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

Hdl Handle:
http://hdl.handle.net/10147/621053
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; Ginis, Kathleen A M
Citation:
International Journal of Behavioral Nutrition and Physical Activity. 2017 Feb 08;14(1):18
Issue Date:
8-Feb-2017
URI:
http://dx.doi.org/10.1186/s12966-016-0436-0; http://hdl.handle.net/10147/621053
Abstract:
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, 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. 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.
Language:
en
Keywords:
DIABETES MELLITUS; DIET; PHYSICAL ACTIVITY

Full metadata record

DC FieldValue Language
dc.contributor.authorCradock, Kevin Aen
dc.contributor.authorÓLaighin, Gearóiden
dc.contributor.authorFinucane, Francis Men
dc.contributor.authorGainforth, Heather Len
dc.contributor.authorQuinlan, Leo Ren
dc.contributor.authorGinis, Kathleen A Men
dc.date.accessioned2017-02-10T16:32:52Z-
dc.date.available2017-02-10T16:32:52Z-
dc.date.issued2017-02-08-
dc.identifier.citationInternational Journal of Behavioral Nutrition and Physical Activity. 2017 Feb 08;14(1):18en
dc.identifier.urihttp://dx.doi.org/10.1186/s12966-016-0436-0-
dc.identifier.urihttp://hdl.handle.net/10147/621053-
dc.description.abstractAbstract 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, 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. 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.-
dc.language.isoenen
dc.subjectDIABETES MELLITUSen
dc.subjectDIETen
dc.subjectPHYSICAL ACTIVITYen
dc.titleBehaviour change techniques targeting both diet and physical activity in type 2 diabetes: A systematic review and meta-analysisen
dc.language.rfc3066en-
dc.rights.holderThe Author(s).-
dc.date.updated2017-02-08T17:04:04Z-
All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.