A simple meal plan emphasizing healthy food choices is as effective as an exchange-based meal plan for urban African Americans with type 2 diabetes

David C. Ziemer, Kathy J. Berkowitz, Rita M. Panayioto, Imad M. El-Kebbi, Victoria C. Musey, Lynda A. Anderson, Nancy S. Wanko, Margaret L. Fowke, Carol W. Brazier, Virginia G. Dunbar, Wrenn Slocum, Gael M. Bacha, Daniel L. Gallina, Curtiss B. Cook, Lawrence S. Phillips

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

OBJECTIVE - To compare a simple meal plan emphasizing healthy food choices with a traditional exchange-based meal plan in reducing HbA1c levels in urban African Americans with type 2 diabetes. RESEARCH DESIGN AND METHODS - A total of 648 patients with type 2 diabetes were randomized to receive instruction in either a healthy food choices meal plan (HFC) or an exchange-based meal plan (EXCH) to compare the impact on glycemic control, weight loss, serum lipids, and blood pressure at 6 months of follow-up. Dietary practices were assessed with food frequency questionnaires. RESULTS - At presentation, the HFC and EXCH groups were comparable in age (52 years), sex (65% women), weight (94 kg), BMI (33.5), duration of diabetes (4.8 years), fasting plasma glucose (10.5 mmol/l), and HbA1c (9.4%). Improvements in glycemic control over 6 months were significant (P < 0.0001) but similar in both groups: HbA1c decreased from 9.7 to 7.8% with the HFC and from 9.6 to 7.7% with the EXCH. Improvements in HDL cholesterol and triglycerides were comparable in both groups, whereas other lipids and blood pressure were not altered. The HFC and EXCH groups exhibited similar improvement in dietary practices with respect to intake of fats and sugar sweetened foods. Among obese patients, average weight change, the percentage of patients losing weight, and the distribution of weight lost were comparable with the two approaches. CONCLUSIONS - Medical nutrition therapy is effective in urban African Americans with type 2 diabetes. Either a meal plan emphasizing guidelines for healthy food choices or a low literacy exchange method is equally effective as a meal planning approach. Because the HFC meal plan may be easier to teach and easier for patients to understand, it may be preferable for low-literacy patient populations.

Original languageEnglish (US)
Pages (from-to)1719-1724
Number of pages6
JournalDiabetes Care
Volume26
Issue number6
DOIs
StatePublished - Jun 1 2003
Externally publishedYes

Fingerprint

African Americans
Type 2 Diabetes Mellitus
Meals
Food
Weights and Measures
Nutrition Therapy
Blood Pressure
Lipids
HDL Cholesterol
Weight Loss
Fasting
Triglycerides
Research Design
Fats
Guidelines
Glucose
Serum
Population

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Ziemer, D. C., Berkowitz, K. J., Panayioto, R. M., El-Kebbi, I. M., Musey, V. C., Anderson, L. A., ... Phillips, L. S. (2003). A simple meal plan emphasizing healthy food choices is as effective as an exchange-based meal plan for urban African Americans with type 2 diabetes. Diabetes Care, 26(6), 1719-1724. https://doi.org/10.2337/diacare.26.6.1719

A simple meal plan emphasizing healthy food choices is as effective as an exchange-based meal plan for urban African Americans with type 2 diabetes. / Ziemer, David C.; Berkowitz, Kathy J.; Panayioto, Rita M.; El-Kebbi, Imad M.; Musey, Victoria C.; Anderson, Lynda A.; Wanko, Nancy S.; Fowke, Margaret L.; Brazier, Carol W.; Dunbar, Virginia G.; Slocum, Wrenn; Bacha, Gael M.; Gallina, Daniel L.; Cook, Curtiss B.; Phillips, Lawrence S.

In: Diabetes Care, Vol. 26, No. 6, 01.06.2003, p. 1719-1724.

Research output: Contribution to journalArticle

Ziemer, DC, Berkowitz, KJ, Panayioto, RM, El-Kebbi, IM, Musey, VC, Anderson, LA, Wanko, NS, Fowke, ML, Brazier, CW, Dunbar, VG, Slocum, W, Bacha, GM, Gallina, DL, Cook, CB & Phillips, LS 2003, 'A simple meal plan emphasizing healthy food choices is as effective as an exchange-based meal plan for urban African Americans with type 2 diabetes', Diabetes Care, vol. 26, no. 6, pp. 1719-1724. https://doi.org/10.2337/diacare.26.6.1719
Ziemer, David C. ; Berkowitz, Kathy J. ; Panayioto, Rita M. ; El-Kebbi, Imad M. ; Musey, Victoria C. ; Anderson, Lynda A. ; Wanko, Nancy S. ; Fowke, Margaret L. ; Brazier, Carol W. ; Dunbar, Virginia G. ; Slocum, Wrenn ; Bacha, Gael M. ; Gallina, Daniel L. ; Cook, Curtiss B. ; Phillips, Lawrence S. / A simple meal plan emphasizing healthy food choices is as effective as an exchange-based meal plan for urban African Americans with type 2 diabetes. In: Diabetes Care. 2003 ; Vol. 26, No. 6. pp. 1719-1724.
@article{0036657988664e809d6d1ef66b023ed4,
title = "A simple meal plan emphasizing healthy food choices is as effective as an exchange-based meal plan for urban African Americans with type 2 diabetes",
abstract = "OBJECTIVE - To compare a simple meal plan emphasizing healthy food choices with a traditional exchange-based meal plan in reducing HbA1c levels in urban African Americans with type 2 diabetes. RESEARCH DESIGN AND METHODS - A total of 648 patients with type 2 diabetes were randomized to receive instruction in either a healthy food choices meal plan (HFC) or an exchange-based meal plan (EXCH) to compare the impact on glycemic control, weight loss, serum lipids, and blood pressure at 6 months of follow-up. Dietary practices were assessed with food frequency questionnaires. RESULTS - At presentation, the HFC and EXCH groups were comparable in age (52 years), sex (65{\%} women), weight (94 kg), BMI (33.5), duration of diabetes (4.8 years), fasting plasma glucose (10.5 mmol/l), and HbA1c (9.4{\%}). Improvements in glycemic control over 6 months were significant (P < 0.0001) but similar in both groups: HbA1c decreased from 9.7 to 7.8{\%} with the HFC and from 9.6 to 7.7{\%} with the EXCH. Improvements in HDL cholesterol and triglycerides were comparable in both groups, whereas other lipids and blood pressure were not altered. The HFC and EXCH groups exhibited similar improvement in dietary practices with respect to intake of fats and sugar sweetened foods. Among obese patients, average weight change, the percentage of patients losing weight, and the distribution of weight lost were comparable with the two approaches. CONCLUSIONS - Medical nutrition therapy is effective in urban African Americans with type 2 diabetes. Either a meal plan emphasizing guidelines for healthy food choices or a low literacy exchange method is equally effective as a meal planning approach. Because the HFC meal plan may be easier to teach and easier for patients to understand, it may be preferable for low-literacy patient populations.",
author = "Ziemer, {David C.} and Berkowitz, {Kathy J.} and Panayioto, {Rita M.} and El-Kebbi, {Imad M.} and Musey, {Victoria C.} and Anderson, {Lynda A.} and Wanko, {Nancy S.} and Fowke, {Margaret L.} and Brazier, {Carol W.} and Dunbar, {Virginia G.} and Wrenn Slocum and Bacha, {Gael M.} and Gallina, {Daniel L.} and Cook, {Curtiss B.} and Phillips, {Lawrence S.}",
year = "2003",
month = "6",
day = "1",
doi = "10.2337/diacare.26.6.1719",
language = "English (US)",
volume = "26",
pages = "1719--1724",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "6",

}

TY - JOUR

T1 - A simple meal plan emphasizing healthy food choices is as effective as an exchange-based meal plan for urban African Americans with type 2 diabetes

AU - Ziemer, David C.

AU - Berkowitz, Kathy J.

AU - Panayioto, Rita M.

AU - El-Kebbi, Imad M.

AU - Musey, Victoria C.

AU - Anderson, Lynda A.

AU - Wanko, Nancy S.

AU - Fowke, Margaret L.

AU - Brazier, Carol W.

AU - Dunbar, Virginia G.

AU - Slocum, Wrenn

AU - Bacha, Gael M.

AU - Gallina, Daniel L.

AU - Cook, Curtiss B.

AU - Phillips, Lawrence S.

PY - 2003/6/1

Y1 - 2003/6/1

N2 - OBJECTIVE - To compare a simple meal plan emphasizing healthy food choices with a traditional exchange-based meal plan in reducing HbA1c levels in urban African Americans with type 2 diabetes. RESEARCH DESIGN AND METHODS - A total of 648 patients with type 2 diabetes were randomized to receive instruction in either a healthy food choices meal plan (HFC) or an exchange-based meal plan (EXCH) to compare the impact on glycemic control, weight loss, serum lipids, and blood pressure at 6 months of follow-up. Dietary practices were assessed with food frequency questionnaires. RESULTS - At presentation, the HFC and EXCH groups were comparable in age (52 years), sex (65% women), weight (94 kg), BMI (33.5), duration of diabetes (4.8 years), fasting plasma glucose (10.5 mmol/l), and HbA1c (9.4%). Improvements in glycemic control over 6 months were significant (P < 0.0001) but similar in both groups: HbA1c decreased from 9.7 to 7.8% with the HFC and from 9.6 to 7.7% with the EXCH. Improvements in HDL cholesterol and triglycerides were comparable in both groups, whereas other lipids and blood pressure were not altered. The HFC and EXCH groups exhibited similar improvement in dietary practices with respect to intake of fats and sugar sweetened foods. Among obese patients, average weight change, the percentage of patients losing weight, and the distribution of weight lost were comparable with the two approaches. CONCLUSIONS - Medical nutrition therapy is effective in urban African Americans with type 2 diabetes. Either a meal plan emphasizing guidelines for healthy food choices or a low literacy exchange method is equally effective as a meal planning approach. Because the HFC meal plan may be easier to teach and easier for patients to understand, it may be preferable for low-literacy patient populations.

AB - OBJECTIVE - To compare a simple meal plan emphasizing healthy food choices with a traditional exchange-based meal plan in reducing HbA1c levels in urban African Americans with type 2 diabetes. RESEARCH DESIGN AND METHODS - A total of 648 patients with type 2 diabetes were randomized to receive instruction in either a healthy food choices meal plan (HFC) or an exchange-based meal plan (EXCH) to compare the impact on glycemic control, weight loss, serum lipids, and blood pressure at 6 months of follow-up. Dietary practices were assessed with food frequency questionnaires. RESULTS - At presentation, the HFC and EXCH groups were comparable in age (52 years), sex (65% women), weight (94 kg), BMI (33.5), duration of diabetes (4.8 years), fasting plasma glucose (10.5 mmol/l), and HbA1c (9.4%). Improvements in glycemic control over 6 months were significant (P < 0.0001) but similar in both groups: HbA1c decreased from 9.7 to 7.8% with the HFC and from 9.6 to 7.7% with the EXCH. Improvements in HDL cholesterol and triglycerides were comparable in both groups, whereas other lipids and blood pressure were not altered. The HFC and EXCH groups exhibited similar improvement in dietary practices with respect to intake of fats and sugar sweetened foods. Among obese patients, average weight change, the percentage of patients losing weight, and the distribution of weight lost were comparable with the two approaches. CONCLUSIONS - Medical nutrition therapy is effective in urban African Americans with type 2 diabetes. Either a meal plan emphasizing guidelines for healthy food choices or a low literacy exchange method is equally effective as a meal planning approach. Because the HFC meal plan may be easier to teach and easier for patients to understand, it may be preferable for low-literacy patient populations.

UR - http://www.scopus.com/inward/record.url?scp=10744224637&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10744224637&partnerID=8YFLogxK

U2 - 10.2337/diacare.26.6.1719

DO - 10.2337/diacare.26.6.1719

M3 - Article

VL - 26

SP - 1719

EP - 1724

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 6

ER -