Abstract
ObjectiveTo test the effectiveness of a dance program to improve fitness and adherence to physical activity in subjects with type 2 diabetes and obesity.Research Design and MethodsFollowing a motivational interviewing session, 100 subjects with diabetes and/or obesity were enrolled either in a dance program (DP, n = 42) or in a self-selected physical activity program (SSP, n = 58), according to their preferences. Outcome measures were reduced BMI/waist circumference, improved metabolic control in type 2 diabetes (−0.3% reduction of HbA1c) and improved fitness (activity expenditure >10 MET-hour/week; 10% increase in 6-min walk test (6MWT)). Target achievement was tested at 3 and 6 months, after adjustment for baseline data (propensity score).ResultsAttrition was lower in DP. Both programs significantly decreased body weight (on average, −2.6 kg; P < 0.001) and waist circumference (DP, −3.2 cm; SSP, −2.2; P < 0.01) at 3 months, and the results were maintained at 6 months. In DP, the activity-related energy expenditure averaged 13.5 ± 1.8 MET-hour/week in the first three months and 14.1 ± 3.0 in the second three-month period. In SSP, activity energy expenditure was higher but highly variable in the first three-month period (16.5 ± 13.9 MET-hour/week), and decreased in the following three months (14.2 ± 12.3; P vs. first period < 0.001). At three months, no differences in target achievement were observed between groups. After six months the odds to attain the MET, 6MWT and A1c targets were all significantly associated with DP.ConclusionDance may be an effective strategy to implement physical activity in motivated subjects with type 2 diabetes or obesity (Clinical trial reg. no.NCT02021890, clinicaltrials.gov).
Highlights
After six months the odds to attain the Metabolic equivalent (MET), 6-min walk test (6MWT) and A1c targets were all significantly associated with Dance program (DP)
Lifestyle changes aiming at healthy diet and habitual physical activity are mandatory for the prevention and treatment of type 2 diabetes [1], as well as in other metabolic disorders [2]
During a recruitment session carried out according to the principles of motivational interviewing [17], the patients were asked to select two different physical activity options: a) a standard ballroom and Latin dance program (DP) organized twice a week by diabetes associations, or b) a self-selected program (SSAP), with the option to receive support from sport associations, for training sessions to be carried out at least twice weekly
Summary
Lifestyle changes aiming at healthy diet and habitual physical activity are mandatory for the prevention and treatment of type 2 diabetes [1], as well as in other metabolic disorders [2]. Dietary restrictions and physical activity promote weight loss, reduce the progression from prediabetes to diabetes [3], improve metabolic control and reduce the long-term risk of complications, at any stage of disease severity. Specific programs to increase motivation and adherence to physical activity have been developed in subjects with type 2 diabetes [9], following the seminal experience of the Diabetes Prevention Program [10]. Both the metabolic control and the cardiovascular risk profile improve in parallel with the increased participation in structured physical activity programs [11,12]. Procedures and strategies derived from motivational interviewing and cognitive-behavior therapy are rarely applied outside research settings, and most patients continue to receive suboptimal or ineffective treatments
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