Abstract P061: Effects of Diet Modification and Weekly Web Based Health Awareness Teaching on Metabolic and Cardiovascular Risk Factors
Authors: Reddy Kota J , Singh Manmeet , John Shirely , Bangit Joey , Espinoza Yersenia , Zaheer Misbah , Ali Fahad , Buchar Subodh 
Published: July 2021

Background:
Dietary intervention is an established strategy for prevention of cardiovascular disease. However, what kind of diet is more appropriate to modify cardiovascular risk factors remains a matter of intense controversy.

Aim:
To evaluate the effects of carbohydrate restricted diet modification and health awareness teaching on metabolic and cardiovascular risk factors of patients with type 2 diabetes (DM).

Methods:
A total of 482 participants with known DM were screened for this cross sectional study. 276 participants passed the initial screening criteria (BMI ≥30 kg/m2, A1C >6.5%) and were enrolled in the final study. The protocol was approved by IRB. Demographic, clinical and laboratory data was determined pre and post study. Web based weekly teaching described as live webinar sessions on elimination of carbohydrates & saturated fats from daily diet was conducted. A 200 variety menu options with recipes without carbohydrates and saturated fats along with weekly free supply of low carbohydrate bread (Reddy Bread) were provided. Each individual was required a daily use Reddy Bread instead of the regular breads. These sessions were not always attended by all participants, so these sessions were recorded and were available for all on the institute web site with individual login and passwords. A hotline number was provided for immediate help/questions on the website which was available 24/7 for all the participants. Compliance was checked by mandatory online T.I.D Accu-check(AC)entries, phone calls and information obtained from participants during weekly bread collections at study Center. Based on AC supervised changes in the medications were done.

Results:
Mean age was 57.8 ± years with BMI of 35.4 kg/m2 and 69 % were females. A total of 156 (56.5 % of study participants) completed the study for 90 days without deviation from the diet. Noncompliance to diet was the most common reason for non-completion. A significant drop in BMI (2.42 ±2.2 kg/m2, paired t test p<0.001) and HbA1c (1.75±1.08, p<0.001) was observed in those who completed the study. Similarly, reductions in Apo B (94.68± 26.4 v/s 85.9 ± 23.4 mg/dl) and total cholesterol (182.3±40.1 v/s 174.1±38.9 mg/dl) were significant at p value of <0.001. There was either dose reduction or elimination in number of diabetic medications in 22.5 % (n=45) of participants over the duration of study.

Conclusion:
Dietary modification consisting of low carbohydrate recipes and bread, in concomitance with weekly health awareness teaching, showed positive and encouraging changes in cardiac risk profile over 90 days. There was trend towards less need for diabetic medications among participants compliant to the diet. Effectiveness of our life-style intervention was comparable, if not superior, to many of the hypoglycemic agents used to manage DM. The long-term effects of our intervention will have to be confirmed in larger prospective clinical trials.