Result of school-based intervention on cardiovascular risk factors Effectiveness of Systematic Health Education Model for Type 2 Diabetes Patients Effectiveness of PRECEDE model for health education on changes and level of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes mellitus Investigating the effect of DASH diet on blood pressure of patients with type 2 diabetes and prehypertension: Randomized clinical trial. [Group versus individual education for type-2 diabetes patients]. The influence of a physician and patient intervention program on dietary intake. [Effects of Web-based health education on blood glucose and blood pressure improvement in postmenopausal women with impaired fasting blood glucose]. Effects of the Dietary Approaches to Stop Hypertension (DASH) Eating Plan on Cardiovascular Risks Among Type 2 Diabetic Patients Oat ingestion reduces systolic and diastolic blood pressure in patients with mild or borderline hypertension: a pilot trial. Outcome of intensive integrated intervention in participants with impaired glucose regulation in China Effects of intensive blood pressure control in the management of patients with type 2 diabetes mellitus in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Effects of a structured health education programme by a diabetic education nurse on cardiovascular risk factors in Chinese Type 2 diabetic patients: a 1-year prospective randomized study. Determinants and consequences of adherence to the dietary approaches to stop hypertension diet in African-American and white adults with high blood pressure: results from the ENCORE trial. The PREMIER intervention helps participants follow the Dietary Approaches to Stop Hypertension dietary pattern and the current Dietary Reference Intakes recommendations. Effects of meal preparation training on body weight, glycemia, and blood pressure: results of a phase 2 trial in type 2 diabetes A significant decrease in blood pressure through a family-based nutrition health education programme among community residents in Taiwan. Changes in BMI and blood pressure after a school based intervention: the CHILDREN study.
Abstract Objective . To assess the effectiveness of a two-year school-based intervention , consisting of integrated and replicable physical activity and nutritional education on weight , fat percentage , cardiovascular risk factors , and blood pressure . Design and setting . Six elementary schools in Reykjavik were r and omly assigned to be either intervention ( n = 3 ) or control ( n = 3 ) schools . Seven-year-old children in the second grade in these schools were invited to participate ( n = 321 ) ; 268 ( 83 % ) underwent some or all of the measurements . These 286 children were followed up for two years . Intervention . Children in intervention schools participated in an integrated and replicable physical activity programme , increasing to approximately 60 minutes of physical activity during school in the second year of intervention . Furthermore , they received special information about nutrition , and parents , teachers , and school food service staff were all involved in the intervention . Subjects . 321seven-year-old schoolchildren . Main outcome measures . Blood pressure , obesity , percentage of body fat , lipid profile , fasting insulin . Results . Children in the intervention group had a 2.3 mmHg increase in systolic blood pressure ( SBP ) and a 2.9 mmHg increase in diastolic blood pressure ( DBP ) over the two-year intervention period , while children in the control group increased SBP by 6.7 mmHg and DPB by 8.4 mmHg . These changes were not statistically significant . Furthermore there were no significant changes in percentage body fat , lipid profile , or fasting insulin between the intervention and control schools . Conclusion . A two-year school-based intervention with increased physical activity and healthy diet did not have a significant effect on common cardiovascular risk factors Background Health education is considered to be essential in the overall care of patients with type 2 diabetes mellitus ( T2DM ) ;  systematic health education integrates individual education not only during hospitalization but also extended care outside of a hospital . To test effectiveness of the systematic health education model for T2DM , we conducted a r and omized study with a control group among patients with T2DM living in Nanjing , China . Methods 998 eligible patients completed the enrollment and were r and omized to systematic health education model and conventional model groups ( 498 and 500 patients , resp . ) . The systematic health education model was based on the following aspects : image education , visitation of the exhibition hall , dissemination of educational material s , individualized medical nutrition therapy and exercise programs , WeChat group and regular health lectures , evaluation of complications , lifestyle modification , systematic treatment scheme , self-monitoring of glycemic control , monthly evaluation of the therapeutic effect , proposed improvement measures , and individualized follow-up scheme . The main outcome measures were glycated hemoglobin A1c ( HbA1c ) , blood pressure , body mass index ( BMI ) , and lipids during the 2-year follow-up . Results The systematic health education model led to a favorable variation in HbA1c , LDL cholesterol , and systolic blood pressure ( SBP ) ( P < 0.05 ) . After adjusted analysis , the HbA1c decreased by 0.67 % ( P < 0.01 ) in the systematic health education model , SBP decreased by 10.83 mmHg ( P < 0.01 ) , and the level of diastolic blood pressure ( DBP ) , HDL cholesterol , and total cholesterol decreased slightly and was not significant . The BMI did not change significantly during the study in either of the two groups . Conclusions The systematic health education model is a useful method in the treatment of T2DM because it contributes to decrease in HbA1c , LDL cholesterol , and SBP levels , as well as helps in increasing the compliance with the control criteria , except for DBP and BMI Background Individual health education is considered to be essential in the overall care of patients with type 2 diabetes ( DM2 ) , although there is some uncertainty regarding its metabolic control benefits . There have been very few r and omized studies on the effects of individual education on normal care in DM2 patients with a control group , and none of these have assessed the long-term results . Therefore , this study aims to use this design to assess the effectiveness of the PRECEDE ( Predisposing , Reinforcing , Enabling , Causes in Educational Diagnosis , and Evaluation ) education model in the metabolic control and the reduction of cardiovascular risk factors , in patients with type 2 diabetes . Methods An open community effectiveness study was carried out in 8 urban community health centers in the North-East Madrid Urban Area ( Spain ) . Six hundred patients with DM2 were r and omized in two groups : PRECEDE or conventional model for health promotion education . The main outcome measures were glycated hemoglobin A1c , body mass index ( BMI ) , blood pressure , lipids and control criteria during the 2-year follow-up period . Results Glycated hemoglobin A1c and systolic blood pressure ( SBP ) levels decreased significantly in the PRECEDE group ( multivariate analysis of covariance , with baseline glycated hemoglobin A1c , SBP , and variables showing statistically significant differences between groups at baseline visits ) . The decrease levels in diastolic blood pressure ( DBP ) , triglycerides and LDL cholesterol were nonsignificant . PRECEDE increased compliance in all control criteria , except for LDL cholesterol . BMI did not change during the study in either of the two models analyzed . Conclusions PRECEDE health education model is a useful method in the overall treatment in patients with type 2 diabetes , which contributes to decrease glycated hemoglobin A1c and SBP levels and increase the compliance in all the control criteria , except for LDL cholesterol . Trial registration number Clinical Trials.gov BACKGROUND AND OBJECTIVES Prehypertension in people with type 2 diabetes is associated with increased risk of cardiovascular disease and lower extremity damages compared to people with normal blood pressure . On the other h and , limited studies have conducted to investigate the effect of DASH diet on blood pressure and prehypertension in patients with type 2 diabetes . Therefore , in this study , we aim ed to evaluate the effect of DASH diet on blood pressure and prehypertension in patients with type 2 diabetes . MATERIAL S AND METHODS In this clinical trial , 80 patients with diabetes type 2 and prehypertension in the age range of 18 - 65 years were r and omly allocated to intervention ( n = 40 ) and control ( n = 40 ) groups for 12 weeks . The intervention group had DASH diet and the control group received diabetic diet in accordance with the recommendations of the American Diabetes Association ( ADA ) with 24-h dietary recall ; systolic and diastolic blood pressures were measured before and after study . RESULTS Taking DASH diet and diabetic diet for 12 weeks caused significant reduction in systolic blood pressure in the intervention group ( P value = 0.003 ) . Diastolic blood pressure showed no significant change in none of the two groups . CONCLUSION Following the DASH diet in patients with prehypertension has beneficial effects in improving systolic blood pressure and can be effective to prevent the development of hypertension . Hence , there are needs for long-term interventions with larger sample size in future studies OBJECTIVES To compare the effectiveness of group ( GE ) and individual ( IE ) health education in type-2 diabetes patients , and identify the improvement in knowledge , metabolic control and risk factors . DESIGN R and omised clinical trial . SETTING Primary care . Participants . 68 patients with type-2 diabetes , diagnosed 6 months before the start of the study and who had not received GE . Patients aged over 75 , those with sensory , psychological and /or physical deficiencies and those not monitored in primary care were excluded ( alpha=0.05 ; beta=0.2 ) . Interventions . Patients were selected according to the inclusion criteria and allocated at r and om to the IE ( n=33 ) or GE ( n=35 ) group . Individual and group lessons were given at the same time for a year . The contents were evaluated with a vali date d , self-administered test . MAIN MEASUREMENTS General , demographic variables , analyses , blood pressure , the Body Mass Index ( BMI ) , the presence of cardiovascular risk factors , diabetes-related complications and therapeutic variables were all measured . RESULTS The two kinds of education showed no significant differences from each other . The two groups improved the level of knowledge ( P<0.001 ) , and reduced HbA1c ( P<0.001 ) , HDL-C ( P<0.001 ) , the BMI ( P=0.001 ) and systolic pressure ( P=0.004 ) , and increased their use of reactive strips ( P=0.02 ) . CONCLUSIONS Health education on diabetes improved knowledge of the disease , metabolic control and cardiovascular risk factors . The two educational methods evaluated were equally effective BACKGROUND Efficient dietary interventions for patients with hypertension in clinical setting s are needed . OBJECTIVE To assess the separate and combined influence of a physician intervention ( MD-I ) and a patient intervention ( PT-I ) on dietary intakes of patients with hypertension . DESIGN A nested 2 × 2 design , r and omized controlled trial conducted over 18 months . PARTICIPANTS A total of 32 physicians and 574 out patients with hypertension . INTERVENTION MD-I included training modules addressing the Seventh Report of the Joint National Committee on Prevention , Detection , Evaluation , and Treatment of High Blood Pressure hypertension management guidelines and lifestyle modification . PT-I included lifestyle coaching to adopt the Dietary Approaches to Stop Hypertension ( DASH ) eating pattern , reduce sodium intake , manage weight , increase exercise , and moderate alcohol intake . MAIN OUTCOME MEASURES Dietary intakes were measured by the Block Food Frequency Question naire . Concordance with the DASH dietary pattern was estimated by a DASH score . STATISTICAL ANALYSES The main effects of MD-I and PT-I , and their interaction , were evaluated using analysis of covariance . RESULTS After 6 months of intervention , MD-I participants significantly increased intakes of potassium , fruits , juices , and carbohydrate ; decreased intake of fat ; and improved overall dietary quality as measured by the Healthy Eating Index . PT-I intervention result ed in increased intakes of carbohydrate , protein , fiber , calcium , potassium , fruits and fruit juices , vegetables , dairy and Healthy Eating Index score , and decreased intakes in fat , saturated fat , cholesterol , sodium , sweets , and added fats/oils/sweets . In addition , PT-I improved overall DASH concordance score . The change in DASH score was significantly associated with the changes in blood pressure and weight at 6 months . At 18 months , most changes reversed back toward baseline levels , including the DASH score . CONCLUSIONS Both MD-I and PT-I  improved eating patterns at 6 months with some sustained effects at 18 months . Even though all dietary changes observed were consistent with the DASH nutrient targets or food group guidelines , only the PT-I intervention was effective in improving the overall DASH concordance score . This finding affirms the role of medical nutrition therapy in long-term intensive interventions for hypertension risk reduction and weight management and underlines the need for development of maintenance strategies . Furthermore , this study emphasizes the importance of collaborations among physicians , registered dietitians and other dietetics practitioners , and lay health advisors while assisting patients to make healthy behavior changes PURPOSE The purpose of this study was to investigate the effectiveness of an educational intervention that used both cellular phones and the Internet to provide a short messaging service ( SMS ) relating to blood glucose , blood pressure , and serum lipid levels in postmenopausal women with impaired fasting glucose ( IFG ) . METHODS Twenty-eight postmenopausal women were assigned to an intervention group and twenty-one postmenopausal women to a control group . The intervention was provided for 12 weeks . Patients in the intervention group were asked to access a web site by using a cellular phone or to use the Internet directly and input their blood glucose and blood pressure levels weekly . Participants were sent the optimal recommendations weekly by both cellular phone and Internet . RESULTS The intervention group had a mean decrease in systolic blood pressure ( SBP ) level of 8.1 mmHg but changes for the control group were not significant . There was a significant mean change in diastolic blood pressure ( DBP ) level for the intervention group ( -7.7 mmHg ) . The mean change in the control group was not significant . CONCLUSION This educational intervention using the Internet and a SMS by cellular phone improved levels of SBP and DBP in postmenopausal women with IFG OBJECTIVE To determine the effects of the Dietary Approaches to Stop Hypertension ( DASH ) eating pattern on cardiometabolic risks in type 2 diabetic patients . RESEARCH DESIGN AND METHODS A r and omized crossover clinical trial was undertaken in 31 type 2 diabetic patients . For 8 weeks , participants were r and omly assigned to a control diet or the DASH eating pattern . RESULTS After following the DASH eating pattern , body weight ( P = 0.007 ) and waist circumference ( P = 0.002 ) reduced significantly . Fasting blood glucose levels and A1C decreased after adoption of the DASH diet ( −29.4 ± 6.3 mg/dl ; P = 0.04 and −1.7 ± 0.1 % ; P = 0.04 , respectively ) . After the DASH diet , the mean change for HDL cholesterol levels was higher ( 4.3 ± 0.9 mg/dl ; P = 0.001 ) and LDL cholesterol was reduced ( −17.2 ± 3.5 mg/dl ; P = 0.02 ) . Additionally , DASH had beneficial effects on systolic ( −13.6 ± 3.5 vs. −3.1 ± 2.7 mmHg ; P = 0.02 ) and diastolic blood pressure ( −9.5 ± 2.6 vs. −0.7 ± 3.3 mmHg ; P = 0.04 ) . CONCLUSIONS Among diabetic patients , the DASH diet had beneficial effects on cardiometabolic risks OBJECTIVES We assessed the short-term antihypertensive effects of soluble fiber-rich whole oat cereals when added to a st and ard American diet . In addition , multiple assessment s of insulin sensitivity were conducted . STUDY DESIGN This was a r and omized , controlled , parallel-group pilot study design ed to compare an oat cereal group ( st and ardized to 5.52 g/day beta-glucan ) to a low-fiber cereal control group ( less than 1.0 g/day total fiber ) over 6 weeks . POPULATION A total of 18 hypertensive and hyperinsulinemic (= 10 U/mL or more ) men and women completed the trial . OUTCOMES MEASURED Primary study outcomes were changes in systolic blood pressure ( SBP ) and diastolic blood pressure ( DBP ) . Secondary outcomes included blood lipid , fasting glucose , and insulin levels and side effects related to elevated blood pressure and increased dietary fiber intake . RESULTS The oat cereal group experienced a 7.5 mm Hg reduction in SBP ( P < .01 ) and a 5.5 mm Hg reduction in DBP ( P < .02 ) , while there was virtually no change in either SBP or DBP in the control group . In the oat cereal group , a trend was observed for a lower total insulin response to a glucose load , suggesting improved insulin sensitivity . However , this could not be confirmed using estimates from the Bergman Minimal Model , perhaps because of our small sample size . The oats group experienced a significant reduction in both total cholesterol ( 9 % ) and low-density lipoprotein cholesterol ( 14 % ) . CONCLUSIONS The addition of oat cereals to the normal diet of patients with hypertension significantly reduces both SBP and DBP .  Soluble fiber-rich whole oats may be an effective dietary therapy in the prevention and adjunct treatment of hypertension Introduction This study investigated the outcomes and identified influencing factors of intensive integrated intervention over 2 years in Chinese patients with impaired glucose regulation ( IGR ) . Methods Adults in Beijing , China , were screened for IGR using the 75 g oral glucose tolerance test . Participants with IGR received lifestyle and health education ; those who still had IGR after 1 year were r and omly assigned to either a routine care group or to an intensive integrated intervention group . Results Of 2344 adults screened , 463 had IGR . Of these , 210 adults had IGR after 1 year and were therefore recruited and r and omized to an intensive integrated intervention group ( n=106 ) or a control group ( n=104 ) . The percentage of patients who reached the set targets of plasma glucose , blood pressure , body mass index , or triglycerides was significantly higher in the intensive integrated intervention group . None of the patients within the intensive integrated intervention group progressed to diabetes , whereas eight ( 9.3 % ) cases of the control group developed type 2 diabetes mellitus ( T2DM ) . Logistic regression analysis showed that both an increase in waist circumference and systolic blood pressure ( SBP ) were positively correlated with the development of T2DM , whereas improvement in islet beta cell function was negatively correlated with the development of T2DM . Conclusions Intensive integrated intervention may significantly decrease the conversion rate of IGR to T2DM , and increase the conversion ratio to normal glucose tolerance . The increase of waist circumference or SBP and the deterioration of islet beta cell function may be important risk factors for progression from prediabetes to diabetes To appreciate the importance of the Action to Control Cardiovascular Risk in Diabetes ( ACCORD ) trial,1 one needs to remember that the systolic blood pressure ( BP ) target currently recommended by major guidelines for diabetic patients , that is , 130 mm Hg , except in the Appropriate Blood Pressure Control in Diabetes Study ( ABCD ) normotensive trial,7 which consisted of only a few hundred patients and had changes in creatinine clearance as the primary end point . Thus , ACCORD represents the only large-scale r and omized trial that provides information on what happens to the cardiovascular risk of diabetic patients  when SBP is reduced to 130 mm Hg as a result of r and omization to the usual ( rather than the tight ) BP control treatment strategy . Thus , the message from ACCORD to guidelines and clinical practice is that in diabetic patients it is not necessary to adopt AIMS To assess the effect of regular diabetic health education on cardiovascular risk factors in Chinese Type 2 diabetic patients . METHODS This was a 1-year prospect i ve r and omized study . One hundred and eighty Type 2 diabetic subjects were recruited from three regional diabetic centres in Hong Kong . Ninety received additional structured reinforcement of diabetic health education by a trained nurse after the doctors ' consultations every 3 months ( intervention group ) . The others received the same medical care except no nursing reinforcement ( control group ) . Outcome measures included fasting plasma glucose , HbA(1c ) , body mass index , waist circumference , blood pressure and lipid profiles , which were assessed before the study and after 1 year . RESULTS Two of the controls defaulted follow-up . The intervention group and controls had similar age and sex distribution . At the end of study , the intervention group had reducted their waist circumference , diastolic blood pressure , HbA(1c ) , total cholesterol and low-density lipoprotein cholesterol levels . The controls had reduced their total cholesterol and low-density lipoprotein cholesterol levels . Other cardiovascular risk factors were not significantly changed in the controls . Addition of drugs and /or dosage increment of anti-diabetic drugs , lipid-lowering agents and anti-hypertensive agents were similar between the two groups . CONCLUSIONS Regular structured reinforcement with diabetic health education is useful . It helps to control more successfully some of the cardiovascular risk factors in Chinese Type 2 diabetic patients BACKGROUND Although the Dietary Approaches to Stop Hypertension ( DASH ) diet is an accepted nonpharmacologic treatment for hypertension , little is known about what patient characteristics affect dietary adherence and what level of adherence is needed to reduce blood pressure ( BP ) . OBJECTIVE Our aim was to determine what factors predict dietary adherence and the extent to which dietary adherence is necessary to produce clinical ly meaningful BP reductions . DESIGN Ancillary study of the ENCORE ( Exercise and Nutrition Interventions for Cardiovascular Health ) trial -- a 16-week r and omized clinical trial of diet and exercise . PARTICIPANTS / SETTING Participants included 144 sedentary , overweight , or obese adults ( body mass index 25 to 39.9 ) with high BP ( systolic 130 to 159 mm Hg and /or diastolic 85 to 99 mm Hg ) . INTERVENTION Patients were r and omized to one of three groups : DASH diet alone , DASH diet plus weight management , and Usual Diet Controls . MAIN OUTCOMES MEASURES Our primary outcomes were a composite index of adherence to the DASH diet and clinic BP . STATISTICAL ANALYSES PERFORMED General linear models were used to compare treatment groups on post-treatment adherence to the DASH diet . Linear regression was used to examine potential predictors of post-treatment DASH adherence . Analysis of covariance was used to examine the relation of adherence to the DASH diet and BP . RESULTS Participants in the DASH diet plus weight management ( 16.1 systolic BP [ SBP ] ; 95 % CI 13.0 to 19.2 mm Hg and 9.9 diastolic BP [ DBP ] ; 95 % CI 8.1 to 11.6 mm Hg ) and DASH diet alone ( 11.2 SBP ; 95 % CI 8.1 to 14.3 mm Hg and 7.5 DBP ; 95 % CI 5.8 to 9.3 mm Hg ) groups showed significant reductions in BP in comparison with Usual Diet Controls participants ( 3.4 SBP ; 95 % CI 0.4 to 6.4 mm Hg and DBP 3.8 ; 95 % CI 2.2 to 5.5 mm Hg ) . Greater post-treatment consumption of DASH foods was noted in both the DASH diet alone ( mean = 6.20 ; 95 % CI 5.83 to 6.57 ) and DASH diet plus weight management groups ( mean = 6.23 ; 95 % CI 5.88 to 6.59 ) compared with Usual Diet Controls ( mean = 3.66 ; 95 % CI 3.30 to 4.01 ; P<0.0001 ) , and greater adherence to the DASH diet was associated with larger reductions in clinic SBP and DBP ( P ≤ 0.01 ) . Only ethnicity predicted dietary adherence , with African Americans less adherent to the DASH diet compared with whites ( 4.68 ; 95 % CI 4.34 to 5.03 vs 5.83 ; 95 % CI 5.50 to 6.11 ; P<0.001 ) . CONCLUSIONS Greater adherence to the DASH diet was associated with larger BP reductions independent of weight loss . African Americans were less likely to be adherent to the DASH dietary eating plan compared with whites , suggesting that culturally sensitive dietary strategies might be needed to improve adherence to the DASH diet OBJECTIVE To examine the influence of the PREMIER study lifestyle interventions on dietary intakes and adherence to the Dietary Approaches to Stop Hypertension ( DASH ) dietary pattern and the Dietary Reference Intakes ( DRI ) . DESIGN An 18-month multicenter , r and omized controlled trial comparing two multicomponent lifestyle intervention programs to an advice only control group . SUBJECTS/ SETTING A total of 810 participants were recruited from local communities and r and omized into the study . Individuals were eligible if they were aged 25 years or older , had body mass index between 18.5 and 45.0 , not taking antihypertensive medication , and had prehypertension or stage 1 hypertension ( systolic blood pressure 120 to 159 mm Hg and diastolic blood pressure 80 to 95 mm Hg ) . INTERVENTION The two active intervention programs were a behavioral lifestyle intervention that implements established recommendations , and an established intervention plus the DASH dietary pattern . Both interventions consisted of intensive group and individual counseling sessions . The control group received a brief advice session after r and omization and again after 6 months of data collection . Dietary intakes were collected by two r and om 24-hour recalls at baseline , 6 months , and 18 months . MAIN OUTCOME MEASURES The primary outcome of the PREMIER study was change in systolic blood pressure at 6 months . The main outcomes examined here include dietary variables collected by 24-hour recall at each time point . STATISTICAL ANALYSES Nutrient intakes were calculated and compared among the time points and the three intervention groups using mixed models with repeated measures at 6 and 18 months . Proportion of participants who met or achieved the original DASH nutrient intake levels and the DRIs were calculated and compared among the three intervention groups . P<0.01 was considered statistically significant . RESULTS Participants in both the established intervention and established intervention plus DASH dietary pattern groups substantially reduced energy , total fat , saturated fat , and sodium intake and these reductions persisted throughout the study . Established intervention plus DASH dietary pattern group participants increased intakes of fruits , vegetables , dairy , and many vitamins and minerals ; these increases were significantly greater than that of the control and established intervention groups . A majority of established intervention plus DASH dietary pattern group participants achieved at least two thirds of the DRI recommendations for most nutrients at 6 months , despite their reduction in total energy intake . Some but relatively small recidivism occurred at 18 months . CONCLUSIONS Both the established intervention and established intervention plus DASH dietary pattern group intervention were effective in helping participants follow established recommendations to control blood pressure . The advice-only control group also made some behavior changes , mainly decreasing energy and sodium intake . Only the established intervention plus DASH dietary pattern group significantly increased intakes of DASH-specific food groups , including fruits , vegetables , and dairy products , and nutrients , including protein , fiber , calcium , potassium , and magnesium . Most of the increases did not reach the levels consumed in the original DASH feeding studies . Whereas the established intervention plus DASH dietary pattern group intervention provides a useful platform to achieve the DASH dietary pattern and current DRI recommendations , intervention enhancements , including a greater emphasis on nutrient-dense foods , would likely improve this intervention Background Modest reductions in weight and small increases in step- related activity ( e.g. , walking ) can improve glycemic and blood pressure control in type 2 diabetes mellitus ( DM2 ) . We examined changes in these parameters following training in time- efficient preparation of balanced , low- energy meals combined with pedometer- based step count monitoring . Methods Seventy- two adults with DM2 were enrolled in a 24- week program ( i.e. , 15 three- hour group sessions ) . They prepared meals under a chef ’s supervision , and discussed eating behaviours/nutrition with a registered dietitian . They maintained a record of pedometer- assessed step counts . We evaluated changes from baseline to 24 weeks in terms of weight , step counts , hemoglobin A1c ( HbA1c , glycemic control ) , blood pressure , and eating control ability ( Weight Efficacy Lifestyle WEL Question naire ) . 53 participants ( 73.6 % ) completed assessment s. Results There were improvements in eating control ( 11.2 point WEL score change , 95 % CI 4.7 to 17.8 ) , step counts ( mean change 869 steps/day , 95 % CI 198 to 1,540 ) , weight ( mean change −2.2 % ; 95 % CI −3.6 to −0.8 ) , and HbA1c ( mean change −0.3 % HbA1c , 95 % CI −0.6 to −0.1 ) , as well as suggestion of systolic blood pressure reduction ( mean change −3.5 mm Hg , 95 % CI −7.8 to 0.9 ) . Findings were not attributable to medication changes . In linear regression models ( adjusted for age , sex , ethnicity , insulin use , season ) , a −2.5 % weight change was associated with a −0.3 % HbA1c change ( 95 % CI −0.4 to −0.2 ) and a −3.5 % systolic blood pressure change ( 95 % CI −5.5 to −1.4 ) . Conclusions In this ‘ proof of concept ’ study , persistence with the program led to improvements in eating and physical activity habits , glycemia reductions , and suggestion of blood pressure lowering effects . The strategy thus merits further study and development to exp and the range of options for vascular risk reduction in DM2 OBJECTIVE To evaluate the effect on decrease in blood pressure of modifying risk factors for stroke , such as blood lipid profiles , diet habits and indices of body weight , through a family-based nutrition health education programme among hypertensive patients and pre-hypertensive subjects without taking any antihypertensive drugs . DESIGN AND SETTING This was a community-based prospect i ve study . The study population was r and omly selected from communities in Taipei ; potential subjects were invited by telephone to participate . SUBJECTS After excluding subjects whose blood pressure was normal and those using antihypertensive drugs , there were 390 participants included in the study . Subjects in the intervention group ( n 293 ) received nutrition health education on blood pressure control and stroke-related risk factor modification at each visit . Non-intervention subjects ( n 97 ) only acquired a general education sheet available in clinics . The blood pressure of study subjects was measured at baseline and 6-month follow-up to evaluate the intervention 's effect on decrease in blood pressure . RESULTS Significant decreases of 2.0 mmHg and 5.9 mmHg in systolic blood pressure were observed both in pre-hypertensive and hypertensive subjects in the intervention group . Additionally , intervention subjects with improvement of total cholesterol and LDL cholesterol , decrease in indices of body weight and increase in consumption of fruit and vegetables also had significant lowering of blood pressure . CONCLUSIONS The present study provided evidence that the blood pressure of pre-hypertensive and hypertensive subjects could decrease significantly , without taking antihypertensive drugs , after modifying blood lipid profiles and waist by dietary habits changed through a family-based nutrition heath education programme , result ing in a significant effect on stroke risk reduction BACKGROUND Identification of the behavioural , normative and control beliefs influencing children 's behaviour is an important prerequisite in design ing effective interventions . The current study aims to evaluate the effectiveness of an intervention program , based on the Theory of Planned Behaviour ( TPB ) , on  obesity indices and blood pressure ( BP ) in Ioannina , Greece . METHODS Participants were 646 fifth grade pupils ( 360 girls and 286 boys ) . The intervention group ( IG ) consisted of 321 children in 13 r and omly selected schools while the rest ( n = 325 children ) served as the  control group ( CG ) . Based on the outcome of the TPB question naire , the intervention focused on overcoming the barriers in accessing physical activity areas , increasing the availability of fruits and vegetables and increasing parental support . General linear mixed model and mediating variable analysis were used to evaluate the differences between the two groups and to test whether changes in certain dietary , physical activity and anthropometrical indices mediated the effect of the intervention on BP . RESULTS IG had higher consumption of fruits and lower consumption of fats/oils and sweets/beverages compared with the CG . Intervention 's effect on BMI could be explained by the changes in fruit and fats/oils intake whereas the reduction of systolic and diastolic BP could be explained by the reduction of BMI . CONCLUSIONS The findings indicate favourable changes in BP and obesity indices after the implementation of a 1-year school-based intervention program based on the TPB . These results highlight the importance of developing a social and physical environment that promotes balanced eating behaviours and extra-curricular access to physical activity venues
The dietary modifications were more effective in reducing both SBP and DBP vs. control diet .
The Low-sodium , High-fiber , DASH , Low-fat , Low-protein and Vegan dietary approach were significantly more effective in reducing SBP compared to a control diet .
The High-fiber , Low-fat , Low-protein and Vegan diet were significantly more effective in reducing DBP .
The Low-sodium and High fiber diets had the greatest lowering effect on SBP and DBP in T2D patients .
CONCLUSIONS Adopting healthful dietary modifications were more effective in reducing both SBP and DBP vs. control .
The High-fiber and Low-sodium diets had the greatest lowering effect on SBP and DBP in T2D
AIMS We aim ed to investigate the effect of different dietary approaches on systolic and diastolic blood pressure ( SBP and DBP )  in Type II diabetes ( T2D ) .