Cited by 255Diabetes Management and EducationNutritional Studies and DietDiabetes, Cardiovascular Risks, and Lipoproteins

Long-term effects of the Mediterranean lifestyle program: a randomized clinical trial for postmenopausal women with type 2 diabetes

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Toobert, Deborah J, Glasgow, Russell E, Strycker, Lisa A, Barrera, Manuel, Ritzwoller, Debra P, Weidner, Gerdi·2007·International Journal of Behavioral Nutrition and Physical Activity

Abstract

BACKGROUND: Multiple-risk-factor interventions offer a promising means for addressing the complex interactions between lifestyle behaviors, psychosocial factors, and the social environment. This report examines the long-term effects of a multiple-risk-factor intervention. METHODS: Postmenopausal women (N = 279) with type 2 diabetes participated in the Mediterranean Lifestyle Program (MLP), a randomized, comprehensive lifestyle intervention study. The intervention targeted healthful eating, physical activity, stress management, smoking cessation, and social support. Outcomes included lifestyle behaviors (i.e., dietary intake, physical activity, stress management, smoking cessation), psychosocial variables (e.g., social support, problem solving, self-efficacy, depression, quality of life), and cost analyses at baseline, and 6, 12, and 24 months. RESULTS: MLP participants showed significant 12- and 24-month improvements in all targeted lifestyle behaviors with one exception (there were too few smokers to analyze tobacco use effects), and in psychosocial measures of use of supportive resources, problem solving, self-efficacy, and quality of life. CONCLUSION: The MLP was more effective than usual care over 24 months in producing improvements on behavioral and psychosocial outcomes. Directions for future research include replication with other populations.

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  • In a trial among 5145 diabetics, lifestyle advice lowered systolic blood pressure, diastolic blood pressure, triglycerides, fasting glucose, hemoglobin A1c, and proteinuria; increased HDL cholesterol; increased weight loss and physical fitness; and reduced use of diabetic, antihypertensive, and lipid-lowering medications.

    “For example, in a trial among 5145 diabetics, lifestyle advice lowered systolic blood pressure, diastolic blood pressure, triglycerides, fasting glucose, hemoglobin A 1c , and proteinuria; in-creased high-density lipoprotein cholesterol; increased weight loss and physical fitness; and reduced use of diabetic, antihypertensive, and lipid-lowering medications.103”

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Authors
Toobert, D. J., Glasgow, R. E., Strycker, L. A., Barrera, M., Ritzwoller, D. P., & Weidner, G.
Affiliations
  • Oregon Research Institute (US)
  • Kaiser Permanente (US)
  • Arizona State University (US)
  • Preventive Medicine Research Institute (US)
Corresponding author
Toobert, Deborah J
Venue
International Journal of Behavioral Nutrition and Physical Activity
Published
2007-01-17
Volume
4
Issue
1
Pages
1-1
ISSN
1479-5868 (ISSN-L)
OpenAlex
W1571506190
Cited by
255
References
61
Citations by year
2026: 2 · 2025: 2 · 2024: 6 · 2023: 4 · 2022: 6 · 2021: 12 · 2020: 13 · 2019: 12 · 2018: 21 · 2017: 18 · 2016: 20 · 2015: 12 · 2014: 22 · 2013: 24 · 2012: 18
FWCI
11.49
Type
journal article
Language
en
Open access
Locations
  • International Journal of Behavioral Nutrition and Physical Activity (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Heart, Lung, and Blood Institute (R01-HL62156, R01HL062156)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • 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
Keywords
type 2 diabetes, postmenopausal women, lifestyle intervention, healthy eating, physical activity, stress management, smoking cessation, social support, self-efficacy, problem solving, depression, quality of life, cost analysis, long-term outcomes

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