A weight reduction intervention that optimizes use of practitioner's time, lowers glucose level, and raises HDL cholesterol level in older adults.

Objective: The effects of a cognitive-behavioral weight control intervention were compared in two independent-living, older adult (mean age = 70.5 years) communities.

Design: The research design compared the experimental community (n = 163), which received the intervention, with the control community (n = 162).

Trial of antihypertensive intervention and management: greater efficacy with weight reduction than with a sodium-potassium intervention.

The Trial of Antihypertensive Intervention and Management evaluated nine diet-drug combinations in 878 mildly hypertensive, moderately obese participants using a 3 x 3 factorial design. Drugs evaluated were placebo, diuretic (chlorthalidone), and beta-blocker (atenolol); diets were usual (no intervention), weight reduction, and low sodium/high potassium (Na/K). This article reports 6-month dietary changes and the effect of dietary change on blood pressure.

Diabetes quality assurance checklist: assessment of inter-rater and intra-rater reliability.

The Diabetes Quality Assurance (DQA) Checklist was developed to measure adherence to standards of diabetes care. Two raters simultaneously scored a convenience sample of 23 charts of patients with diabetes. These raters scored each chart again 5-7 weeks later.

Metabolic impact of education in NIDDM.

Objective: To evaluate the impact of a model program of diabetes education and weight reduction on diabetes control and weight loss in obese individuals with non-insulin-dependent diabetes mellitus (NIDDM).

Research Design And Methods: Eighty-two obese diabetic subjects were randomized to three levels of educational intensity: 1) a single individual session, 2) a 12-wk behavior-oriented diabetes education and weight control group intervention, or 3) group intervention plus six individual follow-up sessions. Repeated measures of weight, fasting blood glucose, and HbA1c were collected.

The scope of practice of diabetes educators in a metropolitan area.

A survey of 108 members of a local metropolitan AADE chapter was conducted to assess (1) current roles and responsibilities of diabetes educators with respect to medical management and patient education, and (2) the use of behavioral strategy techniques among diabetes educators. Nurses and dietitians specializing in diabetes care performed a range of responsibilities. Approximately 75% of the nurses performed standard patient education roles and 20% performed the majority of roles traditionally considered to be in the medical domain, including insulin adjustment.

The Trial of Antihypertensive Interventions and Management (TAIM) study. Adequate weight loss, alone and combined with drug therapy in the treatment of mild hypertension.

This report examines the effect of weight loss, alone and in combination with drugs, on diastolic blood pressure change in the Trial of Antihypertensive Interventions and Management (TAIM), which is a randomized, multicenter, placebo-controlled clinical trial of drug and diet combinations in the treatment of mild hypertension among 787 patients. Diastolic blood pressure drop (11.6 mm Hg) at 6 months among those patients who were randomized to weight reduction and placebo drug treatment was greater among those who lost 4.

The effect of dietary changes and intentional weight loss on high density cholesterol levels in older adults.

The effect of a behaviorally-oriented program to reduce calories and increase physical activity on HDL cholesterol level was evaluated in overweight older adult subjects (n = 31). HDL cholesterol increased from 45.8 to 52.

Nutrition management for individuals with noninsulin-dependent diabetes mellitus in the 1990s: a review by the Diabetes Care and Education dietetic practice group.

Noninsulin-dependent diabetes mellitus (NIDDM), or Type II diabetes, is characterized by two primary defects: insulin resistance and insulin secretion. The two major goals of management of NIDDM are to achieve near normal metabolic control and to prevent/delay the microvascular and macrovascular complications of diabetes. Nutrition, exercise, and, if necessary, medication are the three primary treatment modalities used in NIDDM.

Aging and weight control: dietary management of diabetes.

Nutritional treatment priorities for elderly patients with diabetes may vary with age, relative body weight, type of diabetes, other health factors and life-style. The age-adjusted tables for recommended body weight have implications for setting weight goals for diabetes treatment and for individuals at risk for developing diabetes. Dietary management of elderly patients with or at high risk for developing diabetes needs to consider: (1) weight changes associated with age, (2) the relative merits of various weight control methods, (3) composition of the recommended diabetic diet, and (4) factors influencing the selection of a therapeutic approach for an individual.

Insulin response and glycemic effects of meals in non-insulin-dependent diabetes.

Glycemic and hormonal responses to two breakfast mixed meals were studied in six obese subjects with NIDDM. The study evaluated a high-glycemic-effect (HGE) and a low-glycemic-effect (LGE) meal, each with approximately 600 kcal and 12% protein, 15% fat, and 73% carbohydrate. Plasma insulin and counterregulatory hormones were measured at baseline and at 30-min intervals for 5 h after meals.

Estimation of protein intake: comparison of dietary assessment and urinary excretion.

Estimates of dietary intake of nutrients have many problems, and confirmation of these estimates by chemical measurements of excretory products helps to establish their validity. The correlation between urinary amino acid excretion and dietary history of protein intake are reported herein. Diet diaries were kept by and 24-h urine collected from participants in the Trial of Antihypertensive Therapy and Management, a multicenter cooperative trial comparing the effects of drugs and diet on blood pressure control, side effects, and quality of life.

Lipids: impact on dietary prescription in diabetes.

The rate of death from coronary artery disease is two to three times higher among individuals with diabetes than among their age- and sex-matched peers. In diabetes, many factors may affect blood lipid levels and complicate formulating an effective dietary prescription. Both Type I and Type II diabetes may have an independent effect on lipids.

Trial of antihypertensive interventions and management. Design, methods, and selected baseline results.

The Trial of Antihypertensive Interventions and Management was a multicenter randomized, placebo-controlled trial designed to assess the effectiveness of various combinations of pharmacologic and dietary interventions in the treatment of mild hypertension (diastolic blood pressure 90-100 mmHg). The primary outcome was blood pressure change between baseline and 6 months. The study consisted of a 3 X 3 factorial design wherein participants were randomly allocated to nine drug-diet treatment groups.

Evaluation of protein in dietary management of diabetes mellitus.

Establishing appropriate recommendations for protein intake in the management of diabetes requires examination of the role that dietary protein plays in overall health, in the control of diabetes, and in the risks to health posed by diabetes. Achieving metabolic control and delaying and/or preventing diabetic complications have previously been established as primary goals for the dietary management of diabetes. Although the primary function of dietary protein is for growth and tissue maintenance, dietary protein may play a role in the regulation of glucose metabolism and in the development of diabetic renal complications.