Abstract
Type 2 diabetes (T2D) patients often find integrating a new dietary pattern into their lifestyle challenging; therefore, the PANDA (Physical Activity and Nutrition for Diabetes in Alberta) menu plan intervention was developed to help people incorporate the Canadian Diabetes Association (CDA) nutrition therapy guidelines into their daily lives. The menu plan focused on recipes and foods that were accessible, available and acceptable to Albertans. The objective was to evaluate the effectiveness of the intervention on blood glucose control and dietary adherence and quality among patients with T2D. Participants with T2D (n = 73) enrolled in a single-arm incorporating interactive education based on a four-week menu plan that incorporated the recommendations of the CDA nutrition therapy guidelines. Post-intervention follow-up was conducted at three and six months. After three months, there were beneficial changes in A1c (−0.7%), body mass index (BMI, −0.6 kg/m2), diastolic blood pressure (−4 mmHg), total cholesterol (−63 mg/dL), HDL- (+28 mg/dL) and LDL-cholesterol (−89 mg/dL), Healthy Eating Index (+2.1 score) and perceived dietary adherence (+8.5 score) (all p < 0.05). The significant improvements in A1c, BMI and lipids were maintained at six months. The PANDA menu plan intervention was effective in improving glycemic control and diet quality. The results suggest that a dietary intervention incorporating interactive education sessions focused on menu planning with familiar, accessible foods may be effective for diabetes management.
Highlights
Diabetes is a major global health issue with over 0.5 billion individuals projected to be diagnosed by 2030 [1]
Estimated energy requirement (EER) for each participant was calculated by using the Institute of Medicine method [23] with physical activity level estimated by converting steps/day from pedometer readings to categories from sedentary (
Multiple regression analyses were used to examine the relationship between changes in body mass index (BMI), HDL-C, total calories, Healthy Eating Index (HEI) and Perceived Dietary Adherence Questionnaire (PDAQ) scores with post-intervention changes in A1c
Summary
Diabetes is a major global health issue with over 0.5 billion individuals projected to be diagnosed by 2030 [1]. Nutrition therapy can reduce glycated hemoglobin (A1c) by 1%–2%, improve serum cholesterol levels and facilitate weight management [4]. Despite these benefits, diabetic patients find it difficult to integrate a dietary pattern consistent with the recommendations into their lifestyle [5,6]. Foods must be generally available to the consumer population of interest, e.g., locally grown or regularly imported [11] Another challenge for T2D patients is translating nutrition recommendations into concrete operational plans such as food procurement, recipe selection, managing time to include food preparation, and budgeting [14]. Addressing environmental barriers may facilitate patient adoption of and adherence to dietary recommendations. The objective of this study was to evaluate the effectiveness of the menu plan plus education sessions among people with T2D in improving glycemic control and promoting dietary changes
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