ABSTRACT
PURPOSE: The purpose of the study was to examine the association of self-monitoring of blood glucose (SMBG) to weight loss and A1C among participants in a behavioral weight loss intervention. METHODS: Multivariate analyses were employed to evaluate the relationship between SMBG and changes in patient weight and A1C levels. Bootstrapping was used to determine whether there was an indirect effect of SMBG on weight loss through diet adherence and an indirect effect of SMBG on A1C through weight loss. RESULTS: The relationship between increased SMBG and greater weight loss was mediated by better adherence to diet. The relationship of increased SMBG and greater reductions in A1C were mediated by greater weight loss. CONCLUSIONS: Results of the study were consistent with the hypothesis that SMBG leads to an increased adherence to dietary recommendations. For patients who are taught to use their diet to lose weight, increased adherence to dietary recommendations is associated with increased weight loss and subsequently better glucose control. SMBG may be of value as an adjunctive intervention in behavioral programs for type 2 diabetes.
Subject(s)
Blood Glucose Self-Monitoring/methods , Blood Glucose/metabolism , Diabetes Mellitus, Type 2/blood , Glycated Hemoglobin/metabolism , Obesity/blood , Weight Reduction Programs/methods , Blood Glucose Self-Monitoring/psychology , Body Weight , Cross-Over Studies , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/psychology , Diabetes Mellitus, Type 2/therapy , Diet, Fat-Restricted , Exercise , Female , Humans , Male , Obesity/epidemiology , Obesity/prevention & control , Obesity/psychology , Patient Compliance , United States/epidemiology , Weight LossABSTRACT
BACKGROUND: Increased consumption of nuts has been advocated because of their health benefits, but the role of nuts in the treatment of obesity is unclear given their high energy density. OBJECTIVE: This study was designed to evaluate the effects of a hypocaloric, almond-enriched diet (AED) compared with a hypocaloric nut-free diet (NFD) on body weight and cardiovascular disease risk factors in the context of an 18-mo behavioral weight-management program. DESIGN: Overweight and obese individuals [n = 123; age = 46.8 y, BMI (in kg/m(2)) = 34.0] were randomly assigned to consume an AED or NFD and instructed in traditional behavioral methods of weight control. Anthropometric and metabolic measurements were made at baseline, 6 mo, and 18 mo. RESULTS: Those in the AED group lost slightly but significantly less weight than did those in the NFD group at 6 mo (-5.5 compared with -7.4 kg; P = 0.04), but there were no differences at 18 mo. No significant differences in body composition were found between the groups at 6 or 18 mo. The AED, compared with the NFD, was associated with greater reductions in total cholesterol (P = 0.03), total:HDL cholesterol (P = 0.02), and triglycerides (P = 0.048) at 6 mo, and no differences were observed between the groups at 18 mo. CONCLUSIONS: The AED and NFD groups experienced clinically significant and comparable weight loss at 18 mo. Despite smaller weight loss in the AED group at 6 mo, the AED group experienced greater improvements in lipid profiles. This trial was registered at clinicaltrials.gov as NCT00194428.
