A study published in the journal Postgraduate Medicine in September 2009 has proven that the Nutrisystem D diet program is more effective in helping control type II diabetes in obese patients than standard diabetes education. Although this study was funded from a research grant from NutriSystem D to Temple University the sponsor had no input on the analyses and interpretation of data in the published article.
Scope of the Study
The study was conducted by Dr. Gary Foster, PhD, and was designed to assess the effects of the Nutrisystem D weight loss program on both weight and glycemic control in patients who were obese and suffering from type 2 diabetes. The study was composed of 69 patients; 49 females and 20 males. The patients had a mean age of 52.2 years, a BMI (body mass index) of 39.0 kg/m2 (BMI above 30 is associated with obesity) and hemoglobin A1c (HbA1c) of 7.5. The hemoglobin A1C test is a valuable measure of how effectively your body controls blood glucose over a period of time. For people without diabetes, the normal range for the hemoglobin A1c test is between 4% and 6%.
The participants were divided into two groups, one group were put on a commercially available portion controlled diet, the Nutrisystem diet, and the other group were put on a diabetes support and education program (DSE). After the first three months of the study, the Nutrisystem D group continued on the same program for the next three months, and the DSE group were put on the Nutrisystem D for the remaining three months.
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Results After the First Three Months
After the first three months, the Nutrisystem D group had lost significantly more weight than the DSE group, and also had greater reductions in HbA1c than the DSE group. For the final three months the Nutrisystem D group had no further change in HbA1c, while the DSE group showed a significant reduction. These results suggest that the Nutrisystem D diet does have a significant impact on weight, glycemic control and also cardiovascular risk factors on obese patients with type 2 diabetes.
Nature of the Diet
The Nutrisystem D diet involved a calorie controlled program, where women consumed approximately 1250 calories per day, and men consumed approximately 1550 calories per day. The women were required to consume three meals and one snack each day from Nutrisystem D foods, as well as two additional sources of dairy, fruit, lean protein and fat and four sources of vegetables added to their daily meal plan. For men the menu included two sources of dairy, fruits and lean proteins, three sources of fat and carbohydrates and four sources of vegetables in addition to their three Nutrisystem D meals and two snacks. The Nutrisystem D foods had an average composition of 47% carbohydrate, 30% protein and 23% fat.
The DSE participants were required to undergo three group sessions with groups of 8 – 12 people on weeks one, five and nine. These sessions comprised of lessons on diabetes management, nutrition, and physical activity.
Required Physical Activity
Both groups of participants were required to perform some physical activity (generally walking for about 30 minutes).
Health Indicators Assessed
All participants had their weight, height, waist circumference, blood pressure and blood serum (hemoglobin A1c, glucose, triglycerides, and total cholesterol all measured after an overnight 12 hour fast) measured at the starting point, after three months and after six months. They were all required to take a quality of life questionnaire which is used to measure general health-related quality of life. In the two groups there were no statistical significances in any of these variables.
Almost all of the participants completed the first three months of the study, and most completed the full six months.
Conclusions of the Nutrisystem D Study
After three months the Nutrisystem D group had lost on average 8.2 kg, while the DSE group had lost 0.6 kg. The Nutrisystem D group also showed much greater reductions in BMI and waist circumference. The Nutrisystem D group continued to lose weight for the final three months, while the DSE group also lost weight when they switched to the Nutrisystem D program.
Participants in the Nutrisystem D group showed greater reductions in Hemoglobin A1c. Specifically, in 79% of them Hemoglobin A1c levels were below 7%, which meets the American Diabetes Association goal, while only 47% of the DSE participants met that goal. The Nutrisystem D also showed greater reductions in systolic blood pressure, triglycerides and total cholesterol than did the DSE group. They also showed a greater improvement on their quality of life assessments.
This study clearly shows that putting obese patients with type 2 diabetes on the Nutrisystem D program is more beneficial than putting them on a traditional diabetes management program. Of interest, studies have shown that for every 1% reduction in HemoglobinA1c the relative risk of microvascular complications decreases by 10%. So, if a patients starts off with an A1c of 10.5 and drops to 8.5, though there are not yet at goal, they have managed to decrease their risk by about 20%. Therefore the 0.9% reduction in HbA1c in the Nutrisystem D group of this study resulted in a significant and impressive decrease in risk of microvascular complications.
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