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- Title
Behaviour change techniques targeting both diet and physical activity in type 2 diabetes: A systematic review and meta-analysis.
- Authors
Cradock, Kevin A.; ÓLaighin, Gearóid; Finucane, Francis M.; Gainforth, Heather L.; Quinlan, Leo R.; Martin Ginis, Kathleen A.
- Abstract
Background: Changing diet and physical activity behaviour is one of the cornerstones of type 2 diabetes treatment, but changing behaviour is challenging. The objective of this study was to identify behaviour change techniques (BCTs) and intervention features of dietary and physical activity interventions for patients with type 2 diabetes that are associated with changes in HbA1c and body weight. Methods: We performed a systematic review of papers published between 1975-2015 describing randomised controlled trials (RCTs) that focused exclusively on both diet and physical activity. The constituent BCTs, intervention features and methodological rigour of these interventions were evaluated. Changes in HbA1c and body weight were meta-analysed and examined in relation to use of BCTs. Results: Thirteen RCTs were identified. Meta-analyses revealed reductions in HbA1c at 3, 6, 12 and 24 months of -1. 11 % (12 mmol/mol), -0.67 % (7 mmol/mol), -0.28 % (3 mmol/mol) and -0.26 % (2 mmol/mol) with an overall reduction of -0.53 % (6 mmol/mol [95 % CI -0.74 to -0.32, < 0.00001]) in intervention groups compared to control P groups. Meta-analyses also showed a reduction in body weight of -2.7 kg, -3.64 kg, -3.77 kg and -3.18 kg at 3, 6, 12 and 24 months, overall reduction was -3.73 kg (95 % CI -6.09 to -1.37 kg, = 0.002). P Four of 46 BCTs identified were associated with >0.3 % reduction in HbA1c: 'instruction on how to perform a behaviour', 'behavioural practice/rehearsal', 'demonstration of the behaviour' and 'action planning', as were intervention features 'supervised physical activity', 'group sessions', 'contact with an exercise physiologist', 'contact with an exercise physiologist and a dietitian', 'baseline HbA1c >8 %' and interventions of greater frequency and intensity. Conclusions: Diet and physical activity interventions achieved clinically significant reductions in HbA1c at three and six months, but not at 12 and 24 months. Specific BCTs and intervention features identified may inform more effective structured lifestyle intervention treatment strategies for type 2 diabetes.
- Subjects
TYPE 2 diabetes treatment; BEHAVIOR modification; BODY weight; CINAHL database; COMBINED modality therapy; CONFIDENCE intervals; GLYCOSYLATED hemoglobin; INFORMATION storage &; retrieval systems; MEDICAL databases; MEDICAL information storage &; retrieval systems; PSYCHOLOGY information storage &; retrieval systems; MEDLINE; META-analysis; ONLINE information services; PROBABILITY theory; REDUCING diets; RESEARCH funding; STATISTICS; T-test (Statistics); TERMS &; phrases; TIME; WEIGHT loss; SYSTEMATIC reviews; EVIDENCE-based medicine; PROFESSIONAL practice; STATISTICAL significance; EFFECT sizes (Statistics); RANDOMIZED controlled trials; INTER-observer reliability; RESEARCH bias; PHYSICAL activity; DATA analysis software; MEDICAL coding; DESCRIPTIVE statistics; EVALUATION
- Publication
International Journal of Behavioral Nutrition & Physical Activity, 2017, Vol 14, p1
- ISSN
1479-5868
- Publication type
Article
- DOI
10.1186/s12966-016-0436-0