Dietary Pattern and Weight Loss in New-onset Type 2 Diabetes Mellitus: A Sub-analysis of the St Carlos Study: A 3-year, Randomized, Clinic-based, Interventional Study.

ABSTRACT

Objective: To assess lifestyle patterns associated with weight loss in newly-diagnosed type 2 diabetic patients (T2DM) in the St Carlos Study. Design: A 3-year, randomized, interventional study with three parallel groups. Setting: A single-center, outpatient clinic-based study. Participants: 195 newly-diagnosed T2DM were randomized to either the intervention group (self monitoring of blood glucose with-or-without an exercise program), or to the HbA1c control group. The same lifestyle-intervention protocol was applied in all patients. A questionnaire was applied to evaluate adherence to recommended lifestyle changes. Main outcome measures: Patients were grouped by quartiles of body-weight loss at the end of follow-up. Analysis: Multivariate linear-regression analyses were conducted to identify the independent effect of lifestyle patterns on three-year weight loss. Results: Following a 3-year follow-up, median body weight loss was 2kg (IQR -6/2.3). A higher level and an increase on physical activity, both leisure-time activity and sport exercise, and an increase in the nutrition score, mainly due to a higher consumption of nuts in substitution of cured sausages as snacks, and to a higher consumption of vegetables, legumes, whole grain cereals and fruits instead of juices, potatoes and white cereals, were associated to a greater weight loss (p<0.05). There was no association between low-fat diet and reduced body weight. Conclusions and Implications The application of simple recommendations (enhanced vegetable consumption, nuts for snacks, fruit instead of juices, wholegrain instead of processed cereals, legumes instead of potatoes, increased daily walking and stairclimbing) can achieve long-term, sustained weight loss in T2DM.