Effects of meal preparation training on body weight, glycemia, and blood pressure: results of a phase 2 trial in type 2
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RESEARCH
Open Access
Effects of meal preparation training on body weight, glycemia, and blood pressure: results of a phase 2 trial in type 2 diabetes Kaberi Dasgupta1,2,3*, Samantha Hajna2, Lawrence Joseph2, Deborah Da Costa1, Stavroula Christopoulos1 and Rejeanne Gougeon1
Abstract 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. Keywords: Body weight, Physical activity, Patient education, Risk factors, Type 2 diabetes
Introduction Type 2 diabetes mellitus (DM2) confers a two- to fourfold risk increase for myocardial infarction (MI) and stroke and is a leading cause of renal injury and visual impairment [1]. A net weight loss of 5% or more leads to improvements in both blood pressure and glycemia, [2-6] and there is even evidence for improvements with net weight loss of as little as 2 to 5% in persons with * Correspondence: [email protected] 1 Department of Medicine, McGill University, Montreal, QC, Canada 2 Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada Full list of author information is available at the end of the article
DM2 [2]. Similarly, small increases in walking and other forms of ‘stepping activity’ have the pot
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