Clin Nutr Res.  2016 Oct;5(4):237-248. 10.7762/cnr.2016.5.4.237.

Effects of Activity-Based Personalized Nutrition Education on Dietary Behaviors and Blood Parameters in Middle-Aged and Older Type 2 Diabetes Korean Outpatients

• Yang SH
• Chung HK
• Lee SM

• KMID: 2355296
• DOI: http://doi.org/10.7762/cnr.2016.5.4.237

Abstract

This study aimed to compare the effects of activity-based personalized nutrition education (APNE) with a general instruction for diabetes (control, CTRL) in middle-aged and older Korean outpatients with type 2 diabetes. After an initial screening, 70 subjects were randomly assigned to APNE (n = 37) or CTRL (n = 33) group. APNE considered each patient's anthropometry, blood chemistry data, and dietary habits in addition to planning meal choices with the aid of registered dietitians. After 3 months, dietary behavior, food intake, and anthropometric and blood measurement results were evaluated. Fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels decreased in the APNE group (n = 33) but not in the CTRL group (n = 23). In the APNE group, the meal intervals and number of days of consuming high-fat food were decreased, while the number of days following a meal plan and balanced diet that entailed consuming fruits, vegetables, and healthy food was increased. A lower consumption of carbohydrates, saccharides, grains, and tuber crops and a higher protein, pulses, and fat-derived calorie intake compared with the initial values were observed in the APNE group. In contrast, only the number of days following the meal plan and balanced diet was increased in the CRTL group, without significantly changing the individual macronutrient-derived calorie intake. The APNE approach appeared to effectively educate outpatients with type 2 diabetes about changing their dietary behavior and food intake and improving the clinical parameters related to diabetic conditions.

Keyword

Type 2 diabetes; Activity-based personalized nutrition education; 2-hour postprandial plasma glucose level; Glycated hemoglobin; Fasting blood glucose

MeSH Terms

Anthropometry
Blood Glucose
Carbohydrates
Chemistry
Diet
Eating
Education*
Fasting
Food Habits
Fruit
Hemoglobin A, Glycosylated
Humans
Mass Screening
Meals
Nutritionists
Outpatients*
Vegetables
Blood Glucose
Carbohydrates

Figure

• 

  Figure 1 Flow diagram of the study design. CTRL, general instruction for diabetes (control); APNE, activity-based personalized nutrition education.

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  Figure 2 Changes in FBG, PP2, and HbA1c levels in the CTRL and APNE groups. The CTRL group represents outpatients with type 2 diabetes who received regular instructions for diabetes. The APNE group represents outpatients who received APNE education. Changes in (A) FBG, (B) PP2, and (C) HbA1c levels in the CTRL and APNE groups. All values appear as mean ± standard error (SE). FBG, fasting blood glucose; PP2, 2-hour postprandial plasma glucose; HbA1c, glycated hemoglobin; CTRL, general instruction for diabetes (control); APNE, activity-based personalized nutrition education. All marks indicate a significant difference between groups according to Student’s t-test (*p < 0.01, †p < 0.05).

• 

  Figure 3 Changes in body weight, BMI, and waist circumference in the CTRL and APNE groups. The CTRL group represents outpatients with type 2 diabetes who received regular instructions for diabetes and did not receive APNE education. APNE group represents outpatients who received APNE education. Changes in body weight (A and D), BMI (B and E), and waist circumference (C and F) in the CTRL and APNE groups, which were divided into sub-groups according to HbA1c (< 7% and ≥ 7%, respectively) and PP2 levels (< 199 mg/dL and ≥ 199 mg/dL, respectively). All values appear as mean ± standard error (SE). BMI, body mass index; CTRL, general instruction for diabetes (control); APNE, activity-based personalized nutrition education; HbA1c, glycated hemoglobin; PP2, 2-hour postprandial plasma glucose. All marks indicate a significant difference between groups according to Student’s t-test (*p < 0.05, †p < 0.01).

• 

  Figure 4 Changes in carbohydrate, protein, and lipid calorie intake in the CTRL and APNE groups. The CTRL group represents outpatients with type 2 diabetes who only received regular instructions for diabetes. The APNE group represents outpatients who received APNE education. Changes in calories derived from (A) carbohydrates, (B) proteins, and (C) lipids in the CTRL and APNE groups. All values appear as mean ± standard error (SE). CTRL, general instruction for diabetes (control); APNE, activity-based personalized nutrition education. All marks indicate a significant difference between groups according to Student’s t-test (*p < 0.001, †p < 0.05).

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