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  • 1
    Online Resource
    Online Resource
    Nutrition and lifestyle intervention in type 2 diabetes: pilot study in the Netherlands showing improved glucose control and reduction in glucose lowering medication
    BMJ ; 2019
    In:  BMJ Nutrition, Prevention & Health Vol. 2, No. 1 ( 2019-06), p. 43-50
    Details
    In: BMJ Nutrition, Prevention & Health, BMJ, Vol. 2, No. 1 ( 2019-06), p. 43-50
    Abstract: Prevalence of type 2 diabetes (T2D) is increasing rapidly and lifestyle interventions to reverse diabetes are seen as a possible solution to stop this trend. New practice-based evidence is needed to gain more insight in the actual, and above all scientific, basis for these claims. Methods This observational study with a pretest post-test design aimed to pilot a 6-month multicomponent outpatient group-based nutrition and lifestyle intervention programme on glycaemic control and use of glucose lowering medication in motivated T2D patients with a body mass index (BMI) 〉 25 kg/m 2 in the Netherlands (February 2015–March 2016). Results 74 T2D patients (56% female) aged 57.4±8.0 years with mean BMI 31.2±4.2 kg/m 2 and mean waist circumference 105.4±10.2 cm were included in the study. Compared with baseline, mean HbA1c levels at 6 months were 5 mmol/mol lower (SD=10, p 〈 0.001) and the number of participants with HbA1c levels ≤53 mmol/mol after intervention had increased (from 36% (n=26/72) to 60% (n=43/72)). At baseline, 90% of participants were taking at least one type of glucose lowering medication. At 6 months, 49% (n=35/72) of the participants had reduced their medication or eliminated it completely (13%). Secondary outcomes were significantly lower fasting glucose levels (− 1.2±2.6 mmol/L), body weight (−4.9±5.1 kg), BMI (−1.70±1.69 kg/m 2 ) and waist circumference (−9.4±5.0 cm). Plasma lipids remained unchanged except for a decrease in triglyceride levels. Furthermore, self-reported quality of life was significantly higher while experienced fatigue and sleep problems were significantly lower. Conclusion This pilot study showed that a 6-month multicomponent group-based program in a routine care setting could improve glycaemic control and reduce the use of glucose lowering medication in motivated T2D diabetics. A fully scaled study is needed to confirm these results.
    Type of Medium: Online Resource
    ISSN: 2516-5542
    URL: Article
    URL: Article
    DOI: 10.1136/bmjnph-2018-000012
    DOI: 10.1136/bmjnph-2018-000012.supp1
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2938786-3
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  • 2
    Online Resource
    Online Resource
    Effect of the Dutch school-based education programme ‘Taste Lessons’ on behavioural determinants of taste acceptance and healthy eating: a quasi-experimental study
    Cambridge University Press (CUP) ; 2015
    In:  Public Health Nutrition Vol. 18, No. 12 ( 2015-08), p. 2231-2241
    Details
    In: Public Health Nutrition, Cambridge University Press (CUP), Vol. 18, No. 12 ( 2015-08), p. 2231-2241
    Abstract: To assess the effect of the Dutch school-based education programme ‘Taste Lessons’ on children’s behavioural determinants towards tasting unfamiliar foods and eating healthy and a variety of foods. Design In a quasi-experimental study design, data on behavioural determinants were collected at baseline, four weeks and six months after the intervention in both the intervention and control group. Children completed consecutively three questionnaires in which knowledge, awareness, skills, attitude, emotion, subjective norm and intention towards the two target behaviours were assessed. Teachers implemented on average a third of the programme activities. Multilevel regression analyses were conducted to compare individual changes in the determinants in the intervention group with those in the control group, corrected for children’s gender and age. Effect sizes were expressed as Cohen’s d . Setting Dutch elementary schools. Subjects Forty-nine classes (1183 children, 9–12 years old) in grades 5–8 of twenty-one elementary schools. Results The intervention group showed a higher increase in knowledge ( d =0·26, P 〈 0·01), which persisted after six months ( d =0·23, P 〈 0·05). After four weeks, the intervention group showed a higher increase in number of foods known ( d =0·22, P 〈 0·05) and tasted ( d =0·21, P 〈 0·05), subjective norm of the teacher ( d =0·17, P 〈 0·05) and intention ( d =0·16, P 〈 0·05) towards the target behaviours. Conclusions Partial implementation of Taste Lessons during one school year showed small short-term effects on increasing behavioural determinants in relation to tasting unfamiliar foods and eating healthy and a variety of foods. Full and repeated implementation of Taste Lessons in subsequent years might result in larger effects.
    Type of Medium: Online Resource
    ISSN: 1368-9800 , 1475-2727
    URL: Article
    DOI: 10.1017/S1368980014003012
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2015
    detail.hit.zdb_id: 2016337-X
    SSG: 21
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  • 3
    Online Resource
    Online Resource
    Lifestyle medicine for type 2 diabetes: practice-based evidence for long-term efficacy of a multicomponent lifestyle intervention (Reverse Diabetes2 Now)
    BMJ ; 2020
    In:  BMJ Nutrition, Prevention & Health Vol. 3, No. 2 ( 2020-12), p. 188-195
    Details
    In: BMJ Nutrition, Prevention & Health, BMJ, Vol. 3, No. 2 ( 2020-12), p. 188-195
    Abstract: A wealth of evidence supports short-term efficacy of lifestyle interventions in type 2 diabetes (T2D). However, little is known about long-term effects of lifestyle interventions in real-life settings. Methods This observational, single-arm study evaluated long-term impact of ‘Voeding Leeft: Reverse-Diabetes2-Now’, a 6-month multicomponent lifestyle programme, on glycaemic control and glucose-lowering medication (GLmed) use, other T2D parameters and quality of life in 438 T2D participants at 6, 12, 18 and 24 months using paired sample t-tests, χ 2 and generalised linear models. Results At 24 months, 234 participants provided information on GLmed and HbA1c (‘responders’). 67% of the responders used less GLmed, and 28% ceased all GLmed. Notably, 71% of insulin users at baseline (n=47 of 66 insulin users) were off insulin at 24 months. Mean HbA1c levels were similar at 24 months compared with baseline (55.6±12.8 vs. 56.3±10.5 mmol/mol, p=0.43), but more responders had HbA1c levels ≤53 mmol/mol at 24 months (53% vs 45% at baseline). Furthermore, triglyceride levels (−0.34±1.02 mmol/L, p=0.004), body weight (−7.0±6.8 kg, p 〈 0.001), waist circumference (−7.9±8.2 cm, p 〈 0.001), body mass index (−2.4±2.3 kg/m 2 , p 〈 0.001) and total cholesterol/high-density lipoprotein (HDL) ratio (−0.22±1.24, p=0.044) were lower, while HDL (+0.17 ± 0.53 mmol/L, p 〈 0.001) and low-density lipoprotein-cholesterol levels (+0.18 ± 1.06 mmol/L, p=0.040) were slightly higher. No differences were observed in fasting glucose or total cholesterol levels. Quality of life and self-reported health significantly improved. Conclusion This study indicates robust, durable real-life benefits of this lifestyle group programme after up to 24 months of follow-up, particularly in terms of medication use, body weight and quality of life in T2D patients.
    Type of Medium: Online Resource
    ISSN: 2516-5542
    URL: Article
    URL: Article
    URL: Article
    DOI: 10.1136/bmjnph-2020-000081
    DOI: 10.1136/bmjnph-2020-000081.supp1
    DOI: 10.1136/bmjnph-2020-000081.supp2
    Language: English
    Publisher: BMJ
    Publication Date: 2020
    detail.hit.zdb_id: 2938786-3
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