December 2017 Study Identifies Successful Dietary Factors in Type 2 Diabetes

Researchers at NUI Galway and the University of British Columbia find addressing dietary environment is more effective than addressing dietary behaviour

A new study published this month in the international journal Diabetes Care, provides important clues as to the most effective components of dietary lifestyle interventions, to help people with type 2 diabetes better control their condition and lose weight.

The international collaboration between scientists from NUI Galway and the University of British Columbia examined the data from all of the relevant published clinical trials. From thousands of studies conducted over four decades, they sought to identify how effective specific behaviour change techniques (BCTs) were in the 54 clinical trials of dietary interventions they identified.

Kevin Cradock, the study’s first author and an Irish Research Council postgraduate scholar at NUI Galway, said: “Behaviour change techniques are methods that can help people change their behaviour using a variety of techniques such as goals and planning or restructuring the environment. Changing the food environment is one of the keys to treating type 2 diabetes. Before we change the food environment we need to look carefully at what it is and how it affects us.”

“We examined systematically the individual behaviour change techniques in the 54 studies that assessed dietary modification strategies in type 2 diabetes patients”, explains Professor Heather Gainforth, senior author of the study from UBC Okanagan’s School of Health and Exercise Sciences. “The evidence indicates that people with type 2 diabetes need more support when it comes to changing their diets. Basically, instead of telling people to change what they eat, they should initially be given healthy meals and receive ongoing support to help change their eating habits.”

Dr Leo Quinlan from the School of Medicine at NUI Galway, said: “We discovered that the studies assessed were using 42 distinct behaviour change techniques, which are different ways to help people. While no individual behaviour change technique stood out, we did find that improvements in diabetes control and weight in affected patients were greater when they were provided with healthy meals and when they had frequent contact with health professionals such as dietitians.”

Professor Gainforth added: “Without any support, behaviour change efforts can quickly fall apart. We need to be thinking about a better way to support people with diabetes. It may seem impractical to provide food and control the food environment. However, we need to examine the viability of providing healthy meals at the beginning of a program, followed by instruction and feedback as to how to choose, shop for, and prepare these foods. Gradually, this approach may support people to prepare healthy meals independently.”

Professor Francis Finucane, study co-author and obesity physician at Galway University Hospitals, said: “It is interesting that interventions which influence the dietary environment were about 56% more effective than those which sought to persuade people to eat less unhealthily. This is consistent with our understanding now that obesity and diabetes are complex neurobehavioral disorders which are strongly genetically determined and are highly susceptible to environmental factors. If type 2 diabetes is a flood, rather than encouraging affected individuals to swim harder, we should seek to lower the water level.”

Professor Gainforth agrees: “It seems very clear that until we change the environment and change the way we look at diet and public policy, people will find it much harder to change their behaviour.”

The study was funded by the Irish Research Council. It involved scientists and engineers from NUI Galway’s Schools of Medicine and Engineering and Informatics and the Human Movement Laboratory at the CÚRAM Centre for Research in Medical Devices, along with behavioural scientists from Canada’s University of British Columbia Okanagan’s Faculty of Health and Social Development.

To read the full study in Diabetes Care, visit: http://care.diabetesjournals.org/content/40/12/1800

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