Elements of the Original Diabetes Prevention Program Study are Used in Other Diabetes Prevention Studies

The CDC’s National Diabetes Prevention Program (National DPP) is considered, by some, to be the “gold standard” for behavioral lifestyle intervention. The program is based on the landmark Diabetes Prevention Program study that was led by the NIH during 1996 to 2001. 

The study created an intensive lifestyle intervention (ILI) method that successfully lowered the risk of type 2 diabetes by 58%. The ILI approach consisted of 16 weekly sessions during the first six months of the study, followed by monthly contacts for the remainder of the study. There were in-person contact sessions at least every two months. The study was the basis for the CDC’s National DPP. And elements similar to those used in the original DPP intervention have been employed in other diabetes prevention studies.

One such recent study compared two weight-maintenance diets to determine which diet would cause a decrease in type 2 diabetes cases. The study lasted three years, and the study used an approach similar to the National DPP, consisting of an initial phase and a follow-on phase. The initial phase involved eight weeks of weight reduction, while the follow-on phase was a three year maintenance period. There were 2326 adult participants in the study. All of the participants had a BMI that was greater than or equal to 25. The primary outcome was type 2 diabetes.

The researchers concluded that the diets were not significant in reducing the risk of type 2 diabetes. However, “the overall protocol combining weight loss, healthy eating, and physical activity was successful in markedly reducing the risk of T2D.” The results showed that the type 2 diabetes "incidence in both [diet] groups was less than one third of predicted incidence."

Just as the original DPP study demonstrated, the above study indicated that establishing an initial phase focusing on a weight loss approach that includes diet and physical activity, followed by a maintenance phase, can lower the risk of type 2 diabetes.

Providers should adopt appropriate elements of the DPP program when treating patients who are at high risk for type 2 diabetes. Further, providers should consider including DPP techniques in treatment protocols for other chronic diseases. The DPP intensive lifestyle intervention is patient-centered, evidence-based, and can, in many cases, be less costly than other approaches to chronic disease treatments.

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Plant Protein vs Animal Protein

We all know that protein is important to our health. We know that protein is helpful in repairing tissue, and protein enables us to build muscle and bones. Protein also helps us to build skin and nails. And eating protein can enable us to lose weight, because protein makes us feel full longer, causing us to eat less food. However, here are some questions often asked about protein: does protein lower the risk of mortality? And which is best, plant protein or animal protein? At least two studies have been done to address these questions.

One of the studies was a meta-analysis where the analysts reviewed 32 papers. After the analysis, the investigators suggested that protein can lower the risk of mortality. Further, plant protein can help us live longer. Specifically, the investigators concluded that “Higher intake of total protein was associated with a lower risk of all cause mortality, and intake of plant protein was associated with a lower risk of all cause and cardiovascular disease mortality.” The investigators went on to say that “replacement of foods high in animal protein with plant protein sources could be associated with longevity.”

And in another study, consisting of 70,696 Japanese adults, the researchers concluded that “higher plant intake was associated with lower total and CVD related mortality. Furthermore, “replacement of red meat protein with plant protein was associated with lower total cancer related and CVD related mortality."

So, in general, protein can lower mortality. Therefore, eating protein is something that should be encouraged. But plant protein may be superior to animal protein, since plant protein may surpass animal protein in health benefits.

Thus, healthcare providers ought to take note. The providers should advise patients on plant protein benefits, and recommend a plant based diet to their patients. Of course this means that providers might want to take the time to gain knowledge of plant diets so that the providers will understand what plants are good protein sources. The knowledge will put providers in the best position to help patients.

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