Objectives
This study evaluated the effectiveness of a multi-component intervention in promoting physical activity (PA) and healthy diet, and its impact on weight, and glycemic control among obese adults with diabetes. Other metabolic and behavioral parameters were also assessed.
Study Design
cluster randomized controlled trial.
Methods
Four health centers (HCs) received monthly motivational interviewing phone consultations combined with pedometer use, while four HCs provided usual care. The intervention targeted ≥150 min of moderate-to-vigorous PA/week and gradual caloric reduction. Participants were physically inactive, overweight/obese adults with diabetes. Primary outcomes were changes in PA (MET.min/week), BMI, and HbA1c. Secondary outcomes included blood pressure, caloric intake, lipid profile, and PA behavior stages.
Results
Of the 595 approached participants [59.5 % female, mean (SD) age 46 (6.3) years], 68.6 % completed follow-up. Increases in PA were significantly greater in the intervention group (IG) compared with controls +262.3 (95 % CI:66.5-458.2, P = 0.009). Regression analysis demonstrated that odds of meeting PA recommendations at 12 months from baseline were 3.2 times higher in the IG vs CG (95 % CI:1.4-2.6, P = 0.004). Between-group differences favored the IG for reductions in mean sitting time hours/day (P = 0.003), BMI (P = 0.042), and caloric intake/day (P < 0.001) including lower intake of carbohydrates, proteins, and fats (all P < 0.001). No significant changes were observed in HbA1c, blood pressure, or lipids. At 12 months from baseline, individuals in the IG had 2.5 times higher odds of being in the maintenance stage compared to controls (95 % CI:1.8-3.5).
Conclusions
Results confirm the feasibility of integrating lifestyle technology bound promotional interventions within the routine diabetes care.