Kramer M Kaye, Venditti Elizabeth M, Semler Linda N, Kriska Andrea M, Miller Rachel G and Orchard Trevor J
The Group Lifestyle Balance (GLB) program, adapted from the Diabetes Prevention Program lifestyle intervention, has demonstrated effectiveness in reducing risk factors for diabetes and cardiovascular disease. Although overall carbohydrate quality was addressed in the GLB program, carbohydrate modification has not been a specific focus. Long- term strategies for maintaining healthy lifestyle practices are lacking. The purpose of this application was to examine the effectiveness of a GLB traditional post-core (TPC) program compared to a carbohydrate modification and hunger focus post-core (CPC) program. Both TPC and CPC consisted of 9 monthly support sessions following completion of identical 12 weekly GLB sessions. The primary outcome was weight change; secondary outcomes included HbA1c, fasting glucose and lipid profile, systolic and diastolic blood pressure (SBP, DPB), and waist circumference (WC). A total of 60 participants with pre-diabetes and/or the metabolic syndrome were enrolled in four intervention groups. After completion of the initial 12 GLB sessions, participants were randomly assigned by group to TPC (N=31) or CPC (N=29). Between baseline and 4 months, by intention-to-treat analysis, similar significant weight loss was noted in both groups (TPC -4.0% vs. CPC -4.5%, p=0.41), along with significant decreases in HbA1c, SBP, DBP, and WC; no differences were noted between TPC and CPC groups. Assessments were also conducted 8 and 12 months from baseline. At 8 months the CPC program initially showed a significant fall in HbA1c (p=0.01); however, no significant fall was seen for TPC. At 12 months, similar significant weight loss (from baseline) was maintained by both groups (TPC-2.6% vs. CPC -3.8%, p=0.31) and similar significant decreases in SBP, DBP and WC were also noted. However, there were no differences between the groups for any measure. These results suggest that both post-core strategies were successful in maintaining a reduction in diabetes and CVD risk factors at 12 months.