A specific nutrition plan, monitored and encouraged by a dietician, was far more effective than standard nutrition advice at controlling A1C levels and weight in type 2 diabetes patients who are overweight or obese, researchers report. Photo by tubartstock/Shutterstock
BOSTON, June 22 (UPI) -- While general advice on how to improve diet to reduce diabetes symptoms and obesity can work, researchers in a recent study found a personalized, specific nutrition plan was far more effective for achieving health goals.
Researchers at the Joslin Diabetes Center found structured nutrition therapy helped patients reach health goals similar to those of medications for type 2 diabetes and was far easier to follow than less structured plans.
Standard nutrition therapy includes individualized advice to make changes to eating habits and preferences; however, using measures of A1C, body weight and blood lipid levels to plan specific nutrient and caloric intakes for the day -- with check-ins from a dietitian -- brought far greater results, the researchers report.
"It was surprising to see all these significant changes in A1C and body weight without altering medications or activity level and without aiming for weight reduction," Dr. Osama Hamdy, medical director for the Obesity Clinical Program at Joslin Diabetes Center, said in a press release. "Which tells us that nutrition therapy can be as effective as medications even after a long duration of the disease."
For the study, researchers recruited 108 overweight or obese patients with type 2 diabetes, randomly assigned them to one of three groups: A standard treatment group receiving advice from a registered dietitian on eating habits and preferences; a group given a highly structured meal plan based on macronutrient ratios and caloric levels, including instructions, menu books and calorie replacement foods, and were asked to keep a food log; and a third group following the highly structured treatment plan, but with additional weekly phone coaching by the dietitian.
The researchers took A1C and body weight measurements at the start of the 16-week trial, finding there was no significant difference in either measure in the standard therapy group from beginning to end of the study.
The second and third groups receiving much more detailed eating advice saw significant reductions in A1C and body weight, which the researchers say is a combination of the benefits of the eating plan. carbohydrates make up about 40 percent of nutrient consumption in the eating plan, with the rest coming from health protein and fat, resulting in a diet high in fiber and lower in saturated fat and sodium.
Hamdy said the structured plan has been used in a diabetes weight reduction program at Joslin for several years, and patients have previously requested they be put on the structured, monitored plan because it is easier to follow than the generic guidance generally given to patients.
"This drop in A1C due to nutrition therapy alone is much better than what we have been able to achieve with many of the current medications for type 2 diabetes," Hamdy said. "This is very encouraging since participants in the study have lived with type 2 diabetes for more than 10 years and were not able to control their blood glucose or weight with multiple medications."