Diet Program Research Articles

Impact of Continuous Glucose Monitoring Versus Blood Glucose Monitoring to Support a Carbohydrate-Restricted Nutrition Intervention in People with Type 2 Diabetes.

Introduction: Low- and very-low-carbohydrate eating patterns, including ketogenic eating, can reduce glycated hemoglobin (HbA1c) in people with type 2 diabetes (T2D). Continuous glucose monitoring (CGM) has also been shown to improve glycemic outcomes, such as time in range (TIR; % time with glucose 70-180 mg/dL), more than blood glucose monitoring (BGM). CGM-guided nutrition interventions are sparse. The primary objective of this study was to compare differences in change in TIR when people with T2D used either CGM or BGM to guide dietary intake and medication management during a medically supervised ketogenic diet program (MSKDP) delivered via continuous remote care. Methods: IGNITE (Impact of Glucose moNitoring and nutrItion on Time in rangE) study participants were randomized to use CGM (n = 81) or BGM (n = 82) as part of a MSKDP. Participants and their care team used CGM and BGM data to support dietary choices and medication management. Glycemia, medication use, ketones, dietary intake, and weight were assessed at baseline (Base), month 1 (M1), and month 3 (M3); differences between arms and timepoints were evaluated. Results: Adults (n = 163) with a mean (standard deviation) T2D duration of 9.7 (7.7) years and HbA1c of 8.1% (1.2%) participated. TIR improved from Base to M3, 61-89% for CGM and 63%-85% for BGM (P < 0.001), with no difference in change between arms (P = 0.26). Additional CGM metrics also improved by M1, and improvements were sustained through M3. HbA1c decreased by ≥1.5% from Base to M3 for both CGM and BGM arms (P < 0.001). Diabetes medications were de-intensified based on change in medication effect scores from Base to M3 (P < 0.001). Total energy and carbohydrate intake decreased (P < 0.001), and participants in both arms lost clinically significant weight (P < 0.001). Conclusion: Both the CGM and BGM arms saw similar and significant improvements in glycemia and other diabetes-related outcomes during this MSKDP. Additional CGM-guided nutrition intervention research is needed.

The relationship between the BMI value of children and the financial situation of families, as well as the age of children

Aim: The research aimed to establish whether the family’s financial situation had an impact on the BMI values of the children studied, to determine the link between the family’s financial situation, the child’s age and the frequency children were given selected foodstuffs, as well as to verify whether the frequency of consumption of selected foodstuffs has an impact on children’s BMI values. Methods: BMI values were calculated for each child. Dietary habits were studied using a developed proprietary questionnaire. The questionnaire contained a list of products from 12 food groups, wherein vegetables and fruit were analysed separately, but without a division into those rich in vitamin C and carotene. Results: Analysis of the study group according to financial situation showed, to name a few, that the median consumption of fish, cold meats and potatoes among children from families declaring their financial situation as average was lower than that in the remaining groups. Children with a good financial situation consumed eggs and poultry statistically significantly more often than those with an average financial situation, and significantly less often - cakes and biscuits. Children over 11 years old consumed ready sauces (ketchup, mayonnaise) more often than younger children. Conclusion: The consumption of particular foodstuffs was affected by the families’ financial situation and the age of children. Children from families with an average financial situation consumed vegetables less often than the remaining children. Despite there being no effect of the frequency of particular foodstuffs consumption on BMI, one in five people were overweight. It is crucial that the healthy lifestyles and proper diet programmes are implemented in educational establishments.

Changes in anthropometry, adiposity, and inflammation in Black and White women engaged in intentional weight loss.

We examined associations among changes in anthropometry, regional adiposity, and inflammatory markers in Black and White women participating in intentional weight loss. A total of 104 women with BMI ≥ 25 kg/m2 self-selected bariatric surgery (n = 66) or a diet and exercise program (n = 38). Anthropometric, dual-energy x-ray absorptiometry-quantified regional adiposity, and inflammatory markers (C-reactive protein [CRP], tumor necrosis factor α [TNF-α], soluble TNF receptor I [sTNFRI], sTNFRII, interleukin [IL]-6, and soluble IL-1 receptor antagonist) were measured at baseline and 6 months. Weight, BMI, visceral adipose tissue, and regional (android and gynoid) adiposity declined in the bariatric surgery group. Among bariatric surgery participants, Black women experienced declines of lesser magnitude in terms of weight and BMI than White women, but changes in regional adiposity and visceral adipose tissue did not differ. In the bariatric surgery group, decreases in weight and BMI were associated with decreases in CRP and IL-6 among White women, but not Black women. Decreases in weight, BMI, and android fat were associated with increases in TNF-α, sTNFRI, and sTNFRII among Black women, but not White women. Decreases in anthropometry and adiposity were observed among Black and White bariatric surgery participants; however, associations among changes in adiposity, anthropometry, and inflammation differed by race.

Exploring the effect of diet programs on the behavior of Sudanese children with autism and the prevalence and association of gastrointestinal symptoms: a multi-center cross-sectional study.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by social difficulties, speech and nonverbal communication issues, and restricted behaviors. Nutritional issues, such as food allergies and intolerances, can affect children with ASD. This study aimed to evaluate the impact of diet programs on ASD behavior and gastrointestinal symptoms, which would be considered as a starting point to increase the family's knowledge about how to practice healthy and suitable dieting for their children. The study was a cross-sectional observational study on 45 children with an autism spectrum disorder in four centers aged 2-18 in Khartoum state. Data was collected through an interview questionnaire, which included sociodemographic, diet, gastrointestinal, and behavioral assessments. The data was analyzed using SPSS to find the correlation between the various variables. Independent t-test, Analysis of Variance, and Mann-Whitney test were used in univariant analysis to assess the association between study variables, while multiple linear regression was used in multivariant analysis for the same purpose. The study involved a large number of children with autism spectrum disorder (ASD), with 80% being male and 73.3% being school-aged. Most had parents as guardians and 71.1% were in intermediate financial status. About 20% were overweight or obese, and 57.8% did not have a specific diet program. Food selectivity was prevalent, with 22.7% having allergies to milk and wheat. ASD children experienced vomiting, gastric reflux, abdominal pain, and changes in stool characteristics. A significant link was found between financial status, behavioral status and gastrointestinal changes. High financial status was significantly different from intermediate and low statuses based on behavioral changes. However, no significant association was found in multivariant analysis. The study found that ASD children generally have good nutritional health, with a higher degree of dietary selection. The financial status of guardians significantly influenced behavioral and gastrointestinal changes in the children. Further interventional studies are recommended to assess the direct impact of diet programs on these symptoms.

The effect of diet-induced weight-loss on subcutaneous adipose tissue expression of genes associated with thyroid hormone action

Background & AimsWe have recently demonstrated that subcutaneous adipose tissue (SAT) expression of genes associated with thyroid hormone (TH) action is altered in obesity and insulin resistance. The aim of the present study was to examine the effect of diet-induced weight-loss on SAT expression of genes associated with TH action. MethodsThe study group comprised 38 individuals with overweight/obesity, which completed 12-week dietary intervention program. Hyperinsulinemic-euglycemic clamp and SAT biopsy were performed before and after the program. Fifteen normal-weight individuals were examined at baseline only. ResultsOverweight/obese individuals had lower free thyroxine (fT4) and higher free triiodothyronine (fT3)/fT4 ratio, lower SAT TH receptor isoforms (TRα and TRβ, encoded by THRA and THRB, respectively) and peroxisome proliferator-activated receptor γ coactivator 1α (PPARGC1A) mRNA expression and higher SAT type II and type III iodothyronine deiodinase (encoded by DIO2 and DIO3, respectively) and nuclear receptor corepressor (NCOR1) mRNA expression in comparison with normal-weight individuals. Diet-induced weight loss resulted in a decrease in fT3 and fT3/fT4 ratio and an increase in SAT THRA, THRB and PPARGC1A. SAT NCOR1 and forkhead box protein O1 (FOXO1) decreased only in individuals, who lost at least 10 kg (n=20). Higher increase in insulin sensitivity after weight loss was associated with a lower decrease in fT3/fT4 ratio. ConclusionsDiet-induced weight loss partly reverses alterations in SAT expression of genes associated with TH action. Responses of circulating TH and SAT expression of genes associated with TH action to diet-induced weight loss are related to body weight and insulin sensitivity.

The needs and prioritization of nutrition and dietary support for individuals with disabilities: an exploratory study

Objectives: Based on a survey of officers, social workers, and dietitians involved in managing nutrition and welfare policies or projects for vulnerable groups in local governments or private welfare institutions, this study aimed to assess the need for nutritional and dietary support policies and programs for persons with disabilities (PWD), as well as to identify appropriate support measures. Methods: An online survey was conducted from March 2 to 15, 2021. The survey included 20 questions exploring perspectives on the nutritional status of PWD, their need for nutritional and dietary support policies and programs, and the prioritization of appropriate support measures. A total of 132 responses were analyzed. Results: Approximately 68.9% of the respondents rated the nutritional status of PWD as “bad” or “very bad.” A substantial number identified “difficulty in purchasing ingredients, cooking, and preparing meals independently due to disability,” and “limited knowledge about nutrition and recipes necessary for maintaining a healthy and balanced diet” as the primary challenges in the dietary and nutritional management of this population. Additionally, 97.0% of the respondents deemed that the introduction of nutritional and dietary support policies and programs for PWD was “needed” or “very much needed.” Priority strategies to implement and strengthen these policies and systems included the “development of customized programs and services tailored to the needs and demands of the target population” and the “establishment of a dedicated department with specialized personnel.” Conclusion: Comprehensive nutritional and dietary support policies and programs should be actively implemented to ensure a healthy and stable diet for PWD, tailored to meet their actual needs and demands.

An educational needs analysis of sustainable dietary education for nutrition teachers: an application of the IPA, Borich needs assessment and The locus for focus model

Objectives: This study aimed to investigate the importance and performance levels of sustainable dietary education across the health, environment, and society domains as perceived by nutrition teachers and evaluate the needs and priorities for sustainable dietary education.Methods: An online survey was conducted for 151 nutrition teachers in Jeollanam-do. The survey included 20 questions across the health, environment, and society domains. The data were analyzed using a paired-sample t-test, the importance-performance analysis (IPA), the Borich needs assessment model, and the locus for focus model. Results: Overall, the average importance levels of the 20 items of sustainable dietary education were significantly higher than their average performance levels (4.44 vs. 3.68). The examination of each educational domain revealed that although the importance of education in the health domain was recognized and actively practiced by the nutrition teachers, the performance was comparatively lower in the environment and society domains. The Borich needs assessment and the locus for focus model identified education on biodiversity conservation, plant-based protein, and the use of local food as the top-priority group in the environment domain along with fair and ethical food, food security, regional food culture, food policy and trade, and family dining culture as the second-priority group in the society domain.Conclusions: The results of this study underscore the need to support the nutrition teachers’ perception and practice of sustainable dietary education in the environment and society domains. We believe that the educational needs and priorities proposed in this study will be considered in the future development and modification of sustainable dietary education programs.

The Role of Greek Olive Leaf Extract in Patients with Mild Alzheimer’s Disease (the GOLDEN Study): A Randomized Controlled Clinical Trial

Background: Olive leaves are a significant source of biophenols, which have a beneficial impact on cognitive performance. Objective: To examine, for the first time, in humans the effect of the daily consumption of a beverage containing olive leaf extract (OLE) versus a Mediterranean diet (MeDi) on patients diagnosed with mild Alzheimer’s Disease (AD), in addition to their regular treatment. Methods: A randomized clinical trial compared OLE’s effects on cognitive and functional performance in 55 mild AD patients. Each participant was randomly assigned to two groups: (1) Group 1 was given olive leaves for making a daily beverage and MeDi instructions through monthly diet programs; (2) Group 2 received only the MeDi instructions. After six months, all participants underwent a second neuropsychological evaluation. Results: Group 1 participants had statistically significantly higher MMSE scores compared to Group 2 with a p-value of 0.0135. Specifically, the mean MMSE difference in patients receiving OLE was close to 0, indicating no memory deterioration, whereas in controls it was −4.1, indicative of cognitive decline. The remaining neuropsychological assessments (FRSSD, FUCAS, ADAS-Cog, CDR, GDS, and NPI) revealed better results in the OLE group, except for GDS, which showed no change, but without statistically significant differences between the two groups.

A 6-month Randomised Controlled Trial to Compare the Effectiveness of Telenutrition Versus Telenutrition Supported by Telemonitoring and Health Coaching in a Weight Loss Program: A Study Protocol.

One of the main challenges in weight loss programs is compliance with diet and achievement of sustainable changes in eating habits and lifestyles. Most clients desire to lose weight quickly, rather than looking at long-term changes. The literature suggests applying telenutrition, owing to its convenience and easy access in combination with both telemonitoring and health coaching, where confounding factors in the diet are tackled. A 6-month randomised controlled trial will be conducted to compare the effectiveness of Telenutrition Versus Telenutrition supported by weekly telemonitoring and monthly health coaching in a weight loss program. Participants are obese and overweight adults of both sex groups, aged 20-50 years who will be randomized to join a control or an intervention group. A total of three visits will be scheduled for all participants: at baseline, after three months, and after six months. This study aims to answer the question of whether participants following a weight loss program supported by telemonitoring and health coaching will increase their weight loss and compliance to the diet in comparison with the control group. This will be the first trial to assess the impact of integrating telemonitoring and health coaching in weight loss programs, including the evaluation of associated confounding factors such as general nutrition education, eating behaviour, Sensory modalities and hunger, and stress. This trial will support dietary weight loss programs, contribute to the emerging field of telenutrition, and provide advice for clinical dietitians and health coaches to work together to help individuals lose and maintain weight.

Current Status of Diabetes Prevention and Control in China and Early-Stage Intervention Strategies

In recent years, the prevalence of diabetes in China has continued to rise, with the adult prevalence expected to reach 12.8% by 2023. To control this trend, the government has introduced several policies and invested substantial funds in the prevention and treatment of diabetes, achieving certain results. Prediabetes is a stage where blood glucose metabolism can still be restored. For individuals in this stage, dietary and exercise intervention programs are recommended to prevent or delay the onset of diabetes, improve quality of life, and reduce the burden of disease on individuals, families, and society.

Effect of plastic-free diet, education and Bisphenol A exposure feedback on urine BPA in adolescent

Abstract Background BPA is an endocrine disrupting chemical and is mostly taken orally. Adolescence is the critical sensitivity to these chemicals is maximum. This study was conducted to compare the effects of a plastic-free diet program, plastic-free diet education program and BPA exposure feedback on urine BPA levels in adolescents with high use of packaged products. Methods The first phase of the two-phase study is descriptive, the second phase is a single-centre, single-blind, three-arm non-randomized experimental design. The study was conducted at Antalya/Türkiye in the 2022-2023 academic year, and in the first stage, adolescents with high use of plastic packaged products and low attitudes towards healthy nutrition were identified. In the second stage, participants were assigned to the group-1 (n = 36), group-2 (n = 36) and group-3 (n = 36) by simple random sampling method. An eight-week plastic-free diet program was applied to the group 1, plastic-free diet education program and BPA exposure feedback was given to the group-2, and only BPA exposure feedback was given to the group-3. Plastic Packaged Product Usage Survey, Attitude Scale towards Healthy Nutrition, and spot urine samples were used to collect data. Results It was found that 2% of adolescents used low plastic packaging, 34% medium, 57% high, and 7% very high. Pre-posttest urine BPA levels ng/ml (µg/g creatinine) were 1.98 (2.54), 1.43 (1.51) in the intervention1 group, respectively; 1.91 (2.35), 1.43 (1.47) in the intervention2 group; It was found to be 1.97 (2.49) and 1.49 (1.66) in the intervention3 group. The effect sizes of pre-posttest BPA/creatinine values were calculated as 1.38, 1.13 and 1.09 in intervention1-2-3 groups, respectively. Conclusions All three interventions (plastic-free diet program, plastic-free diet education program and BPA exposure feedback) were effective in reducing urinary BPA levels, reducing plastic-packaged product use levels, and increasing attitudes towards healthy eating. Key messages • Since all three interventions are effective in reducing adolescents’ urinary BPA levels, it may be recommended to use the intervention appropriate to the field conditions. • In the post-tests, the use of plastic packaged products by adolescents in all three groups decreased and their attitudes towards healthy nutrition increased.

The Effect of a Multidisciplinary Lifestyle Intervention Program on Apelin-12, Vaspin and Resistin Concentrations in Children and Adolescents with Overweight and Obesity.

Background: Obesity in childhood and adolescence has reached epidemic proportions in recent decades. Methods: In the present study, we determined the concentrations of apelin-12, vaspin and resistin in 106 children and adolescents with overweight or obesity before and after the implementation of a multidisciplinary, personalized lifestyle intervention program of diet, sleep and exercise for 1 year. All subjects attended our Center for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence. Results: Following the lifestyle intervention, there were significant decreases in BMI (p < 0.01), apelin-12 (p < 0.05) and resistin (p < 0.01) concentrations, and an increase in vaspin (p < 0.01) concentration. Glucose was the best positive predictor of apelin-12 (b = 0.236, p < 0.05), and osteopontin was the best negative predictor of changes in apelin-12 (b = -0.299, p < 0.05). Vaspin correlated positively with adiponectin (b = 0.29, p < 0.05), while vitamin D (b = 0.621, p < 0.05) was the best positive predictor of vaspin. BMI z score (b = -0.794, p < 0.05), HDL (b = -0.284, p < 0.05) and HbA1C (b = -0.262, p < 0.05) were the best negative predictors of changes in vaspin. BMI z score was the best positive predictor of resistin (b = 0.437, p < 0.05). Conclusions: These findings suggest that apelin-12, vaspin and resistin correlate with indices of obesity, glucose, lipids and bone metabolism, while interaction with other proteins, such as osteopontin and adiponectin, was also noted. Therefore, apelin-12, vaspin and resistin may be used as biomarkers in children and adolescents with overweight and obesity.

Obesity medicine provider-directed health coaching in a commercial weight loss program: Proof of concept

BackgroundObesity remains a leading serious chronic disease and cause of death in the U.S. Despite previous research in diets (i.e., caloric restriction), physical activity levels, and biochemical markers, no studies to date have investigated the combination of an obesity medicine physician with a health coach alongside a commercial program for reducing body weight. As a result, this pilot study aims to assess the relationship between a commercial diet program and health and wellness coaching (HWC) for weight reduction outcomes when delivered in conjunction with an obesity medicine physician chronic disease care model, as a proof-of-concept study. MethodsThis 24-week proof-of-concept study was pragmatic, being an unblinded, unrandomized, uncontrolled, longitudinal, observational study. Its purpose was to assess participant weight reduction from a commercial weight reduction program using a pre-packaged portion-controlled reduced-calorie diet while meeting with a health coach and obesity medicine physician for counseling and support. Participants in the sample underwent a commercial weight reduction program through dietary control while meeting with an HWC. A repeated measures ANOVA was conducted to determine the weight reduction trends across a 24-week program. ResultsThis study included n = 53 participants; a majority were white females (n = 45; 85 %), with an average (SD) age of 50.3 (12.2) years. There was a significant improvement in weight reduction (21.8 ± 9.4 lbs. WL) seen throughout the 24-week program (F (7, 364) = 33.129, p < 0.001), with a large effect (η2 = 0.922). ConclusionThis proof-of-concept project found that Obesity Medicine Physician-directed, portion-controlled meals and HWC can improve weight reduction across a 24-week program using portioned-controlled meals. Confirmation of these findings and their clinical significance requires a follow-up randomized, controlled clinical trial using validated assessment tools.

Association of Body Mass Index (BMI) with Diet, Physical Activity, and Lifestyle among Undergraduate Dental Students in a Private Dental College in Bangladesh

Background: Obesity can lead to severe health problems and elevate the risk of diseases such as hypertension, dyslipidemia and diabetes due to metabolic changes. Undergraduate dental students often struggle to maintain a healthy lifestyle and eating habits due to academic pressures. BMI, a standard obesity measure, is simple to calculate and assess nutritional status, helping to identify and prevent obesity-related diseases in at-risk individuals. Method: A cross-sectional study was performed among 253 students of Sapporo Dental College, a private dental college in Uttara, Dhaka, Bangladesh, to reveal the prevalence of overweight and obesity according to BMI and its association with dietary habits, physical activities, and lifestyles among them. Data was collected using a self-written, anonymous, semi-structured questionnaire using the convenient sampling technique between July 2023 and September 2023. Result: Among the 253 participants, females (n = 190, 75.10%) are more than males (n = 63, 25%). The prevalence of normal weight, underweight, overweight, and obesity among the participants was 132 (37.93%), 31 (8.91%), 56 (16.09%), and 129 (37.07%), respectively, based on BMI. 84% of obese students were taken 1 meal from outside per day (p values &lt; 0.05). 52% obese students did not engage in any form of physical activity on a weekly basis (p value 0.03). 55.5% obese students slept for &lt; 6 hours every night (p-value 0.04). Conclusion: Early modifications of lifestyle improve health. Annual screenings help to prevent obesity. Fitness and diet programs can reduce dental students' chronic disease risk. Study participants are future physicians. Thus, dental students should be physically active and aware of their eating and sleep habits to reduce obesity, which might influence patients' outlooks. Update Dent. Coll. j: 2024; 14(2):15-20

Weight changes during the initial phase of orthodontic treatment with clear aligners versus fixed appliances: a pilot prospective cohort study.

The aim was to assess adult patients' weight changes during the initial phase of orthodontic treatment (OT) with clear aligner therapy (CAT) versus fixed bracket systems (FBS). This pilot prospective cohort study included systemically-healthy adults who were treated with CAT or FBS. Participants with eating disorders and/or undergoing dietary programs were excluded. Weight was assessed using a calibrated digital scale at the start of OT (T1), 6-8 weeks (T2), and 12-16 weeks (T3) after starting OT. A questionnaire was used to record demographic variables, diet and exercise habits, self-reported compliance and discomfort during OT, and use of analgesics. Repeated measures analysis of variance was used to assess the association between treatment type (FBS versus CT) and time-period (T1, T2, T3) on participants' weight while adjusting for baseline covariates such as age, gender, height, and weight. Forty-two participants (CAT group: 22 and FBS group: 20) were analysed. In the CAT group, there was a slight initial mean weight gain of 0.2 Kg (~ 0.4 pounds) (T2-T1), and 0.8 Kg (~ 1.7 pounds) overall mean weight loss between T1 and T3. For the FBS group, there was a slight initial weight loss of 0.3 Kg (~ 0.7 pounds) (T2-T1) and no overall change between T1 and T3. Treatment type (CAT versus FBS) was not significantly associated with weight changes during the initial phase of OT. There were no significant differences in the weight changes during the initial phase of OT with CAT compared with FBS. Clear aligner therapy should not be advertised as a weight loss strategy.

Dietary satisfaction and quality of life in individuals following diet programs satisfaction of diet programs

Purpose The purpose of this study was to assess individuals’ satisfaction with their diet programs and evaluate the impact of their diet on their quality of life (QOL). Design/methodology/approach This cross-sectional study was conducted with 812 females and 334 males (n = 1,046) aged 18–65 years, all of whom were following a diet program under the guidance of a dietitian. The questionnaire included personal information as well as items related to dietary satisfaction and QOL, measured using the SF-36 scale. Findings Of the participants, 38.4% were aged 18–24, and 32.6% were aged 25–40. The mean score for dietary satisfaction was 3.0 ± 0.9 (out of 5), while the mean scores for the mental and physical components of the QOL scale were 62.0 ± 17.8 and 74.3 ± 19.2, respectively. Factors such as age, BMI and duration of the diet were associated with dietary satisfaction, whereas age, gender, health status, diet type and BMI impacted QOL (p &lt; 0.05). Dietary satisfaction scores showed a weak positive correlation with QOL scores (r = 0.125; p &lt; 0.01). Originality/value Dietary satisfaction and QOL are influenced by demographic characteristics, health status, diet type and the duration of the diet program. Additionally, there is a correlation between dietary satisfaction and QOL. To ensure the sustainability and suitability of long-term dietary plans, it is crucial to monitor patients’ dietary satisfaction. In this context, assessing the QOL in individuals on diet programs, using a newly validated diet satisfaction scale, adds originality and value to the study.

Disease management program in patients with type 2 diabetes.

The aim of this paper was to study ethnic and socioeconomic (SEP) factors' association with provision and participation in a type 2 diabetes disease-management program. In 2016-21, 3464 persons were referred to type 2 diabetes management in Copenhagen municipality. Personalized plans included a mix of activities; program consultations, dietary education, telephone conversations, patient education, and physical training. We estimated the association between education, income, civic status, employment, and country of origin with the number of booked and participated activities using Poisson regression models. A total of 55394 program sessions were scheduled. Small differences in booked dietary education, program consultations, telephone conversations, and patient education were seen between SEP groupings. In situations where groups with lower SEP had booked more sessions (e.g. unemployed bookings of dietary education), these were predominantly translated into equal or more participated sessions among persons with high SEP. Regarding physical training, considerably more booked and participated sessions were delivered to women with lower SEP and ethnic minorities. This study is unique, in the sense that it is the first of its kind to analyze data on diabetes-management programs, systematically collected by primary healthcare workers. Our results suggest that specific elements of the program together with a higher number of booked sessions promoted vulnerable women to participate in more physical training sessions. In closing, these findings have the potential to provide motivation and ideas for policymakers and health professionals in how to design equitable type 2 diabetes management activities.

6656 Frequently sampled HbA1c Shows Low-Sodium, High-Carbohydrate Rice Diet To Be Effective in Type 2 Diabetes

Abstract Disclosure: F.A. Neelon: None. S. Sanoff: None. P. Lin: None. Hemoglobin and glucose react to form HbA1c, which persists until red blood cells (RBCs) are removed from circulation. Since RBCs survive approximately 122 days, HbA1c is usually measured at intervals of months to years, but more frequent measurement can illuminate changes in blood glucose (BG). We used Beach’s equation for the kinetics of HbA1c formation, to construct graphical depictions of how HbA1c should decline over the 122 days after a drop from constantly high to constantly normal BG levels. As part of routine patient care (not an experimental protocol), we measured HbA1c at 2-4-week intervals in a convenience sample of 10 patients (one of whom was evaluated on 2 occasions) with Type 2 diabetes, obesity, and elevated HbA1c who attended the now defunct Rice Diet Program (RDP) in Durham, NC. All were fed 3 meals/day, comprising 800-1000 kcal of rice, fruits, grains, and vegetables (70-90% carbohydrates) and 300 mg of sodium. Two patients were initially taking insulin; 1, glipizide; and 1, sitagliptin, exenatide, metformin; all hypoglycemic agents were eventually discontinued, and none added. Mean initial HbA1c of 9.7% (range, 8.3-11.7) fell to a mean of 6.2% (range 5.3-8.4) after a mean of 82 days (range, 41-139). Variability in final HbA1c values reflects, at least in part, variable duration of voluntary residence at the RDP. In 9 patients, HbA1c declined in close accordance with the course predicted for complete normalization of blood glucose from the very start of the diet; in 1 patient, HbA1c declined slowly for 25 days, after which the rate increased to near that for complete normalization of BG. Plots of Hb1c values extrapolate back through the point of origin, implying normalization of BG occurs within days of starting the RDP, and is maintained thereafter. Data from frequent measurement of HbA1c show: 1) Normalization of BG occurs almost immediately upon dietary restriction, implying that hyperglycemia in Type 2 diabetes is driven by daily calorie excess, not by accumulated calorie excess (ie, obesity). 2) Contrary to some misperceptions, a high-carbohydrate, sodium- and calorie-restricted diet is not deleterious to ― and may actually benefit ― glucose control in Type 2 diabetes. Presentation: 6/3/2024

Health Dietary Program for Patient after Sleeve Gastrectomy: Case - Control Study

Background: In general, obesity has been increasing at an alarming rate over the past 50 years. In 2022, obesity and its comorbidities accounted for 14.3 percent of this world healthcare expenditure. Weight loss surgery is considered a safe and durable treatment option for obesity. The techniques have been continuously evolving to yield better outcomes. The studies showed that post-operative complications increased with physical inactivity and therefore reduces patient’s quality of life (1), The Gastroenterology Endoscopic Department Al-Kindy-Teaching Hospital – Baghdad-Iraq (2019), mentioned that dietary habits play a significant role in the development of gastrointestinal disorders(2). so that this activity describes the dietary program after sleeve gastrectomy and highlights the role of the interprofessional team in the management of patients with obesity. and the extent to which a patient's behavior conforms to the instructions given by health practitioners (3). Objective: To find out the effectiveness of rehabilitation program on patient's nutritional status after sleeve gastrectomy, to find out the relationship between patient's nutritional status and demographic characteristics (age, sex, and level of education). Material and Methods: The design used in the current study is a quasi-experimental design -experimental design (two -groups comparison), the study was conducted in center of hepatopathy and digestive diseases in AL-Hussein Teaching Hospital at AL-Muthanna city in Iraq. Study Sample: A non-probability (purposive) sample was taken from patients who performed gastric sleeve and the sample was (50) patients. Use questionnaire in this study. Result: It was found that there is an effectiveness of the program on the case group with the post-test when compared with the control group after implementation program. Conclusion: The patient after sleeve gastrectomy have inadequate knowledge concerning dietary. The program which implemented on patients had a benefit feedback on patients.

Relationship between Dash Diet Compliance and Sodium, Fat and Potassium Intake in Outpatient Hypertension Patients RS Muhammadiyah Palembang

Data from the World Health Organization (WHO) shows that the incidence of hypertension in the world will increase every year and reach 29.2% in 2023. Dash diet compliance has factors that influence patient compliance, namely compliance in implementing the diet program related to understanding of instructions and knowledge. The DASH diet is a diet that recommends consuming low fat, low salt and increasing potassium intake to help lower blood pressure. To determine the relationship between compliance with the Dash diet and sodium, fat and potassium intake in patients with hypertension. This method uses a Semi Quantitative Form-FFQ questionnaire with an interview method. The number of subjects in this study were 60 hypertensive patients with heart complications. Results: There is a relationship between diet compliance and fat and sodium intake (p value &lt; 0.05). There is no relationship between diet compliance and potassium intake (p value ≥ 0.05).