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Reviews
Cradock, KA;OLaighin, G;Finucane, FM;McKay, R;Quinlan, LR;Ginis, KAM;Gainforth, HL
2017
December
Diet Behavior Change Techniques in Type 2 Diabetes: A Systematic Review and Meta-analysis
Published
1
Optional Fields
LOW-CARBOHYDRATE DIET RANDOMIZED CONTROLLED-TRIAL WEIGHT-LOSS PROGRAM BLOOD-GLUCOSE CONTROL LOW-GLYCEMIC INDEX SIMPLE MEAL PLAN QUALITY-OF-LIFE NUTRITION EDUCATION PHYSICAL-ACTIVITY RISK-FACTORS
OBJECTIVEDietary behavior is closely connected to type 2 diabetes. The purpose of this meta-analysis was to identify behavior change techniques (BCTs) and specific components of dietary interventions for patients with type 2 diabetes associated with changes in HbA(1c) and body weight.RESEARCH DESIGN AND METHODSThe Cochrane Library, CINAHL, Embase, PubMed, PsycINFO, and Scopus databases were searched. Reports of randomized controlled trials published during 1975-2017 that focused on changing dietary behavior were selected, and methodological rigor, use of BCTs, and fidelity and intervention features were evaluated.RESULTSIn total, 54 studies were included, with 42 different BCTs applied and an average of 7 BCTs used per study. Four BCTs-"problem solving," "feedback on behavior," "adding objects to the environment," and "social comparison"-and the intervention feature "use of theory" were associated with >0.3% (3.3 mmol/mol) reduction in HbA(1c). Meta-analysis revealed that studies that aimed to control or change the environment showed a greater reduction in HbA(1c) of 0.5% (5.5 mmol/mol) (95% CI -0.65, -0.34), compared with 0.32% (3.5 mmol/mol) (95% CI -0.40, -0.23) for studies that aimed to change behavior. Limitations of our study were the heterogeneity of dietary interventions and poor quality of reporting of BCTs.CONCLUSIONSThis study provides evidence that changing the dietary environment may have more of an effect on HbA(1c) in adults with type 2 diabetes than changing dietary behavior. Diet interventions achieved clinically significant reductions in HbA(1c), although initial reductions in body weight diminished over time. If appropriate BCTs and theory are applied, dietary interventions may result in better glucose control.
ALEXANDRIA
AMER DIABETES ASSOC
0149-5992
1800
1810
10.2337/dc17-0462
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