A randomized controlled trial to evaluate the effects of high P rotein C omplete (l A cto) VE geta R ian (PACER) diet in non-diabetic obese Asian Indians in North India

Bhardwaj, Swati; Misra, Anoop; Gulati, Seema; Anoop, Shajith; Kamal, Vineet Kumar; Pandey, Ravindra Mohan

doi:10.1016/j.heliyon.2017.e00472

Cited by 14 publications

(21 citation statements)

References 49 publications

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“…Two long‐term intervention studies from India (30 months duration) and China (6 years duration analyzed after 14 years) showed the benefits of intensive lifestyle interventions for prevention of diabetes. Other intervention trials for metabolic syndrome and obesity, predominantly in Asian Indians, also showed benefits of diet and lifestyle modifications . Despite these studies and guiding principles, public efforts for prevention remain rudimentary in most developing countries because of various challenges (Table ).…”

Section: Preventionmentioning

confidence: 99%

Diabetes in developing countries

Misra

Gopalan

Jayawardena

et al. 2019

Journal of Diabetes

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197

129

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Highlights• Diabetes in developing countries is increasing and often undiagnosed. In South Asians, diabetes and related metabolic abnormalities develop at a younger age and at a lower body mass index and waist circumference than in Whites. • Overall glycemic control and management of diabetes is suboptimal, driven by multiple factors (eg, unawareness, cost of drugs and insulin etc.), and the load of complications is high. • To stem this epidemic, strong actions for prevention and management are required using innovative and low-cost approaches. AbstractThere has been a rapid escalation of type 2 diabetes (T2D) in developing countries, with varied prevalence according to rural vs urban habitat and degree of urbanization. Some ethnic groups (eg, South Asians, other Asians, and Africans), develop diabetes a decade earlier and at a lower body mass index than Whites, have prominent abdominal obesity, and accelerated the conversion from prediabetes to diabetes. The burden of complications, both macro-and microvascular, is substantial, but also varies according to populations. The syndemics of diabetes with HIV or tuberculosis are prevalent in many developing countries and predispose to each other. Screening for diabetes in large populations living in diverse habitats may not be cost-effective, but targeted high-risk screening may have a place. The cost of diagnostic tests and scarcity of health manpower pose substantial hurdles in the diagnosis and monitoring of patients. Efforts for prevention remain rudimentary in most developing countries. The quality of care is largely poor; hence, a substantial number of patients do not achieve treatment goals. This is further amplified by a delay in seeking treatment, "fatalistic attitudes", high cost and non-availability of drugs and insulins. To counter these numerous challenges, a renewed political commitment and mandate for health promotion and disease prevention are urgently needed. Several low-cost innovative approaches have been trialed with encouraging outcomes, including training and deployment of non-medical allied health professionals and the use of mobile phones and telemedicine to deliver simple health messages for the prevention and management of T2D.

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Section: Preventionmentioning

confidence: 99%

Diabetes in developing countries

Misra

Gopalan

Jayawardena

et al. 2019

Journal of Diabetes

Self Cite

197

129

View full text Add to dashboard Cite

show abstract

“…The net mean change was calculated as the mean change in the intervention group minus the mean change in the comparison group, i.e., DiD. Net relative percentage change in the outcomes was estimated in both the groups as endline mean minus baseline mean divided by the baseline mean and multiplied by 100 [33]. We conducted confirmatory hypothesis tests for the four primary outcomes, i.e., fat, sugar, salt, and fruit and vegetable intake.…”

Section: Social Networking App (Whatsapp)mentioning

confidence: 99%

Effectiveness of information technology–enabled ‘SMART Eating’ health promotion intervention: A cluster randomized controlled trial

Kaur¹,

Kaur²,

Chakrapani³

et al. 2020

PLoS ONE

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Background Unhealthy dietary behaviour-high intake of fat, sugar, and salt, and low intake of fruits and vegetables-is a major risk factor for chronic diseases. There is a lack of evidence-based interventions to promote healthy dietary intake among Indian populations. Therefore, we tested the effectiveness of an information technology-enabled 'SMART Eating' intervention to reduce the intake of fat, sugar and salt, and to increase the intake of fruits and vegetables. Methods In Chandigarh, a North Indian city, a cluster randomized controlled trial was implemented in twelve geographical clusters, based on the type of housing (i.e., LIG: Low-income group; MIG; Middle-income group, and HIG: High-income group-a proxy for socioeconomic status). Computer-generated randomization was used to allocate clusters to intervention and comparison arms after pairing on the basis of socioeconomic status and geographical distance between clusters. The sample size was 366 families per arm (N = 732). One adult per family was randomly selected as an index case to measure the change in the outcomes. For behaviour change, a multi-channel communication approach was used, which included information technology-short message service (SMS), email, social networking app and 'SMART Eating' website, and interpersonal communication along with distribution of a 'SMART Eating' kit-kitchen calendar, dining table mat, and measuring spoons. The intervention was implemented at the family level over a period of six months. The comparison group received pamphlets on nutrition education. Outcome measurements were made at 0 and 6 months post-intervention at the individual level. Primary outcomes were changes in mean dietary intakes of fat, sugar, salt, and fruit and vegetables. Secondary outcomes

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“…Intervention studies with nuts in patients who have metabolic syndrome [79] and with high monounsaturated vegetable oils in patients who have NAFLD [23] have shown reductions in weight and liver fat, respectively. In vegetarians, increasing protein intake to 26.9% energy has led to a significant weight loss in Asian Indians [80]. Furthermore, meal replacement with a protein drink led to a decrease in body weight, body fat, and waist circumference, and it also had beneficial effects on metabolic parameters [81].…”

Section: Management Of Obesity In South Asiansmentioning

confidence: 99%

Obesity in South Asia: Phenotype, Morbidities, and Mitigation

2019

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Purpose of Review Obesity has increased in South Asian countries that are still grappling with undernutrition. In this review, we highlight the characteristics of obesity, its relation to morbidities, and its management in South Asians. A literature search was conducted using relevant search engines and based on key words focusing on obesity in South Asians. Recent Findings The increasing trend in obesity prevalence is caused by imbalanced diets and physical inactivity. South Asians, in general, have higher body fat and lower skeletal muscle mass at the same or lower BMIs compared to white people ("high body fat-normal BMI-low muscle mass" phenotype). In addition, excess abdominal adiposity, typically seen in South Asians, and increased hepatic fat (non-alcoholic fatty liver disease) are associated with an increased risk for type 2 diabetes and cardiovascular disease. Challenges in treatment include lack of awareness regarding correct diets and non-compliance to diet and exercise regimens. Social and cultural issues limit physical activity in South Asian women. Finally, there is a lack of expert health professionals to deal with increased cases of obesity. Aggressive management of obesity is required in South Asians, with more intensive and earlier diet and exercise interventions (i.e., at lower BMI levels than internationally accepted). At a population level, there is no clear policy for tackling obesity in any South Asian country. Prevention strategies focusing on obesity in childhood and the creation of food and activity environments that encourage healthy lifestyles should be firmly applied. Summary Obesity in South Asians should be evaluated with ethnic-specific guidelines and prevention and management strategies should be applied early and aggressively.

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A randomized controlled trial to evaluate the effects of high P rotein C omplete (l A cto) VE geta R ian (PACER) diet in non-diabetic obese Asian Indians in North India

Cited by 14 publications

References 49 publications

Diabetes in developing countries

Diabetes in developing countries

Effectiveness of information technology–enabled ‘SMART Eating’ health promotion intervention: A cluster randomized controlled trial

Obesity in South Asia: Phenotype, Morbidities, and Mitigation

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