complicações metabólicas.Segundo relatório recente da Organização Mundial da Saúde (OMS) sobre dieta, nutrição e prevenção de doenças crônicas não-transmissíveis (DCNT), a associação entre o ganho de peso, obesidade abdominal, sedentarismo e o desenvolvimento de diabetes mellitus tipo 2 é convincente, e o consumo alimentar habitual é considerado um dos principais fatores passí-veis de modificação relacionados ao desenvolvimento de DCNT 5 .

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“…0 kg/m 2 for intervention group; fasting plasma glucose < 1400 mg/l Design: RCT over 4 years Intervention: intervention group, intensive lifestyle intervention, detailed instructions on lifestyle repeated every 3-4 months during hospital visits; control group, standard intervention Results: after 4 years a significant reduction in risk of DM by 67 . 4%; weight decrease in both groups but significantly greater in the intervention group; subjects with a low insulinogenic index † developed DM at a significantly higher rate than those with a normal index Conclusion: lifestyle intervention designed to achieve and maintain a ideal body weight (BMI < 22 kg/m 2 ) is an effective means of reducing incidence of type 2 DM in men with IGT Japanese male workers (60) n 173, age 35-70 years, workers at high risk for type 2 DM from a centre in Tokyo, Japan Design: RCT with 1 year follow up Aim: to assess the effectiveness of a new dietary education (NDE) programme in reducing plasma glucose levels Intervention: intervention group, NDE through individual counselling by a nutritionist; NDE based on dietary practices by participants, obtained by use of an FFQ; control group, conventional dietary education Results: intervention group had a significantly lower energy intake at dinner daily than the control group; intervention group had a decreased 2 h plasma glucose after 1 year whereas there was an increase in the control group with a significant percentage change Conclusions: the NDE was shown to reduce glucose levels in subjects at high risk for type 2 DM Malmo Feasibility Study (35) 6956 males from Malmo, Sweden, age 47-49 years Design: 5-year screening including an initial 6 months (randomised) pilot study, consisting of dietary treatment and/or increase of PA Intervention: emphasis on lifestyle changes; group A, patients with newly-detected type 2 DM; group B, with IGT, enrolled in the DM prevention programme; group C, non-randomised, not enrolled in the prevention programme, IGT informed their condition; group D, normal control group with normal OGTT Results: BP, lipids and hyperinsulinaemia were reduced; improvement in glucose tolerance was correlated with weight reduction and increased fitness Conclusion: long-term intervention in the form of diet and PA is feasible even on a large scale and substantial metabolic improvement can be achieved that may contribute to prevent or postpone manifest DM Reduced-fat diet (61) 176 participants with glucose intolerance, 2 h blood glucose (7 . 0-11 .…”

Section: Existing Reviews On Interventions For Diabetes Preventionmentioning

confidence: 91%

Nutrition interventions for the prevention of type 2 diabetes

2008

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Diabetes mellitus is escalating globally and it is predicted that 200 million individuals worldwide will have diabetes by 2010 and 300 million by 2025. However, there is compelling evidence from many studies that for subjects with impaired fasting glucose or impaired glucose tolerance the presentation of type 2 diabetes can be delayed by lifestyle modification. The aim of the present review is to present a summary of lifestyle modification interventions that have included a dietary component in their overall diabetes prevention programme. Medline, allied health literature and diabetes journals were searched for peer-reviewed literature using the terms 'diet*' and 'diabetes' and 'intervention'. Inclusion criteria were: peer-reviewed studies from 1975 to 2008; a sample of at least fifty subjects; a healthy eating and/or physical activity component; prevention of diabetes as a primary goal. Generally, the participants were in a high-risk category for the development of diabetes. Outcomes were evaluated at two points in time (pre-and post-intervention) in terms of knowledge, behaviour change and clinical improvement, which included weight, blood pressure, BMI, body fat, waist circumference, waist :hip ratio and physiological and/or biochemical measures. Findings indicate that the most successful interventions combine individual dietary counselling with an activity component. Further factors predicting success are weight loss achieved, duration and intensity of the intervention and dietary compliance. Nutrition interventions: Type 2 diabetes: Diabetes prevention: Lifestyle modificationWith the global escalation of diabetes mellitus it is predicted that 200 million individuals worldwide will have diabetes by 2010 (1) and 300 million by 2025 (2) . The cumulative lifetime risk of developing diabetes for individuals born in the USA in 2000 is 38 . 5 % for women and 32 . 8% for males (3) . However, there is impelling evidence from many studies that subjects with impaired fasting glucose or impaired glucose tolerance (IGT) can be delayed by lifestyle modification (4) .The Nurses' Study, in which 84 941 female nurses were followed from 1980 to 1996 was one of the first cohorts to provide evidence on the importance of lifestyle and development of type 2 diabetes (5) . A low-risk group for development of diabetes was defined as one with five variables: BMI < 25 kg/m 2 ; diet high in cereal fibre and PUFA and low in trans-fatty acids with a low glycaemic load; moderate-to-vigorous physical activity (PA) for ‡30 min/d; not smoking; consumption of on average ‡15 ml spirits or ‡ 125 ml wine daily. Furthermore, overweight or obesity was found to be the single most important predictor of diabetes. Lack of PA, unhealthy diet, smoking, and abstinence from alcohol were all shown to be associated with an increased risk of diabetes even after adjusting for BMI.It is generally accepted that b-cell dysfunction and insulin resistance are major factors involved in development of diabetes. It is proposed that subjects at risk of diabetes hav...

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Randomized Controlled Trial of a New Dietary Education Program to Prevent Type 2 Diabetes in a High-Risk Group of Japanese Male Workers

Cited by 54 publications

References 14 publications

Common risk factors for changes in body weight and psychological well-being in Japanese male middle-aged workers

Common risk factors for changes in body weight and psychological well-being in Japanese male middle-aged workers

Intervenção nutricional e prevenção primária do diabetes mellitus tipo 2: uma revisão sistemática

Nutrition interventions for the prevention of type 2 diabetes

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