Behaviour change techniques targeting both diet and physical activity in type 2 diabetes: A systematic review and meta-analysis

International Journal of Behavioral Nutrition and Physical Activity

Review

Francis M. Finucane¹  Gearóid ÓLaighin²  Leo R. Quinlan³  Kevin A. Cradock⁴  Kathleen A. Martin Ginis⁵  Heather L. Gainforth⁶ 

[1] Bariatric Medicine Service, Galway Diabetes Research Centre, HRB Clinical Research Facility, Galway, Ireland;Electrical & Electronic Engineering, School of Engineering & Informatics, NUI Galway, University Road, Galway, Ireland;National Centre for Biomedical Engineering Science, NUI Galway, University Road, Galway, Ireland;Physiology, School of Medicine, NUI Galway, University Road, Galway, Ireland;Physiology, School of Medicine, NUI Galway, University Road, Galway, Ireland;Electrical & Electronic Engineering, School of Engineering & Informatics, NUI Galway, University Road, Galway, Ireland;School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia, ART 129-1147 Research Road, V1V 1 V7, Kelowna, BC, Canada;School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia, ART 129– 1147, Research Road, V1V 1 V7, Kelowna, BC, Canada;

关键词: Behaviour change techniques;    Diet;    Physical activity;    Type 2 diabetes;    HbA;    Systematic review;    Meta-analysis;   

DOI  :  10.1186/s12966-016-0436-0

 received in 2016-07-18, accepted in 2016-10-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundChanging 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.MethodsWe 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.ResultsThirteen 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, P < 0.00001]) in intervention groups compared to control 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, P = 0.002).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.ConclusionsDiet 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.

【 授权许可】

CC BY   
© The Author(s). 2017