Lifestyle changes can be achieved through counseling and follow-up in first-degree relatives of patients with type 2 diabetes

Hilde K Brekke, Per-Anders Jansson, Jan-Eric Månsson, Ragnhild A Lenner
Journal of the American Dietetic Association 2003, 103 (7): 835-43

OBJECTIVE: To describe two lifestyle prevention strategies tested in first-degree relatives of patients with type 2 diabetes and to present the short-term effects of these strategies on nutrient intake, physical activity pattern, and body weight.

DESIGN: In this 16-week controlled intervention trial, subjects were assigned to one of three treatment conditions: diet group (D) (n=25), diet and exercise group (DE) (n=30), or control group (C) (n=22). Subjects/setting Non-diabetic relatives of individuals with diabetes were recruited (n=77; men and women; age 25 to 55 years).

INTERVENTION: Intervention groups received group counseling on two occasions and follow-up through unannounced telephone interviews every 10 days. Counseling regarding diet and physical activity was based on the Nordic Nutrition Recommendations. In addition, increased intake of fatty fish and low glycemic index foods were recommended. Main outcome measures Changes in diet (assessed by food frequency questionnaires), leisure time physical activity (assessed through interviews), fatty acid composition of erythrocyte membrane, and body weight. Statistical analysis One-way analysis of variance and Mann-Whitney U test were used to compare changes among groups.

RESULTS: Compared with the control group, both intervention groups decreased intake of saturated fatty acids (percent of energy), increased intake of dietary fiber, and reduced average glycemic index of the diet. The ratio of n-6:n-3 fatty acids of the erythrocyte membranes decreased, confirming increased intake of fatty fish. Body weight decreased 1.7 kg (2.1%, P=.030) in group DE, and physical activity increased in the least-active subjects (+70 min/week, P<.01 within group). Applications/Conclusions Healthy individuals with heredity for type 2 diabetes can achieve desired changes in lifestyle factors associated with increased risk for the disease.

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