Effectiveness of A Multifactorial Intervention in Increasing Adherence to the Mediterranean Diet among Patients with Diabetes Mellitus Type 2: A Controlled and Randomized Study (EMID Study)

Abstract

The Mediterranean diet (MD) is recognized as one of the healthiest dietary patterns and has benefits such as improving glycaemic control among patients with type 2 diabetes (T2DM). Our aim is to assess the effectiveness of a multifactorial intervention to improve adherence to the MD, diet quality and biomedical parameters. The EMID study is a randomized and controlled clinical trial with two parallel groups and a 12-month follow-up period. The study included 204 subjects between 25–70 years with T2DM. The participants were randomized into intervention group (IG) and control group (CG). Both groups received brief advice about healthy eating and physical activity. The IG participants additionally took part in a food workshop, five walks and received a smartphone application for three months. The population studied had a mean age of 60.6 years. At the 3-month follow-up visit, there were improvements in adherence to the MD and diet quality of 2.2 and 2.5 points, compared to the baseline visit, respectively, in favour of the IG. This tendency of the improvement was maintained, in favour of the IG, at the 12-month follow-up visit. In conclusion, the multifactorial intervention performed could improve adherence to the MD and diet quality among patients with T2DM.

Mediterranean Diet and its Benefits on Health and Mental Health: A Literature Review

“…In 9 studies [ 35 , 38 , 40 , 41 , 44 , 45 , 46 , 48 , 51 ] the EVOO (Extra Virgin Olive Oil) was considered an important element of MD. In 2 studies [ 26 , 27 ], some mobile devices (apps) were employed in the research design. The duration of the studies ranged from 2 weeks to 5 years according to the aim, design and study population.…”

“…Alonso-Domínguez et al . [ 27 ] in the EMID- study (Effectiveness of a Multifactorial Intervention in Diabetics) evaluated the effectiveness of a multifactorial intervention in increasing adherence to the MD, the quality of diet and biomedical parameters after a 12-month follow-up period. The study involved 204 subjects with age ranging from 25- 70 years old affected by type-2 diabetes mellitus.…”

“…It is of note that MD has a confirmed role in improving metabolic as well as cardiovascular parameters with a reduced incidence of major cardiovascular events by approximately 30% [ 41 ]. MD also has benefits in improving metabolic balance in patients affected by type 2 diabetes mellitus [ 27 , 30 ]. The improvement of biochemical markers has been documented for metabolic disorders as well as in patients at risk of specific cancer diseases [ 25 ].…”

Smartphones and Apps to Control Glycosylated Hemoglobin (HbA1c) Level in Diabetes: A Systematic Review and Meta-Analysis

“…Although no significant results have yet been obtained in this field, this line of research is of considerable interest, prioritizing self-care and enhancing the patient's quality of life. Moreover, smartphone apps can be used to design a specific plan for controlling the blood sugar level [43,44]. Finally, all this helps prevent and decrease the prevalence of diabetes [45].…”

Digital disruption of dietetics: are we ready?

“…Text-message programs delivered by dietitians are reported to be effective at improving dietary behaviour in people with cardiovascular disease (55,56) , and web-based nutrition interventions have been shown to improve dietary behaviour among patients with obesity (57) and type 2 diabetes (58) . Similarly, community-based dietetic mHealth and eHealth interventions have demonstrated the capacity to improve dietary behaviour in single studies among people with type 2 diabetes (59) , hypertension (60) , chronic kidney disease (61) and eating disorders (62) . Although these interventions have the potential to improve a variety of health-related behaviours both in hospital-and community-based dietetic services, it is important to note there are a similar number of studies suggesting these interventions may not be effective (63)(64)(65)(66) .…”