Document Detail

Multicenter randomized trial of a comprehensive prepared meal program in type 2 diabetes.
MedLine Citation:
PMID:  10333932     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the clinical effects of a comprehensive prepackaged meal plan, incorporating the overall dietary guidelines of the American Diabetes Association and other national health organizations, relative to those of a self-selected diet based on exchange lists in free-living individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 202 women and men (BMI < or = 42 kg/m2) whose diabetes was treated with diet alone or an oral hypoglycemic agent were enrolled at 10 medical centers. After a 4-week baseline period, participants were randomized to a nutrient-fortified prepared meal plan or a self-selected exchange-list diet for 10 weeks. On a caloric basis, both interventions were designed to provide 55-60% carbohydrate, 20-30% fat, and 15-20% protein. At intervals, 3-day food records were completed, and body weight, glycemic control, plasma lipids, and blood pressure were assessed. RESULTS: Food records showed that multiple nutritional improvements were achieved with both diet plans. There were significant overall reductions in body weight and BMI, fasting plasma glucose and serum insulin, fructosamine, HbA1c, total and LDL cholesterol, and blood pressure (P < 0.001 or better for all). In general, differences in major end points between the diet plans were not statistically significant. CONCLUSIONS: Glycemic control and cardiovascular risk factors improve in individuals with type 2 diabetes who consume diets in accordance with the American Diabetes Association guidelines. The prepared meal program was as clinically effective as the exchange-list diet. The prepared meal plan has the additional advantages of being easily prescribed and eliminating the complexities of meeting the multiple dietary recommendations for type 2 diabetes management.
F X Pi-Sunyer; C A Maggio; D A McCarron; M E Reusser; J S Stern; R B Haynes; S Oparil; P Kris-Etherton; L M Resnick; A Chait; C D Morris; D C Hatton; J A Metz; G W Snyder; S Clark; M McMahon
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetes care     Volume:  22     ISSN:  0149-5992     ISO Abbreviation:  Diabetes Care     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-07-09     Completed Date:  1999-07-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7805975     Medline TA:  Diabetes Care     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  191-7     Citation Subset:  IM    
Division of Endocrinology, Diabetes, and Nutrition, St. Luke's-Roosevelt Hospital Center, Columbia University, College of Physicians and Surgeons, New York, NY 10025, USA.
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MeSH Terms
Blood Glucose / metabolism
Blood Pressure
Body Weight
Diabetes Mellitus, Type 2 / blood,  diet therapy*,  physiopathology
Diabetic Diet*
Diet Records
Energy Intake
Food Preferences*
Fructosamine / blood
Hemoglobin A, Glycosylated / analysis
Hypoglycemic Agents / therapeutic use
Lipids / blood
Middle Aged
Risk Factors
United States
Voluntary Health Agencies
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 0/Lipids; 4429-04-3/Fructosamine

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