Cooking, diabetes self-management education, intervention improves quality of life

COLUMBUS, Ohio – Researchers at The Ohio State University Wexner Medical Center and School of Medicine partnered with Local Matters on a study that tested whether a kitchen intervention that provided food, along with education for the ‘diabetes self-management to encourage healthy eating and physical activity improve hemoglobin A1C levels and diabetes management.

In this randomized, waitlist-control study, 48 adults with type 1 or type 2 diabetes completed the six-week “Cooking Matters for Diabetes” intervention.

“This study showed that Cooking Matters for Diabetes can be an effective method for improving diet-related self-care and health-related quality of life, particularly among people living with food insecurity, and should be tested in larger randomized controlled trials,” he said. co-author Amaris Williams, a postdoctoral fellow in Ohio State’s Division of Endocrinology, Diabetes and Metabolism.

Cooking Matters for Diabetes was adapted from Cooking Matters and the American Diabetes Association’s Diabetes Self-Management Education and Support Program into a 6-week intervention with weekly food supplies. Cooking Matters is a program run by Share Our Strength, a nonprofit organization working to solve hunger and poverty in the United States and around the world.

Local Matters, a Columbus-area nonprofit working to build healthy communities through food education, access and advocacy, partnered in the design and delivery of the intervention, including the ‘cooking instructor, kitchen equipment, food supply and Local Affairs volunteers. The Ohio State Wexner Medical Center Diabetes Education Team provided the community facilities for the program and certified diabetes education and care specialists.

Weekly classes included cooking demonstrations along with lessons on diabetes and treatment options; healthy eating; physical activity; use of medication; monitoring and use of patient-generated health data; prevent, detect and treat acute complications; Healthy coping with psychosocial problems and concerns and problem solving. In addition, one class took an interactive tour of a grocery store.

The cooking portion provided education on food safety, knife techniques, nutrition facts and ingredient label reading, meal planning, budgeting, and shopping. Each class, except for the grocery store visit, involved participants cooking a meal in small groups. Afterwards, all the participants sat down and shared the meal together, with the aim of the participants creating a sense of community.

“Teaching cooking skills has been shown to help reduce the burden of food insecurity. But the broader skills needed to put food on the table, such as meal planning, shopping, budgeting, food safety and nutrition, are also critically important,” said Michelle Moskowitz Brown, executive director of Local Affairs .

Participants completed surveys about their diabetes self-care activities along with health surveys of medical outcomes, diet history, and a food safety questionnaire. In addition, participants’ A1C was measured at baseline, post-intervention, and 3-month follow-up.

A1C is an important predictor of who will have poor long-term outcomes in diabetes, such as heart disease, stroke, kidney disease (nephropathy), eye disease (retinopathy), and nerve disease (neuropathy). Keeping A1c below 7% for most people living with diabetes is key to reducing risk, said lead author Dr. Joshua J. Joseph, an endocrinologist and assistant professor in the Division of Endocrinology , Ohio State Diabetes and Metabolism.

Diabetes remains one of the most common chronic diseases in the United States, affecting more than 34 million adults. Education and support for diabetes self-management are the cornerstones of diabetes care, but only one in two adults with diabetes achieves healthy hemoglobin A1C goals of less than 7%.

“We found that study participants ate more vegetables and fewer carbohydrates. We saw improvements, including significant changes in diabetes self-management activities and lower A1C numbers among study participants with insecurity This is important because food insecurity and lack of access to nutritious foods can make diabetes management and A1C control more difficult,” said study co-investigator Jennifer C. Shrodes, a registered dietitian. and licensed and board certified diabetes care and education specialist in the Ohio State Division of Endocrinology, Diabetes and Metabolism.

In 2018, 11.5% of American households experienced some food insecurity over the course of the year. Several studies have identified a higher prevalence of food insecurity among people with type 2 diabetes compared to the national average, the researchers noted.

“Many outcomes improved more substantially among those who were food insecure compared to those who were not. But during the post-intervention follow-up period, the food insecure group experienced greater regression, emphasizing in the importance of sustained monitoring of vulnerable populations related to one or more social determinants of health,” said Joseph.

The research team included members of the Ohio State Medical Dietetics; Biostatistics Center; Department of Biomedical Informatics; Faculty of Nursing; School of Health and Rehabilitation Sciences; The John Glenn College of Public Affairs and the Wake Forest School of Medicine.

This study was funded by the Diabetes Dietetic Practice Group Karen Goldstein Memorial Grant for Diabetes Medical Nutrition Therapy, administered by the Academy of Nutrition and Dietetics Foundation. Joseph’s time was funded by National Institutes of Health K23 DK117041.

Media Contact: Eileen Scahill, Wexner Medical Center Media Relations, [email protected]

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