Effectiveness of A Multifactorial Intervention in Increasing Adherence to the Mediterranean Diet among Patients with Diabetes Mellitus Type 2: A Controlled and Randomized Study (EMID Study)

Rosario Alonso-Domínguez, Luis García-Ortiz, Maria C Patino-Alonso, Natalia Sánchez-Aguadero, Manuel A Gómez-Marcos, José I Recio-Rodríguez, Rosario Alonso-Domínguez, Luis García-Ortiz, Maria C Patino-Alonso, Natalia Sánchez-Aguadero, Manuel A Gómez-Marcos, José I Recio-Rodríguez

Abstract

The Mediterranean diet (MD) is recognized as one of the healthiest dietary patterns and has benefits such as improving glycaemic control among patients with type 2 diabetes (T2DM). Our aim is to assess the effectiveness of a multifactorial intervention to improve adherence to the MD, diet quality and biomedical parameters. The EMID study is a randomized and controlled clinical trial with two parallel groups and a 12-month follow-up period. The study included 204 subjects between 25⁻70 years with T2DM. The participants were randomized into intervention group (IG) and control group (CG). Both groups received brief advice about healthy eating and physical activity. The IG participants additionally took part in a food workshop, five walks and received a smartphone application for three months. The population studied had a mean age of 60.6 years. At the 3-month follow-up visit, there were improvements in adherence to the MD and diet quality of 2.2 and 2.5 points, compared to the baseline visit, respectively, in favour of the IG. This tendency of the improvement was maintained, in favour of the IG, at the 12-month follow-up visit. In conclusion, the multifactorial intervention performed could improve adherence to the MD and diet quality among patients with T2DM.

Keywords: Mediterranean diet; health education; information and communication technologies; type 2 diabetes.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses or interpretation of data; in the writing of the manuscript or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flow-chart of the EMID Study: enrolment of the participants and completion of the study.
Figure 2
Figure 2
Changes in the number of subjects with suitable adherence to the Mediterranean diet and quality of diet. The chi-squared test or Fisher exact test was carried out.
Figure 3
Figure 3
Changes in the MEDAS score and the DQI score tasks in response to the multifactorial intervention. Repeated-measures ANOVA was been performed with adjustment for the baseline visit. MEDAS: Mediterranean Diet Screener; DQI: Diet Quality Index.

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