*For medical professionals only
"Diet therapy can't save diabetes", I was still a little surprised to see this conclusion in the results of clinical trials, because this is completely different from the existing perception, and it is said that lifestyle adjustments such as diet adjustment are very effective for diabetes?
If you look closely, you will understand the difference, but this clinical trial is actually a food safety support program called the "food-as-medicine program" in the United States. The incidence of diet-related chronic diseases is increasing year by year, and the program aims to improve people's health and reduce health care expenditures by helping people who do not have access to safe and healthy food.
The paper, published in JAMA Internal Medicine, is a small-scale result for people with type 2 diabetes. Participants were provided with healthy food, health guidance and disease education, but unfortunately, after 1 year of follow-up, although the participants' health awareness increased, there was no significant improvement in glycosylated hemoglobin (HbA1C).
Diagram of the title of the dissertation
The trial included participants with a diagnosis of type 2 diabetes with HbA1C levels of 8% or above and who were struggling with food safety concerns. The trial had a wait-list design, in which participants were randomly assigned to either a treatment group or a control group, with the treatment group participating immediately and the control group participating after six months, with a total follow-up of one year. The program will provide healthy ingredients for the whole family of participants with 10 meals per week, and arrange dietitian consultation, health guidance, diabetes disease education, and regular diabetes-related check-ups for participants.
A total of 349 of the enrolled participants were included in the analysis with laboratory results at six months. The median age of the participants was 55.4 years, 53.6% were female, and the median HbA1C level at baseline was 10.29%.
According to self-reports, the support program significantly made participants more health-conscious. At six months of follow-up, the treatment group had a significant increase in the number of times they consumed vegetables per week (6.3 versus four times/week), with a higher proportion of those who did not eat fast food (43.3 versus 36.3 percent) and less intake of sugar-sweetened beverages (2.8 versus 3.4 times/week). However, there is no statistically significant difference in these figures.
These data did not lead to more "health" among participants in the treatment group. At 6 months, there was a significant reduction in HbA1C levels in both the treatment and control groups by 1.5% and 1.3%, respectively, with no significant difference after adjusting for influencing factors. Re-examination at 12 months follow-up showed the same results.
Other laboratory findings, such as cholesterol, triglycerides, and fasting blood glucose levels, showed no significant changes.
Laboratory findings
Obviously, health awareness has improved, and material help has been received, but why has it not been translated into health benefits?
The researchers' thinking was that the program only provided the participants with the ingredients, but failed to take into account the difficulties in preparing the food later. It's understandable, it's that I don't know what food is healthy, it's that I don't know how good it is to make it myself than takeout, but do I have that time/money/craft?
On the paper's official website, one scholar also commented that the plan did not actually mention a specific dietary composition. According to previous research evidence, a low-fat diet based on plant-based foods can actually improve diabetes, and if the program only provides participants with "free food", then it can only solve some food safety problems.
Resources:
[1]https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2812982
The author of this article丨 Dai Siyu