The “Nutrition Pathway Study” compared three models of nutrition therapy for patients who are overweight and obese with type 2 diabetes and found that a highly structured nutrition plan provided the most significant impact on A1C, body weight, and lipid profiles.
Participants in the structured nutrition therapy arm of the study reduced A1C levels by an average of 0.67 percent and reduced body weight by an average of 3.5 kilograms over 16 weeks.
“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,” said Osama Hamdy, MD, PhD, of the Obesity Clinical Program at Joslin Diabetes Center.
The first group of participants followed a traditional model. They met with a registered dietician (RD) to review their eating habits and preferences. They were then given individualized advice on eating plans to fit those eating habits and preferences.
The second group met with the RD to receive a highly structured meal plan based on macronutrient ratios and caloric levels specified in the Joslin Clinical Nutrition Guideline for Overweight and Obese Adults with Type 2 Diabetes, Prediabetes or Those at High Risk for Developing Type 2 Diabetes. This included instructions on the specific macronutrient and caloric composition of their meals, menu books, a snack list, and a supply of one to three diabetes-specific calorie replacement foods per day. They were also asked to keep food logs.
A third group followed the highly structured meal plan, and in addition received weekly phone coaching by the RD.
Compared to baseline, the A1C level and body weight did not change in the first group. But in the second and third groups, which followed the highly structured plan, the A1C and body weight significantly decreased.
These results were achieved without increasing exercise, changing medications, or undertaking behavioral changes, Hamdy noted.
This article was adapted from information provided by Joslin Diabetes Center.
