Long-term changes in dietary and food intake behaviour in the Diabetes Prevention Program Outcomes Study
Open accessAbstract
AIMS: To compare change in dietary intake, with an emphasis on food groups and food intake behaviour, over time across treatment arms in a diabetes prevention trial and to assess the differences in dietary intake among demographic groups within treatment arms. METHODS: Data are from the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study. Participants were randomized to a lifestyle intervention (n = 1079), metformin (n = 1073) or placebo (n = 1082) for an average of 3 years, after which the initial results regarding the benefits of the lifestyle intervention were released and all participants were offered a modified lifestyle intervention. Dietary intake was assessed using a food frequency questionnaire at baseline and at 1, 5, 6 and 9 years after randomization. RESULTS: Compared with the metformin and placebo arms, participants in the lifestyle arm maintained a lower total fat and saturated fat and a higher fibre intake up to 9 years after randomization and lower intakes of red meat and sweets were maintained for up to 5 years. Younger participants had higher intakes of poultry and lower intakes of fruits compared with their older counterparts, particularly in the lifestyle arm. Black participants tended to have lower dairy and higher poultry intakes compared with white and Hispanic participants. In the lifestyle arm, men tended to have higher grain, fruit and fish intakes than women. CONCLUSIONS: Changes in nutrient intake among participants in the lifestyle intervention were maintained for up to 9 years. Younger participants reported more unhealthy diets over time and thus may benefit from additional support to achieve and maintain dietary goals.
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Diet differences across intervention groups were negligible 9 years after randomization, so diet was not included in the model.
“Although diet was assessed by food frequency questionnaire intermittently throughout DPP and DPPOS, there were negligible differences across intervention groups 9 years after randomization and, therefore, was not included in the model (15).”
From The impact of physical activity on the prevention of type 2 diabetes: Evidence and lessons learned from the Diabetes Prevention Program, a long-standing clinical trial incorporating subjective and objective activity measures (2021) · cites this paper as [15]
The Results (page not provided) report that lifestyle participants had lower total and saturated fat intake and higher fiber intake than the other groups up to nine years after randomization, contrary to the claim that dietary differences were negligible. The Methods (page not provided) describe models used to analyze dietary intake; the paper does not give the claimed rationale for excluding diet from the citing authors’ model. (LLM, conf=0.86)
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BackgroundResultLongitudinal data analysis using generalized linear models
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- Authors
- Jaacks, L. M., Ma, Y., Davis, N., Delahanty, L. M., Mayer‐Davis, E. J., Franks, P. W., Brown‐Friday, J., Isonaga, M., Kriska, A. M., Venditti, E. M., Wylie‐Rosett, J., & the Diabetes Prevention Program Research Group
- Affiliations
- University of North Carolina at Chapel Hill (US)
- George Washington University (US)
- Albert Einstein College of Medicine (US)
- Harvard University (US)
- Albert Einstein College of Medicine Bronx NY
- University of Hawaiʻi at Mānoa (US)
- University of Pittsburgh (US)
- Corresponding author
- Ma, Y.
- Wylie‐Rosett, J.
- ORCID
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2014-07-05
- Volume
- 31
- Issue
- 12
- Pages
- 1631-1642
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- PMC
- PMC4307949
- OpenAlex
- W2103694763
- Cited by
- 40
- References
- 28
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 2 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 2 · 2017: 4 · 2016: 4 · 2015: 5 · 2014: 1
- FWCI
- 4.62
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Diabetic Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Massachusetts General Hospital
- National Institutes of Health (UL1TR001073)
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK048489, P30DK017047)
- NIH Clinical Center
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- dietary intake, type 2 diabetes prevention, lifestyle intervention, metformin, Diabetes Prevention Program Outcomes Study, saturated fat intake, dietary fiber, red meat consumption, fruit consumption, age differences in diet, sex differences in diet, long-term dietary change
- MeSH terms
- Adult, Energy Intake, Diabetes Mellitus, Type 2, Diet, Reducing, Dietary Fats, Dietary Fiber, Eating, Feeding Behavior, Female, Follow-Up Studies, Fruit, Humans, Hypoglycemic Agents, Male, Metformin, Middle Aged, Vegetables, Diet, Fat-Restricted, Risk Reduction Behavior
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