Dietary Patterns and Weight Loss in New-onset Type 2 Diabetes Mellitus: A Sub-analysis of the St Carlos Study: A 3-year, Randomized, Clinic-based, Interventional Study

Objective: To assess lifestyle patterns associated with weight loss in newly-diagnosed type 2 diabetic patients (T2DM) in the St Carlos Study.
Design: A 3-year, randomized, interventional study with three parallel groups.
Setting: A single-center, outpatient clinic-based study.
Participants: 195 newly-diagnosed T2DM were randomized to either the intervention group (self monitoring of blood glucose with-or-without an exercise program), or to the HbA1c control group. The same lifestyle-intervention protocol was applied in all patients. A questionnaire was applied to evaluate adherence to recommended lifestyle changes.
Main outcome measures: Patients were grouped by quartiles of body-weight loss at the end of follow-up.
Analysis: Multivariate linear-regression analyses were conducted to identify the independent effect of lifestyle patterns on three-year weight loss.
Results: Following a 3-year follow-up, median body weight loss was 2kg (IQR: -6/2.3). A higher level and an increase on physical activity, both leisure-time activity and sport exercise, and an increase in the nutrition score, mainly due to a higher consumption of nuts in substitution of cured sausages as snacks, and to a higher consumption of vegetables, legumes, whole grain cereals and fruits instead of juices, potatoes and white cereals, were associated to a greater weight loss (p<0.05). There was no association between low-fat diet and reduced body weight.
Conclusions and Implications: The application of simple recommendations (enhanced vegetable consumption, nuts for snacks, fruit instead of juices, wholegrain instead of processed cereals, legumes instead of potatoes, increased daily walking and stair-climbing) can achieve long-term, sustained weight loss in T2DM.