Abstract
In studies of the effect of diets in obese type 2 diabetic patients, information about the degree of compliance or non-compliance is generally lacking or incomplete, though their poor long-term success rate is widely recognized. We have quantified the degree of short-term compliance with a personalized hypocaloric diet (800–1500 kcal) in 77 obese type 2 diabetic patients (mean age 60, mean BMI 34.4) three months after explaining their dietary schedule and its expected advantages by means of simple but essential nutritional advice lasting about 20 minutes of the type currently used for such patients attending diabetes care institutions or outpatient departments. Even though a mean 14% reduction in daily food intake was achieved, the mean daily energy intake at the interview (assessed by means of the 3-day recall method) still exceeded the prescribed diet by 40–50%. The worst compliance in terms of total excess energy intake or carbohydrate and fat intake was found in the older patients. The greater the excess of food intake, the poorer the metabolic control, as expected.
References
Vinik A., Wing R.R.: Nutrition management of the person with diabetes. In: Ritkin H., Porte D. Jr, (Eds.), Diabetes Mellitus. New York, Elesevier, 1990, pp. 464–496.
United Kingdom Prospective Diabetes Study Group: United Kingdom Prospective Diabetes Study 16: Overview of 6 years’ therapy of type II diabetes: a progressive disease. Diabetes, 44, 1249–1258, 1995.
American Diabetes Association Position Statement: Nutrition recommendations and principles for people with diabetes mellitus. Diabetes Care, 22 (Suppl. 1), S42–S45, 1999.
Brown S.A., Upchurch S., Anding R., Winter M., Ramirez G.: Promoting weight loss in type II diabetes. Diabetes Care, 19, 613–624, 1996.
Henry R.R., Scheaffer L., Olefsky J.M.: Glycemic effect of intensive caloric restriction and isocaloric refeeding in non-insulindependent diabetes mellitus. J. Clin. Endocrinol. Metab., 61, 917–925, 1985.
Wing R.R., Marcus M.D., Bahr E.H., Watanabe R., Bononi P., Bergman R.: Caloric restriction per se is a significant factor in improvements in glycemic control and insulin sensitivity during weight loss in obese NIDDM patients. Diabetes Care, 17, 30–36, 1994.
Maggio C.A., Pi-Sunyer F.X.: The prevention and treatment of obesity. Application to type 2 diabetes. Diabetes Care, 20, 1744–1766, 1997.
Bloomgarden Z.T., Kermally W., Metzger M.J., Brothers M., Nechemias C., Bookman J., Faierman D., Ginsberg-Fellner F., Rayfield E., Brown W.V.: Randomized, controlled trial of diabetic patients education: improved knowledge without improved metabolic status. Diabetes Care, 10, 263–272, 1987.
Lutfey K.E., Wishner W. J.: Beyond "compliance" is “adherence”. Diabetes Care, 22, 635–639, 1999.
Barnard R.J., Jung T., Inkeles S.B.: Diet and exercise in the treatment of NIDDM: the need for early emphasis. Diabetes Care, 17, 1469–1472, 1994.
Gruesser M., Bott U., Ellerman P., Kronsbein P., Joergens V.: Evaluation of a structural treatment and teaching program for non-insulin-treated type II diabetic outpatients in Germany after the nationwide introduction of reinbursement policy for physicians. Diabetes Care, 16, 1268–1275, 1993.
Kirkman M.S., Weinberger M., Landsman P.B., Samsa G.P., Shortliffe E.A., Simel D.L., Feussner J.R.: A telephone-delivered intervention for patients with NIDDM: effect on coronary risk factors. Diabetes Care, 17, 840–846, 1994.
Blonk M.C., Jacobs M.A.J.M., Biesheuvel E.H.E., Weeda-Mannak W.L., Heine R.J.: Influences on weight loss in type 2 diabetic patients: little long-term benefits from group behaviour therapy and exercise training. Diabet. Med., 11, 449–457, 1994.
Vanninen E., Uusitupa M., Siityonen O., Laitinen J., Lansimies E.: Habitual physical activity, aerobic capacity and metabolic control in patients with newly-diagnosed type 2 (non-insulin-dependent) diabetes mellitus: effect of 1-year diet and exercise intervention. Diabetologia, 35, 340–346, 1992.
Campbell L.V., Barth R., Gosper J.K., Jupp J.J., Simons L.A., Chisholm D.J.: Impact of intensive educational approach to dietary change in NIDDM. Diabetes Care, 13, 841–847, 1990.
Christensen N.K., Terry R.D., Wyatt S., Pichert J.W., Lorenz R.A.: Quantitative assessment of dietary adherence to patients with insulin-dependent diabetes mellitus. Diabetes Care, 6, 145–150, 1983.
Cameron M.E., VanStavern W.A.: Manual on methodology for food consumption studies. New York, Oxford University Press, 1988.
Friedenreich C.M., Slimani N., Riboli E.: Measurement of past diet: review of previous and proposed methods. Epidemiol. Rev., 14, 177–196, 1992.
Acheson K.J., Campbell I.T., Edholm O.G., Miller D.S., Stock M.J.: The measurement of food and energy intake in man - an evaluation of some techniques. Am. J. Clin. Nutr., 33, 1147–1154, 1980.
de Vries J.H.M., Zock P.L., Mensink R.P., Katan M.B.: Underestimation of energy intake by 3-d records compared with energy intake to maintain body weight in 269 nonobese adults. Am. J. Clin. Nutr., 60, 855–860, 1994.
Shoeller D.A.: How accurate is self-reported dietary energy intake? Nutr. Rev., 48, 373–379, 1990.
Bandini L.G., Schoeller D.A., Cyr H.N., Dietz W.H.: Validity of reported energy intake in obese and nonobese adolescents. Am. J. Clin. Nutr., 52, 421–425, 1990.
Poppitt S.D., Swann D., Black A.E., Prentice A.M.: Assessment of selective under-reportIng of food intake by both obese and non obese women in a metabolic facility. Int. J. Obes., 22, 303–311, 1998.
Cleveland L.E., Cook D.A., Krebs-Smith S.M., Friday J.: Method for assessing food intake in terms of serving based on food guidance. Am. J. Clin. Nutr., 65 (Suppl. 4), 12545–12635, 1997
Willett W.C., Howe G.R., Kushi L.H.: Adjustment for total energy intake in epidemiologic studies. Am. J. Clin. Nutr., 65 (Suppl. 4), 12205–12285, 1997.
Melchionda N., Enzi G., Caviezel F., Contaldo F., Gallo M.R.A., Parenti M., Pasquali R., Rago S., Babini A.C., Casimirri F., Di Giorgi A., Ferrari S., Crepaldi G., Labo G.: Epidemiologia della malnutrizione net soggetti anziani. Lo studio mulficentrico del CNR. Giorn. Gerontol., 37, 563–587, 1989.
Bogardus C., Lilhoja S., Ravussin E., Abbott W., Zawadski J.K., Young A., Knowler W.C., Jacobwitz R., Moll P.P.: Familial dependence of the resting metabolic rate. N. Engl. J. Med., 313, 96–100, 1986.
Heshka S., Yang M., Wang J., Burt P., Pi-Sunyer F.X.: Weight loss and change in resting metabolic rate. Am. J. Clin. Nutr., 45, 914–920, 1990.
Piaggesi A., Giampietro O., Picaro L., Miccoli R., Navalesi R.: Individual teaching as first-step intervention for the education of diabetic subjects. Acta Diabetol. Lat., 26, 225–235, 1989.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Zilli, F., Croci, M., Tufano, A. et al. The compliance of hypocaloric diet in type 2 diabetic obese patients: A brief term study. Eat Weight Disord 5, 217–222 (2000). https://doi.org/10.1007/BF03354449
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03354449