3. DPP – ORIGINAL RESEARCH
MULTICENTER NIH CLINICAL TRIAL
• 3,234 PARTICIPANTS WITH PREDIABETES
• 27 CLINICAL CENTERS IN U.S.
LIFESTYLE
• REDUCED CALORIES, LOW-FAT DIET
• 150 MINUTES OF EXERCISE PER WEEK (30
MINUTES OF WALKING 5 DAYS PER WEEK)
• WEIGHT LOSS GOAL = 7% OF BODY WEIGHT
MEDICATION
• 850 MILLIGRAMS METFORMIN TWICE DAILY
PLACEBO
STUDY RESULTS
LIFESTYLE
• RISK FOR DEVELOPING DIABETES DECREASED
BY 58%
METFORMIN
• RISK FOR DEVELOPING DIABETES DECREASED
BY 31%
DPP Research Group. New England Journal of Medicine. 346: 393-403, 2002.
4. PREVENTION CAN LAST 15+ YEARS
Intervention Risk Reduction @ 3
Years
Risk Reduction @ 10
Years
Risk Reduction @ 15
years
Lifestyle 58% 34% 27%
Metformin 31% 18% 18%
DPP Research Group. Lancet. 374: 1677-1686, 2009. Lancet Diabetes Endocrinology.
DOI: http://dx.doi.org/10.1016/S2213-8587(15)00291-0, 2015.
5. THE 1 YEAR PROGRAM HELPS MAKE HEALTHY LIFESTYLE CHANGES THAT LAST, HOLD PARTICIPANT
ACCOUNTABLE BY ATTENDING CLASSES, AND GET SUPPORT FORM THE GROUP TO HELP MEET GOALS!
PROGRAM GOALS
•WEIGHT LOSS: 5-7% OF STARTING
BODY WEIGHT
•INCREASING PHYSICAL ACTIVITY TO
150 MINUTES +
PROGRAM STRUCTURE
• 1 Year Program: weekly, bi-monthly & monthly
sessions
• one hour sessions with make-ups available
• self-monitoring of weight, food intake, minutes of
physical activity required
• goal/action plan set at each session
• The Power of Peer Support: trained lifestyle coach
leverages group process to allow group to problem-
solve and support change
6. ELIGIBLE
NATIONAL DPP
PARTICIPANTS
OVERWEIGHT & OBESE ADULTS:
• ADULT AGED 18 YEARS AND OLDER WITH A BMI OF 25 OR GREATER (ASIAN
AMERICANS: 23 OR GREATER)
WITH PREDIABETES AND/OR AT RISK FOR DIABETES:
• PREDIABETES DIAGNOSED THROUGH BLOOD TEST
• FASTING BLOOD SUGAR, A1C, ORAL GLUCOSE TOLERANCE TEST
• OR HISTORY OF GESTATIONAL DIABETES
• MEDICARE BENEFICIARIES ALSO NEED BLOOD TEST ABOVE
• OR INCREASED RISK BASED ON PREDIABETES RISK QUIZ
• FOR THOSE WITHOUT MEDICARE
HTTPS://DOIHAVEPREDIABETES.ORG/PDF/PREDIABETES_RISKTEST_12.11.PDF
7. DISCUSSION TOPICS
(26 CDC SESSIONS)
• EATING WELL INCLUDING SHOPPING, COOKING, EATING AWAY FROM
HOME, ETC.
• GETTING ACTIVE
• COPING WITH TRIGGERS
• POSITIVE THINKING
• MANAGING STRESS
• GETTING SUPPORT
• HEART HEALTH
• CARBOHYDRATES
• BURNMORE CALORIES THANYOU TAKE IN
• STAYING MOTIVATED
8. HEALTHY
MEAL
BASED ON MY PLATE IDEA FROM
THE AMERICAN DIABETES
ASSOCIATION.
(MEETS THE DRI NEEDS)
9. HEALTHY DPP DIET FOR PREDIABETES
FOODS TO EMPHASIZE
• Vegetables
• Fish
• Plant-based proteins, such as beans, peas, lentils, tofu, and nuts
• Whole grains and whole-grain products
• Healthy fats such as olive oil and avocado
• Fresh fruit
• Spices and herbs
• Starchy vegetables (e.g., Peas, winter squash, corn, and sweet
potatoes)
• Lean animal proteins, such as skinless poultry and eggs.
• Reduced-fat dairy products, such as low-fat cheese and fat-free
cottage cheese and plain yogurt.
Water and other low-calorie, hydrating beveragES SUCH AS
DECAFFEINATED GREEN TEA.
PROS
• Lower insulin resistance and blood glucose levels
(a1c).
• Lower blood pressure, improving cholesterol levels.
• Can aid in weight loss due to:
• Weekly weigh in, daily tracking of food, physical acty..
• Calorie reduction by swapping low-calorie foods such
as lean proteins and vegetables, and having smaller
portions
• Swapping empty calories for high-fiber choices such
as fruit and whole grains.
• Suggestions for small changes.
• Allowances for special occasions and cravings.
https://www.ncbi.nlm.nih.gov/pubmed/22812594
10. HEALTHY DPP DIET FOR PREDIABETES
FOODS TO LIMIT OR AVOID
• PROCESSED MEATS
• FRIED FOODS
• FATTY RED MEAT AND POULTRY WITH SKIN
• SOLID FATS (E.G., LARD AND BUTTER)
• REFINED GRAINS (E.G., WHITE BREAD, PASTA, RICE, AND CRACKERS, AND REFINED
CEREALS)
• SWEETS (E.G., CANDY, CAKE, ICE CREAM, PIE, PASTRIES, AND COOKIES)
• SUGAR-SWEETENED BEVERAGES, (E.G., SOFT DRINKS, ENERGY DRINKS, SPORTS
DRINKS, AND SUGAR-SWEETENED COFFEE AND TEA BEVERAGES)
• ALCOHOLIC BEVERAGES AND MIXED DRINKS
• SUGAR-SWEETENED FOODS, SUCH AS FLAVORED YOGURT AND OATMEAL, AND
SUGARY CONDIMENTS
• DRIED FRUIT AND FRUIT JUICE
Water and other low-calorie, hydrating beveragES SUCH AS
DECAFFEINATED GREEN TEA.
CONS
• IS LESS FOCUSED ON COUNTING CALORIES AND
GRAMS OF CARBOHYDRATE, FAT, AND PROTEIN
GRAMS .
• IS NOT A PRESCRIPTIVE MEAL PLAN
11. EXPERIENCE ON DIET
• Easy to follow
• Choose from variety of food
• Can’t stick to well crafted plan.
• Effort to enter data and track
• Hard to meet Iron
• Easy to met Vit A, C, Calcium, Potassium
• High on fiber, low on sodium
• Weight lost : ½ pound (62.5- 62.1)
13. WAYS TO ADDRESS BARRIERS/CHALLENGES
• FIND OUT THE MOTIVATION
• SMALL STEPS AT A TIME
• FRESH. FROZEN, CANNED ALL COUNTS TOWARDS MEETING
DAILY GOAL
• MENU PLANNING, GROCERY LIST, STOCKING PANTRY.
• LOGGING ON THE DAYS YOU THINK YOU EAT MORE.
Though a diet is easy to follow, for me it was a struggle because of the hectic schedule. . I did not like to track the food because it an extra work and takes time and effort in entering data. However, it helped me to see that most of my micro-nutrients need are not meeting.
