title: Changes in Food Choices of Participants in the Special Diabetes Program for Indians-Diabetes Prevention Demonstration Project, 2006-2010.
abstract: BACKGROUND
  American Indians/Alaska Natives (AI/ANs) have a disproportionately high rate of type 2 diabetes. Changing food choices plays a key role in preventing diabetes. This study documented changes in the food choices of AI/ANs with diagnosed prediabetes who participated in a diabetes prevention program.
  
  
  METHODS
  The Special Diabetes Program for Indians-Diabetes Prevention Demonstration Project implemented the evidence-based Diabetes Prevention Program (DPP) lifestyle intervention in 36 health care programs nationwide, engaging 80 AI/AN communities. At baseline, at 30 days post-curriculum, and at the first annual assessment, participants completed a sociodemographic survey and 27-item food frequency questionnaire and underwent a medical examination assessing fasting blood glucose (FBG), blood pressure, body mass index (BMI), low-density lipoprotein [LDL], high-density lipoprotein [HDL], and triglycerides. Multiple linear regressions were used to assess the relationship between temporal changes in food choice and other diabetes risk factors.
  
  
  RESULTS
  From January 2006 to July 2010, baseline, post-curriculum, and first annual assessments were completed by 3,135 (100%), 2,046 (65%), and 1,480 (47%) participants, respectively. An increase in healthy food choices was associated initially with reduced bodyweight, BMI, FBG, and LDL and increased physical activity. At first annual assessment, the associations persisted between healthy food choices and bodyweight, BMI, and physical activity.
  
  
  CONCLUSIONS
  AI/AN adults from various tribal and urban communities participating in this preventive intervention made sustained changes in food choices and had reductions in diabetes risk factors. The outcomes demonstrate the feasibility and effectiveness of translating the DPP lifestyle intervention to community-based settings.
authors.affiliation: PO Box 245209, 1295 N. Martin Ave, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724. Email: teufel@email.arizona.edu.
authors.forename: Nicolette I
authors.initials: NI
authors.lastname: Teufel-Shone
authors.affiliation: University of California, Irvine, Irvine, California.
authors.forename: Luohua
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Center, Aurora, Colorado.
authors.forename: Janette
authors.initials: J
authors.lastname: Beals
authors.affiliation: Colorado Health Outcomes Program, University of Colorado Anschutz Medical Center, Aurora, Colorado.
authors.forename: William G
authors.initials: WG
authors.lastname: Henderson
authors.affiliation: US Department of Health and Human Services, San Francisco, California.
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Acton
authors.affiliation: Indian Health Service, Rockville, Maryland.
authors.forename: Yvette
authors.initials: Y
authors.lastname: Roubideaux
authors.affiliation: Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Center, Aurora, Colorado.
authors.forename: Spero M
authors.initials: SM
authors.lastname: Manson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000517:prevention & control*; D005260:Female; D005518:Food Preferences / Q000208:ethnology*; D006801:Humans; D007198:Indians, North American / Q000208:ethnology; D008019:Life Style / Q000208:ethnology*; D016014:Linear Models; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D011236:Prediabetic State / Q000517:prevention & control*; D012307:Risk Factors; D012959:Socioeconomic Factors; D014280:Triglycerides / Q000097:blood; D014481:United States / Q000208:ethnology; D055815:Young Adult
chemical_list: D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides