title: Three-year effects on dietary quality of health education: a randomized controlled trial of people with screen-detected dysglycaemia (The ADDITION study, Denmark).
abstract: BACKGROUND
  Healthy diet is a core component in prevention and self-management of type 2 diabetes and cardiovascular disease. The long-term efficacy was assessed of a theory-based health education programme 'Ready to Act' on dietary quality in people with screen-detected dysglycaemia.
  
  
  METHODS
  Five hundred and nine adults with prediabetes (impaired glucose tolerance, impaired fasting glycaemia) or type 2 diabetes were recruited through screening for type 2 diabetes [the ADDITION (Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care) study, DK] and then randomly assigned to health education or to a control group (I = 322; C = 187). The intervention group was offered a 12-week programme in health-related action competence including 2 one-to-one and 8 group sessions (18 h). Dietary quality was measured by the Dietary Quality Score_revised (0-8 points) at baseline and at one- and 3-year follow-up. Changes were analysed by multilevel analyses.
  
  
  RESULTS
  The analysis included data from 444 participants (87%). At the 3-year follow-up, the intervention group had significantly increased dietary quality compared with the control group (net change: 0.39 Dietary Quality Score_revised points, P = 0.04). The intake of unsaturated fats used on bread and for cooking increased in the intervention group compared with the control group at the 3-year follow-up (net change: 31 g/week; P = 0.02). A non-significant tendency toward an increased intake of vegetables in the intervention group compared with the control group was seen (net change: 111 g/week; P = 0.16). No changes were seen in fish intake.
  
  
  CONCLUSIONS
  Health education aiming at action competence improved the long-term dietary quality in a population with dysglycaemia, especially according to the intake of unsaturated fat. The ADDITION trial was registered at ClinicalTrials.gov ID no NCT00237549.
authors.affiliation: Section for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors.forename: Helle Terkildsen
authors.initials: HT
authors.lastname: Maindal
authors.forename: Ulla
authors.initials: U
authors.lastname: Toft
authors.forename: Torsten
authors.initials: T
authors.lastname: Lauritzen
authors.forename: Annelli
authors.initials: A
authors.lastname: Sandbæk
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control; D016000:Cluster Analysis; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000517:prevention & control; D004032:Diet / Q000523:psychology* / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000175:diagnosis / Q000517:prevention & control; D044882:Glucose Metabolism Disorders / Q000175:diagnosis* / Q000517:prevention & control*; D006442:Glycated Hemoglobin / Q000032:analysis; D006126:Group Processes; D015438:Health Behavior; D006266:Health Education; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data; D012648:Self Care; D012923:Social Class; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin