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The use of intensive lifestyle interventions focused on modifying dietary and physical activity patterns with the help of behavioral strategies can lead to sustained weight loss in African Americans and Hispanics with type 2 diabetes (T2D), according to a new study published online today at Obesity, the flagship newspaper of the society of obesity.
The researchers explain that rates of obesity and T2DM are particularly high among African American and Hispanic adults and underlie the considerable health disparities observed in these populations. Limited published data are available on the specific components of effective lifestyle interventions for men and women with minority-acquired T2DM or on individual weight control practices badociated with weight control, leaving gaps in scientific literature and a lack of guidance on how to customize intervention approaches for these high-risk populations.
"Current research indicates key elements of the lifestyle intervention program that are badociated with effective and long-term weight control among minority men and women, as well as specific behavioral strategies that could be highlighted within individual subgroups in order to optimize the results "said one of the authors of the study, Delia West, PhD, of the Arnold School of Public Health & Health University of South Carolina at Columbia.
To extend the previous results, West and his colleagues reviewed the information collected as part of the Action for Health in Diabetes (Look AHEAD) trial. The researchers studied 2,361 men and African-American white women, Hispanic and non-Hispanic, with obesity and T2D, who were randomized to receive the Interactive Lifestyle Intervention (ILI). Participants received a 10% weight loss goal to achieve through a decrease in calorie and fat intake; and increased physical activity. Weight changes were measured at one, four and eight years of age.
Study participants attended weekly, individual and group counseling sessions for the first six months (three group sessions and one individual session), followed by three sessions per month (two group sessions and one individual session). ), during the second semester. Structured meal plans and meal replacements were provided free of charge to facilitate the attainment of weight loss goals. Participants were required to participate in at least 175 minutes / week of moderate intensity physical activity and unattended, such as brisk walking. Researchers asked participants to record their dietary intake, calculate their calorie and fat intake, record their weight, and monitor their physical activity daily with the aid of a paper diary. Behavioral strategies included goal setting, problem solving, social support, and relapse prevention.
Results revealed strong participation in individual and group counseling sessions. According to West and colleagues, participation in an individual session appears to be particularly important for successful weight loss in Hispanic and African-American men, while group participation is strongly badociated with weight loss among men. Hispanic and African-American women.
The study's authors also found that the use of meal replacements was high during the first year of intervention. The researchers however indicated that meal replacements were not an independent predictor of weight loss among Hispanics or African-American men, but that they were strongly badociated with weight loss. lower in African-American women.
The researchers found that daily monitoring of body weight was badociated with successful weight loss during the first year of intervention in African-American men and women with T2DM and that this treatment remained important for the weight maintenance in African American women, but was not as strongly badociated with weight. loss outcomes in Hispanic men and women with T2D.
"The flu-like syndrome is remarkable in that it has managed to lose weight in eight years in a diverse sample of people with diabetes, more than a third of them self-employed. -identifying as belonging to a group of racial or ethnic minorities.Also, 40% of the participants were male, which contrasts with most previous weight control studies that included few men, "write West and his colleagues in the report.
Jamy Ard, MD, FTOS, professor of epidemiology and prevention at the Wake Forest School of Medicine in Winston-Salem, North Carolina, who was not badociated with the research, said that Study had two important implications.
"First, it shows that people respond differently to different treatments, so we should continue to look for personalized treatment approaches, using different tools in the behavioral toolbox based on individual characteristics." Second, this work shows that Behavioral treatment can be effective for: a diverse population, especially when treatment is frequent and long-term If we want to fight disparities and engage in effective treatment of obesity in diverse populations, it will probably be necessary to provide access to care and insurance coverage for these treatments, "Ard said.
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