Increased consumption of calcium from fat-free milk, energy-restricted diet and educational activities improves metabolic control in overweight type 2 diabetic patients

• Published in: British journal of nutrition Vol. 123; no. 5; pp. 553 - 563
• Main Authors: Costa, Jorge de Assis, Gomes, Júnia Maria Geraldo, Ribeiro, Priscila Vaz de Melo, Alfenas, Rita de Cássia Gonçalves
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 14.03.2020
• Subjects: Activities of daily living; Adult; Alanine; Alanine transaminase; Animals; Anthropometry; Blood Glucose - analysis; Blood pressure; Body Composition; Body fat; body mass index; Body Weight; Calcium; Calcium, Dietary - administration & dosage; Caloric Restriction - methods; clinical trials; Cross-Over Studies; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diet therapy; Diabetes Mellitus, Type 2 - psychology; Diabetic retinopathy; Diameters; Diet; Diet, Diabetic - methods; dietary nutrient sources; Dietary restrictions; Education; Energy; Energy consumption; Exercise; fasting; Fat-free body mass; Female; Food; Food composition; Food intake; glucose; Health Knowledge, Attitudes, Practice; Hip; hip circumference; Humans; Hypertension; Insulin; Insulin resistance; lean body mass; low calorie diet; Male; Metabolism; Milk; Milk - chemistry; noninsulin-dependent diabetes mellitus; Nutrient deficiency; Nutrition research; Overweight; Overweight - complications; Overweight - diet therapy; Overweight - psychology; Parathyroid; Parathyroid hormone; Patient Acceptance of Health Care - psychology; Patient Education as Topic - methods; patients; Physical activity; Proteins; Questionnaires; Self Care - methods; Self Care - psychology; skim milk; Systematic review; systolic blood pressure; Treatment Outcome; Uric acid; Vitamin D; Waist Circumference; Waist-Hip Ratio; Insulin resistance; Type 2 diabetes mellitus; Adiposity; Calcium; Glycaemic control
• ISSN: 0007-1145; 1475-2662; 1475-2662
• DOI: 10.1017/S0007114519003192

We assessed the effects of increased Ca consumption from fat-free milk in an energy-restricted diet and educational activities in the metabolic control of overweight type 2 diabetes mellitus (T2DM) patients. Fourteen subjects with T2DM (BMI 29·4 ( sd 4·5) kg/m 2 , low habitual Ca consumption (<600 mg/d)) were included in this randomised, crossover clinical trial. Subjects were randomly allocated to one of the two interventions: drink containing 700 mg of Ca (DAIR) or drink containing 0 mg of Ca (CONT) for ninety consecutive days each. Energy-restricted diets (–500 kcal/d; –2092 kJ/d), containing 800 mg of Ca from dietary sources/d, were prescribed for both groups. Questionnaires were applied at baseline and at the end of the study to assess the subjects’ knowledge on the disease and on self-care, biochemical variables and physical activity. Blood pressure, food intake, body composition and anthropometry were assessed at baseline, days 45 and 90. There was a higher reduction of body fat %, waist circumference, hip circumference, neck circumference, waist:hip ratio, sagittal abdominal diameter, diastolic/systolic blood pressure and an increase in fat-free mass % in DAIR than in CONT. Uric acid, fasting glucose, Hb1Ac, parathyroid hormone and alanine aminotransferase concentrations reduced and vitamin D concentration increased after 90 d in DAIR compared with CONT. The consumption of energy-restricted diet containing 1200 mg Ca/d seems to favour metabolic control in subjects with T2DM. The educational activities increased the knowledge on the disease care.