Researchers have found that two adapted Diabetes Prevention Program (DPP) lifestyle interventions are more effective at weight loss and reducing BMI over a 15 month period than usual care among overweight or obese adults.
The findings come from a randomized trial published Online First by Archives of Internal Medicine.
More than two thirds (69 percent) of the U.S adult population is either obese or overweight, they are at a very high risk of developing type 2 diabetes mellitus (DM). A Morbidity and Mortality Weekly Report (MMWR) published on November 16th, 2012, described the rise in diabetes rates in the USA over a 15-year period as “dramatic”.
In order to reduce the risk of developing diabetes, lifestyle changes must to made. Moderate-intensity physical activity is linked to a reduced risk of developing type 2 DM, however, in clinical practice there has been a failure to incorporate weight management.
Jun Ma, M.D., Ph.D., of the Palo Alto Medical Foundation Research Institute, Palo Alto, Calif., and her team evaluated the effectiveness of two different DPP lifestyle interventions among overweight or obese adults who had been diagnosed with either metabolic syndrome or diabetes mellitus.
The authors said:
“Proven effective in a primary care setting, the 2 DPP-based lifestyle interventions are readily scalable and exportable with potential for substantial clinical and public health impact,”
The Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care (E-LITE) randomized trial assigned participants to three different groups:
- The first group received a group-led intervention (n=79)
- The second group received a self-directed DVD (n=81) intervention
- The third group received usual care (n=81).
The 3 month behavioral weight loss phase used a home-based DVD or lifestyle coach after which a 12 month maintenance phase followed.
At the start of the study the average body mass index (BMI) of the participants was 32.
After 15 months, the average change in BMI went down by:
- 2.2 (±0.3) in the coach-led group
- 1.6 (±0.3) in the self-directed group
- 0.9 (±0.3) in the usual care group
The weight loss goal of 7 percent of total body weight was reached by:
- 37 percent of people in the coach-led group
- 35.9 percent in the self-directed group
- 14.4 percent in the usual care group
Both intervention groups performed significantly better than the usual care group in all aspects.
The authors conclude:
“The E-LITE trial makes a unique contribution to this growing literature in that its interventions integrate standardized, packaged DPP translational programs (delivered in groups or by DVD) with existing health IT (information technology). Although these intervention components and delivery channels are not new, their integration into structured interventions for use in primary care is novel.”
Written by Joseph Nordqvist