Introduction and Objective: To address the unmet need for sustainable lifestyle interventions in type 2 diabetes (T2D), we evaluated the sustained effects of a Teaching Kitchen (TK) program among patients with T2D in Japan.Methods: We conducted a randomized controlled trial with 112 patients (59 men, 53 women) aged 20-79 years with T2D and BMI ≥23 kg/m² or abdominal obesity. Patients were randomized to an intervention group (IG) or a wait-list control group (CG). The TK program, based on the US TK Multisite Trial, integrated lifestyle education, hands-on cooking, and personalized behavioral goal-setting. The program consisted of a 4-month main phase (weekly classes) and an 8-month maintenance phase (monthly classes). The primary outcome was the between-group difference in HbA1c change during the 4-month randomized phase. Secondary outcomes included CGM metrics, anthropometric measures, and program engagement. Sustained effects on outcomes were assessed 4 months after completion of the 12-month intervention.Results: During the 4-month randomized phase, HbA1c significantly decreased in IG compared to CG (7.4% to 6.9% vs 7.3% to 7.2%, p<0.001). CGM metrics improved, including lower mean glucose (154 to 136 mg/dL), higher time in range (73.2% to 80.7%), reduced time above range (25.4% to 16.3%) and lower glycemic variability (MAGE 108 to 93 mg/dL, all p<0.001), with no significant increase in time below range (1.5% to 3.0%, p=0.23). Importantly, after completion of the 12-month intervention and post-intervention follow-up, improvements were maintained in HbA1c (-0.3%), body weight (-3.1 kg), waist circumference (-4.2 cm), visceral fat area (-17.7 cm²), and systolic/diastolic blood pressure (-10.8/-7.0 mmHg, all p<0.001 vs baseline). The program completion rate was 100%, and the mean class attendance rate was 84.3%.Conclusion: A TK program improved glycemic control and other metabolic outcomes, with benefits sustained after the post-intervention follow-up. High completion and attendance rates support its applicability.
M.Y. Baden: Research Support; Current; Abbott Diabetes, CancerScan Inc. Other – MYB is affiliated with the Department of Lifestyle Medicine, an endowed course supported by Kubara Honke Group Co., Ltd.; Current; Kubara Honke Group Co., Ltd. T. Kagisaki: None. T. Horii: None. Y. Fujishima: None. J. Kozawa: Other – I am affiliated with the Department of Diabetes Care Medicine, an endowed course supported by NISSIN FOODS HOLDINGS CO., LTD.; Current; NISSIN FOODS HOLDINGS CO., LTD. Other – I am affiliated with the Department of Diabetes Care Medicine, an endowed course supported by LOTTE CO., LTD.; Current; LOTTE CO., LTD. Other – I am affiliated with the Department of Diabetes Care Medicine, an endowed course supported by Nippon Boehringer Ingelheim Co., Ltd.; Current; Nippon Boehringer Ingelheim Co., Ltd. H. Nishizawa: None. I. Muraki: Research Support; Current; Ono Pharmaceutical Co., Ltd. Y. Furuya: None. A. Yonekura: None. T. Yamashita: None. T. Kawabe: None. J. Massa: None. A. McClure: None. D. Eisenberg: Consultant; Current; Teaching Kitchen Collaborative, Northwell Health, CancerScan Japan, Nissin, Inc. Japan. F. Hu: None. I. Shimomura: None.
Grants-in-Aid for Scientific Research (23K16772); Young investigator grant from the Japan Diabetes Society; Research grant from the Lotte Foundation; Research grant from the G-7 Scholarship Foundation; Collaborative research funding from Cancerscan, Inc. and Kubara Honke Group Co., Ltd
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