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


METHODS
Seventy- 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.


RESULTS
There 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).


CONCLUSIONS
In 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.
Department of Medicine, McGill University, Montreal, QC, Canada. kaberi.dasgupta@mcgill.ca
Kaberi
K
Dasgupta
Samantha
S
Hajna
Lawrence
L
Joseph
Deborah
D
Da Costa
Stavroula
S
Christopoulos
Rejeanne
R
Gougeon
D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D004032:Diet; D002149:Energy Intake; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D038321:Glycemic Index; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008019:Life Style; D016014:Linear Models; D008297:Male; D062407:Meals; D008875:Middle Aged; D010353:Patient Education as Topic; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016138:Walking
D006442:Glycated Hemoglobin