Nutritional education through Internet-delivered menu plans among adults with type 2 diabetes mellitus: Pilot study

Background: a potential barrier to weight loss and vascular risk reduction is difficulty in operationalizing dietary education into a concrete plan. although a variety of internet-based software tools are now available to address this issue,there has been little formal evaluation of these tools. objective: the aim of this single-arm pilot study is to determine the effect of a 24-week internet-based menu-planning program,by examining pre- to postintervention changes in the body weight,blood pressure,and glycemia,specifically among overweight adults with type 2 diabetes mellitus (dm2),a clinical population at high risk for vascular diseases. methods: a total of 33 adults with dm2 were recruited by collaborating registered dietitians to a 24-week internet-based menu-planning program. individualized dietary prescriptions were operationalized into weekly internet-delivered menu plans through an adapted version of a commercially available service. adherence was defined as logging into the program at least once per week for a minimum of 18 of the 24 weeks. multiple imputations were used for missing data. using baseline and postintervention assessments,we calculated the weight changes (mean,95% ci) and investigated the corresponding effects (linear regression models) on blood pressure (systolic,diastolic) and hemoglobin a1c (ie,glycemia). results: the mean age was 58 (sd 7) years and the mean baseline body mass index was 34.4 (sd 4.6) kg/m2. the results of this study showed that ≥5% weight reduction was achieved by 6/33 participants (18%) and by 5/18 adherent participants (28%). a mean weight change of -2.0% (95% ci -2.6 to -1.4) was observed,with changes occurring in the adherent (-3.6%,95% ci -4.5 to -2.8) but not in the nonadherent (0%,95% ci -0.6 to 0.7). it was found that each 1% reduction in body weight was associated with a -2.4 mmhg change in systolic (95% ci -3.5 to -1.2) and a -0.8 mmhg change in diastolic blood pressure (95% ci -1.4 to -0.2). percent weight change was not found to be related to changes in a1c. conclusions: in adults with dm2,an internet-based menu-planning program has the potential to lead to clinically important weight reductions in more than one quarter of those who adhere,with corresponding improvements in blood pressure. © abeer bader,réjeanne gougeon,lawrence joseph,deborah da costa,kaberi dasgupta.