Introduction and Objective: The National Diabetes Prevention Program (NDPP) can reduce risk of type 2 diabetes (T2D), yet many people face barriers. Alternative diets to the NDPP low fat diet, such as a very low carbohydrate diet (VLCD), may improve engagement and outcomes. Thus, we are conducting a 12-month randomized controlled comparative effectiveness trial of the NDPP and a VLCD version for adults with overweight/obesity and prediabetes. The objective of this study was to compare experiences during the programs to understand acceptability and influences on outcomes.Methods: Interviews were conducted with a subsample of trial participants after 4 months. We invited participants with high and low relative weight loss from both programs to ensure representation in study outcomes. Data were analyzed using thematic analysis, including line-by-line coding, participant summaries, and discussion to develop themes within and between the NDPP and VLCD programs.Results: We have interviewed 31 participants to date (13 NDPP, 18 VLCD). Mean age was 58, 52% were female and 42% were White, 26% Asian, 13% Black, and 13% Hispanic. Themes were: 1) Motivated to lose weight, avoid T2D; 2) Social support promoted accountability, social pressure limited adherence; 3) Growth mindsets helped face challenges; 4) Health improvements increased commitment; 5) Desired more nutrition and T2D risk information. Differences between programs included what type of information was desired, perceived flexibility of the diet, and acceptability among family, friends, and providers.Conclusion: NDPP and VLCD programs were viewed positively, and engagement was supported by program structure. Future interventions may benefit from group interaction to emphasize support and accountability. Understanding the link between diet and T2D could increase motivation and may similarly support patient counseling in clinical settings. VLCD participants may need additional resources to support flexibility in social settings.
M. DeJonckheere: None. D. Dikeman: None. A.M. Fritz: None. S. Greenwell: None. M. Munawar: None. J. Krinock: None. W.S. Yancy: Consultant; FoodMinds. D.H. Griauzde: None. L. Saslow: None.
National Institutes of Health (R01DK125792)
Source link
Leave a Reply