PDF(Pubmed)
Abstract：
BACKGROUND: Nutritional management plays a crucial role in treating patients with type 2 diabetes (T2D), working to prevent and control the progression of chronic non-communicable diseases.
OBJECTIVE: To evaluate the effects of individualized nutritional interventions on weight, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), fasting blood glucose (FBG), hemoglobin A1c (HbA1c), total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), triglycerides (TGs), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR)} over 12 months and subsequently at follow-up (15 months).
METHODS: This longitudinal experimental study (without randomization and blinding) enrolled 84 sedentary participants with T2D (both sexes, aged 18-80 years). They were divided into a control group of 40 participants who received only medical consultations, and an intervention group of 44 participants who received the same medical care along with a nutritional assessment. Consultations occurred quarterly from August 2020 to November 2022 (first-twelfth month), with six to nine patients per session. Subsequently, a follow-up was conducted from December 2022 to November 2023, during which the intervention group had only medical care (during the 12th-15th months). Personalized dietary planning was inspired by the Mediterranean/DASH diets adapted to Brazilian foods and socioeconomic cultures.
METHODS: Normal variables were compared between groups for each time point and also within each group across different time points using a two-way ANOVA (repeated measures for intragroup) followed by the Šídák post hoc test. Non-normal variables were compared between groups for each time point using Kruskal-Wallis followed by the Dunn post hoc test, and within each group across different time points using Friedman followed by the Dunn post hoc test. Data with a Gaussian distribution were presented as mean ± standard deviation (SD), and data with a non-Gaussian distribution were presented as median ± interquartile range (IQR). For all cases, α < 0.05 and p < 0.05 were adopted.
RESULTS: In the intervention group, significant reductions were observed between the first and twelfth month for all parameters (p < 0.05), (except for TC), along with an increase in HDL-C (p = 0.0105). Conversely, in the control group, there was a significant increase in HbA1c, weight, BMI, FBG, and WHR (p < 0.05) between the first and twelfth months. Regarding the comparison between groups, there was a significant difference for all analyzed parameters (p < 0.05) from the first to the twelfth month. In the follow-up, differences were also observed (p < 0.05), except for BMI (p > 0.05).
CONCLUSIONS: The individualized nutritional intervention improved eating habits, anthropometric, biochemical, and cardiovascular markers in T2D over 12 months, with sustained results during follow-up. The dietary plan inspired by the Mediterranean and DASH diets demonstrated good adaptation to the Brazilian food culture and the patients\' socioeconomic contexts. Consistent monitoring and personalized nutritional management are essential for optimizing long-term outcomes. However, more clinical trials are necessary in order to optimize the level of evidence for longitudinal interventions.
OBJECTIVE: To evaluate the effects of individualized nutritional interventions on weight, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), fasting blood glucose (FBG), hemoglobin A1c (HbA1c), total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), triglycerides (TGs), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR)} over 12 months and subsequently at follow-up (15 months).
METHODS: This longitudinal experimental study (without randomization and blinding) enrolled 84 sedentary participants with T2D (both sexes, aged 18-80 years). They were divided into a control group of 40 participants who received only medical consultations, and an intervention group of 44 participants who received the same medical care along with a nutritional assessment. Consultations occurred quarterly from August 2020 to November 2022 (first-twelfth month), with six to nine patients per session. Subsequently, a follow-up was conducted from December 2022 to November 2023, during which the intervention group had only medical care (during the 12th-15th months). Personalized dietary planning was inspired by the Mediterranean/DASH diets adapted to Brazilian foods and socioeconomic cultures.
METHODS: Normal variables were compared between groups for each time point and also within each group across different time points using a two-way ANOVA (repeated measures for intragroup) followed by the Šídák post hoc test. Non-normal variables were compared between groups for each time point using Kruskal-Wallis followed by the Dunn post hoc test, and within each group across different time points using Friedman followed by the Dunn post hoc test. Data with a Gaussian distribution were presented as mean ± standard deviation (SD), and data with a non-Gaussian distribution were presented as median ± interquartile range (IQR). For all cases, α < 0.05 and p < 0.05 were adopted.
RESULTS: In the intervention group, significant reductions were observed between the first and twelfth month for all parameters (p < 0.05), (except for TC), along with an increase in HDL-C (p = 0.0105). Conversely, in the control group, there was a significant increase in HbA1c, weight, BMI, FBG, and WHR (p < 0.05) between the first and twelfth months. Regarding the comparison between groups, there was a significant difference for all analyzed parameters (p < 0.05) from the first to the twelfth month. In the follow-up, differences were also observed (p < 0.05), except for BMI (p > 0.05).
CONCLUSIONS: The individualized nutritional intervention improved eating habits, anthropometric, biochemical, and cardiovascular markers in T2D over 12 months, with sustained results during follow-up. The dietary plan inspired by the Mediterranean and DASH diets demonstrated good adaptation to the Brazilian food culture and the patients\' socioeconomic contexts. Consistent monitoring and personalized nutritional management are essential for optimizing long-term outcomes. However, more clinical trials are necessary in order to optimize the level of evidence for longitudinal interventions.
摘要：
背景：营养管理在治疗2型糖尿病（T2D）患者中起着至关重要的作用，努力预防和控制慢性非传染性疾病的发展。
目的：为了评估个体化营养干预对体重的影响，体重指数（BMI），腰围（WC），腰臀比（WHR），空腹血糖（FBG），血红蛋白A1c（HbA1c），总胆固醇(TC),LDL胆固醇(LDL-C),HDL胆固醇（HDL-C），甘油三酯（TG），收缩压（SBP），舒张压（DBP），和心率（HR）}超过12个月，随后在随访（15个月）。
方法：这项纵向实验研究（没有随机化和致盲）招募了84名久坐的T2D参与者（两种性别，18-80岁)。他们被分成一个由40名参与者组成的对照组，他们只接受医疗咨询，和一个由44名参与者组成的干预组，他们接受了相同的医疗护理以及营养评估。咨询每季度进行一次，从2020年8月到2022年11月（第一个至第十二个月），每节六到九名患者。随后，从2022年12月至2023年11月进行了随访,期间干预组仅接受了医疗护理(12~15个月).个性化饮食计划的灵感来自适应巴西食品和社会经济文化的地中海/DASH饮食。
方法：使用双向方差分析（群体内的重复测量），在每个时间点的组间以及在不同时间点的组间比较正常变量，然后进行希达克事后检验。使用Kruskal-Wallis比较每个时间点的非正态变量，然后进行Dunn事后检验，在不同时间点的每组中使用弗里德曼，然后进行邓恩事后检验。高斯分布的数据以平均值±标准偏差(SD)表示，非高斯分布的数据以中值±四分位数间距(IQR)表示.对于所有情况,采用α<0.05和p<0.05。
结果：在干预组中，在第一个月和第十二个月之间观察到所有参数的显着降低（p<0.05），（TC除外），随着HDL-C的增加（p=0.0105）。相反，在对照组中，HbA1c显着增加，体重,BMI,FBG,第1个月和第12个月之间的WHR（p<0.05）。关于组间比较，从第1个月到第12个月，所有分析参数均存在显着差异（p<0.05）。在后续行动中,也观察到差异(p<0.05)，除BMI外(p>0.05)。
结论：个性化营养干预改善了饮食习惯，人体测量学,生物化学，和T2D的心血管标志物超过12个月，在随访期间有持续的结果。受地中海和DASH饮食启发的饮食计划表现出对巴西饮食文化和患者社会经济环境的良好适应。一致的监测和个性化的营养管理对于优化长期结果至关重要。然而,为了优化纵向干预的证据水平,需要更多的临床试验.
目的：为了评估个体化营养干预对体重的影响，体重指数（BMI），腰围（WC），腰臀比（WHR），空腹血糖（FBG），血红蛋白A1c（HbA1c），总胆固醇(TC),LDL胆固醇(LDL-C),HDL胆固醇（HDL-C），甘油三酯（TG），收缩压（SBP），舒张压（DBP），和心率（HR）}超过12个月，随后在随访（15个月）。
方法：这项纵向实验研究（没有随机化和致盲）招募了84名久坐的T2D参与者（两种性别，18-80岁)。他们被分成一个由40名参与者组成的对照组，他们只接受医疗咨询，和一个由44名参与者组成的干预组，他们接受了相同的医疗护理以及营养评估。咨询每季度进行一次，从2020年8月到2022年11月（第一个至第十二个月），每节六到九名患者。随后，从2022年12月至2023年11月进行了随访,期间干预组仅接受了医疗护理(12~15个月).个性化饮食计划的灵感来自适应巴西食品和社会经济文化的地中海/DASH饮食。
方法：使用双向方差分析（群体内的重复测量），在每个时间点的组间以及在不同时间点的组间比较正常变量，然后进行希达克事后检验。使用Kruskal-Wallis比较每个时间点的非正态变量，然后进行Dunn事后检验，在不同时间点的每组中使用弗里德曼，然后进行邓恩事后检验。高斯分布的数据以平均值±标准偏差(SD)表示，非高斯分布的数据以中值±四分位数间距(IQR)表示.对于所有情况,采用α<0.05和p<0.05。
结果：在干预组中，在第一个月和第十二个月之间观察到所有参数的显着降低（p<0.05），（TC除外），随着HDL-C的增加（p=0.0105）。相反，在对照组中，HbA1c显着增加，体重,BMI,FBG,第1个月和第12个月之间的WHR（p<0.05）。关于组间比较，从第1个月到第12个月，所有分析参数均存在显着差异（p<0.05）。在后续行动中,也观察到差异(p<0.05)，除BMI外(p>0.05)。
结论：个性化营养干预改善了饮食习惯，人体测量学,生物化学，和T2D的心血管标志物超过12个月，在随访期间有持续的结果。受地中海和DASH饮食启发的饮食计划表现出对巴西饮食文化和患者社会经济环境的良好适应。一致的监测和个性化的营养管理对于优化长期结果至关重要。然而,为了优化纵向干预的证据水平,需要更多的临床试验.
