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BMJ Open Diabetes Res Care. 2017 Mar 29;5(1):e000339. doi: 10.1136/bmjdrc-2016-000339. eCollection 2017.

Successful long-term weight loss among participants with diabetes receiving an intervention promoting an adapted Mediterranean-style dietary pattern: the Heart Healthy Lenoir Project.

Author information

1
Ambulatory Care Physician, Durham VA Medical Center, Durham, North Carolina, USA.
2
Department of Nutrition, Center for Health Promotion and Disease Prevention, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA; Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina, USA.
3
Center for Health Promotion and Disease Prevention, University of North Carolina , Chapel Hill, North Carolina , USA.
4
Department of Epidemiology , Gillings School of Global Public Health, University of North Carolina , Chapel Hill, North Carolina , USA.
5
Division of General Medicine and Clinical Epidemiology , School of Medicine, University of North Carolina , Chapel Hill, North Carolina , USA.
6
Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina, USA; Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.

Abstract

OBJECTIVE:

To examine weight change by diabetes status among participants receiving a Mediterranean-style diet, physical activity, and weight loss intervention adapted for delivery in the southeastern USA, where rates of cardiovascular disease (CVD) are disproportionately high.

RESEARCH DESIGN AND METHODS:

The intervention included: Phase I (months 1-6), an individually tailored intervention promoting a Mediterranean-style dietary pattern and increased walking; Phase II (months 7-12), option of a 16-week weight loss intervention for those with BMI≥25 kg/m2 offered as 16 weekly group sessions or 5 group sessions and 10 phone calls, or a lifestyle maintenance intervention; and Phase III (months 13-24), weight loss maintenance intervention for those losing ≥8 pounds with all others receiving a lifestyle maintenance intervention. Weight change was assessed at 6, 12, and 24-month follow-up.

RESULTS:

Baseline characteristics (n=339): mean age 56, 77% female, 65% African-American, 124 (37%) with diabetes; mean weight 103 kg for those with diabetes and 95 kg for those without. Among participants with diabetes, average weight change was -1.2 kg (95% CI -2.1 to -0.4) at 6 months (n=92), -1.5 kg (95% CI -2.9 to -0.2) at 12 months (n=96), and -3.7 kg (95% CI -5.2 to -2.1) at 24 months (n=93). Among those without diabetes, weight change was -0.4 kg (95% CI -1.4 to 0.6) at 24 months (n=154).

CONCLUSIONS:

Participants with diabetes experienced sustained weight loss at 24-month follow-up. High-risk US populations with diabetes may experience clinically important weight loss from this type of lifestyle intervention.

TRIAL REGISTRATION NUMBER:

NCT01433484.

KEYWORDS:

Dietary Intervention; Ethnic Disparities; Physical Activity Intervention(s); Weight Loss Program

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