Title: EFFECTS OF EXERCISE WITH OR WITHOUT AHYPOCALORIC DIET INCLUDING OATMEAL ON RISK FACTORSFOR DIABETES

Author(s): A. Summers, J. Brosnahan, V. Nguyen, L. Zukley,J. Lowndes, J. M. Rippe; Rippe Lifestyle Institute, Celebration, FL

Learning Outcome: To understand the effectiveness of exercisewith or without caloric restriction on risk factors for diabetes.

Text: Research Outcome: Obesity represents an independent riskfactor for diabetes in part by negatively altering body compositionand insulin resistance. Weight loss significantly decreases thelikelihood of developing diabetes in overweight and obese adults.Reduction of caloric intake and increased physical activity are oftenrecommended for weight loss in overweight and obese individuals.Therefore, we measured the effects of exercise alone (EX), or exerciseplus consumption of a hypocaloric diet including daily oatmealconsumption (EX�D), on diabetes risk factors in 47 non-diabeticoverweight and obese participants.Methods: Exercise involved moderate physical activity for a minimumof 15 minutes, 3 days/week. EX�D also received instructions to adopt ahypocaloric diet (daily deficit � 500kcals). Individual meal plans weredeveloped by registered dietitians and included whole grain instantoatmeal (1 packet) for breakfast. Diet options during the remainder ofthe day were based on an exchange list system.Results: Results for the within group changes at 24 weeks were: 1)body mass (�10.88lbs, p�0.001), and percent body fat (�3.14, p�0.001)were reduced for EX�D but not for EX, 2) insulin resistance (HOMA)did not change significantly in either group.Conclusions: These data suggest that a hypocaloric diet includingoatmeal combined with moderate exercise can produce weight loss andimproved body composition in overweight and obese individuals. Thoughinsulin resistance was not affected in this 24 week study, this type ofintervention is an appropriate initial approach for overweight and obeseindividuals at risk for the development of type 2 diabetes.

Funding Disclosure: Grant Support: The Quaker Oats Company.

Title: GROUP VERSUS INDIVIDUAL APPOINTMENTS ANDTHEIR IMPACT ON KIDNEY DISEASE PROGRESSION OF TYPE2 DIABETES PATIENTS WHO ATTEND AN AMBULATORY CAREFACILITY

Author(s): N. Gonzalez,1 L. Byham Gray,2 R. Denmark,2

R. Touger Decker,2 M. Wein2; 1Endocrinology, Cleveland ClinicFlorida, Weston, FL, 2SHRP, UMDNJ, Newark, NJ

Learning Outcome: To compare and evaluate the effectiveness ofthe group sessions and individual appointments for diabetesmanagement of adults � 18 years with type 2 DM by measuringglycemic control, chronic kidney disease progression, and in a distinctthough overlapping population, patient satisfaction

Text: This study was a retrospective outcomes study of 128ambulatory care charts from patients assigned to either a SharedMedical Appointment (SMA) (n�65) group or an IndividualAppointment (n�63) (IA) group. The main outcome measuresanalyzed were glycohemoglobin (HbA1C), creatinine (CR), andestimated glomerular filtration rate (eGFR). Patient satisfaction wasmeasured with a survey in a different but related sample (N�177).Subjects were limited to patients who attended either type of visit,for at least three (3) visits over a period of six (6) months betweenJanuary 2004 and December 2005. Data was analyzed using SPSSv13.0; Chi square, independent and dependent sample t-tests, and 2X 2 Split-Plot ANOVA were used. From baseline to six (6) monthsthere was no significant difference between groups in the clinicaloutcomes HbA1C (6.78 % � 0.83 in the SMA group, and 6.89% �1.12 for the IA group) (p�0.208), CR (1.05 mg � 0.44 in the SMAgroup, and 1.22 mg � 0.63 in the IA group) (p�0.084), and eGFR(79.53 ml/min/1.73 in the SMA group, and 71.85 ml/min/1.73 for theIA group) (p�0.104). Patient satisfaction was significantly higher inthe SMA group (4.64 � 0.532 in the SMA group, and 4.50 � 0.725 inthe IA group) (p�0.002), over the IA group. This study suggests thatgroup sessions are widely accepted by patients, and may be aseffective as individualized appointments in controlling glycemia andkidney disease progression in patients with Type 2 DM.

Funding Disclosure: None

Title: DIABETES EDUCATION FOR ARKANSANS: REDUCINGBARRIERS

Author(s): D. M. Brech,1 M. Blevins,2 A. Balamurugan,3 J. Hall-Barrow4;1Dietetics and Nutrition, Ouachita Baptist University, Arkadelphia, AR,2Allcare Pharmacy, Arkadelphia, AR, 3Chronic Disease EpidemiologySection, Arkansas Department of Health & Human Services, Little Rock,AR, 4Center for Distance Health, University of Arkansas for MedicalSciences, Little Rock, AR

Learning Outcome: Participants will be able to assess if telemedicineimproves diabetes self-management of people living in rural areas ofArkansas.

Text: The goal of this project was to use telemedicine technology to offerresidents in a rural community access to a diabetes self-managementeducation (DSME) program and to increase the proportion of persons withdiabetes who receive formal diabetes education. Promotional materials suchas a brochure, direct mail, and newspaper advertisement were used to recruitparticipants. The participants were assessed on knowledge, attitude andskills (KAS) of diabetes self-management over the telephone by the registerednurse and the registered dietitian who were the instructors in the program.On-site assessments were completed by the registered nurse who coordinatedscheduling of the participants and collected initial blood and urine samples,weight, and blood pressure. Pre-program glycosylated hemoglobin, totalcholesterol, LDL cholesterol, HDL cholesterol, triglycerides, urinemicroalbumin, weight, systolic blood pressure and diastolic blood pressurewere determined for each participant. Five, two-hour educational sessionswere presented during May, June, and July of 2006. Three of the sessionswere provided by the registered dietitian who provided information aboutbasic nutrition, carbohydrate counting, meal and snack planning, hearthealthy nutrition, grocery shopping, and case studies. The registered nurseprovided information on medications, monitoring, complications, skin care,exercise, and stress reduction. Post-program follow-up labs, weight, and bloodpressure were collected and compared to pre-program assessments.Glycosylated hemoglobin dropped from a mean of 7.01 to 6.78. Pre-programand post-program DSME KAS were compared. Statistically significantchanges were in the KAS domains of “possess knowledge to managediabetes,” “possess skills to manage diabetes,” and “feel helpless to managediabetes.”

Funding Disclosure: The grant Diabetic Education for Arkansans wasprovided by the Arkansas Department of Health and Human Services.

Title: PREVALENCE AND TYPES OF FOOD CRAVINGS IN ALARGE CULTURALLY DIVERSE METROPOLITAN UNIVERSITY

Author(s): H. M. Kromschroder, M. R. Freedman, K. Sucher,C. B. Hollenbeck; Nutrition and Food Science, San Jose StateUniversity, San Jose, CA

Learning Outcome: Participants will gain an understanding in thenature of food cravings among students in a large culturally diversemetropolitan university.

Text: Research Outcome: The purpose of this study was to uncoverthe prevalence and types of food cravings experienced in individualsin a culturally diverse metropolitan university setting, and toinvestigate whether relationships exist between food cravings (FC)and socioeconomic status, ethnicity, gender, body mass index (BMI),diet history, and mood.Methods: Three hundred students completed a self-reportquestionnaire that assessed demographics, dieting behaviors, andissues pertaining to food cravings. The mean age was 23.5�0.3 years,and BMI was 23.7�0.2 kg/m2. They were ethnically diverse: Asian(31%), Caucasian (29%), Hispanic (18%), Pacific Islanders (7%),African American (4%), Middle Eastern (2%), Asian Indians (1%), and8% other.Results: The results indicated that over 70% of all subjectsexperienced at least one FC per week, while � 90% experienced atleast one FC a month during the last six months. There were nosignificant differences in the occurrence of FC or reported triggers ofFC as a function of gender, BMI, ethnicity, or socioeconomic status;however, food cravings appear to a have defined ethnic influences.Cravings for rice, tea, spicy vegetables, tortillas and popcorn weresignificantly different among ethnicities and were culture specific.Females reported significantly less satisfaction in their body weight,were significantly more likely to be dieting, to control their weight byrestricting food intake, and to consume meals with others.Conclusion: The present study demonstrates that FC are a commonexperience and occurrence in both male and female universitystudents and may be a learned behavior.

Funding Disclosure: None

SUNDAY, SEPTEMBER 30

POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY

Journal of the AMERICAN DIETETIC ASSOCIATION / A-41