Jeanne Dalen, Ph.D Associate Research Scientist Oregon Research Institute

Jeanne Dalen, Ph.DAssociate Research Scientist

Oregon Research Institute

• Lifestyle interventions resulting in weight loss can reduce the incidence of Type 2 diabetes and its complications

• Though most standardized prescribed diets result in weight loss when followed, most individuals are unable to adhere to a diet for the long term • Psychological distress

• plays a prominent role in self-management behaviors• reduced adherence to regimens, overeating, weight

gain, and poorer glycemic control

•Need to specifically address barriers theorized to be associated with long-term weight loss

Pilot Data In Obese Populations

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Axis T

itle

Figure 3. Treatment-related Changes from Baseline in BMI in the MEAL Group

Compared to Active Control

MEAL Baseline BMI 34.68SUPP Baseline BMI 38.24

1.8

2.2

2.6

3

PRE POST

MEAL SUPP

Int

erleu

kin 6

Figure 5. Treatment-related Changes from Baseline in Interleukin 6.

0.4

0.6

0.8

1

1.2

PRE POST

MEAL SUPP

C

-reac

tive P

rotein

Figure 4. Treatment-related Changes from Baseline in C-reactive Protein.

Proposed Study to Collect Pilot Data In Diabetic Populations• Partnership with NMVAHCS 60 men and women with

T2DM• 35–65 years of age• Randomly assigned to 1) usual diabetes care plus MEAL, or 2) usual diabetes care alone• primary outcomes: dietary patterns, eating behaviors, and distress• secondary health outcomes (e.g. BMI,HbA1c)

Compared MEAL with an active comparison support group (SUPP) 36 post-menopausal obese women Age: M = 58 yrs; SD = 4.9, Weight at baseline (M = 210 pounds; SD = 17.22)

Figure 1. Conceptual Model Linking Intervention Components with Changes in Mindfulness Attitudes and Short and Long-Term Dietary and Health Outcomes.

Meal Intervention Components

Moderators* Primary Outcomes

Secondary OutcomesMediator

Mediator

Independent Predictor

* Moderators are thought to have both direct and indirect effects; some moderators such as age, and medication will be addressed through randomization, others will serve as covariates in the data analyses.

Engagement with Treatment

Psychological Distress

Dietary Quality

Mindfulness Attitudes



Health Outcomes

Eating Behaviors

Dietary Quality

Regimen Adherence


Meditation Practice

Mindful Eating

Yoga

Demographics:ageethnicityincome

Illness Severity:

comorbidit ies medication smoking



Dietary Quality




Health Outcomes

Eating Behaviors

Dietary Quality

Regimen Adherence


Meditation Practice

Mindful Eating

Yoga


Illness Severity:




Dietary Quality




Health Outcomes

Eating Behaviors

Dietary Quality

Regimen Adherence


Meditation Practice

Mindful Eating

Yoga


Illness Severity:




Dietary Quality




Health Outcomes

Eating Behaviors

Dietary Quality

Regimen Adherence

Mindfulness Perceptions

Meditation Practice

Mindful Eating

Yoga


Illness Severity:


• The challenge is not to convey more diet information to people, nor to rely on drugs and surgery with high costs and safety concerns

• Sensible and sustainable approach is to help people develop the lasting skills they need to optimize their relationship to food, eating, and their health

• Mindfulness represents a new avenue of exploration • - targets the psychological and behavioral etiology of

obesity

• Developing research programs to examine the efficacy of a mindfulness-based eating awareness intervention (MEAL) specifically with individuals with T2DM

• Combines behavioral and biomedical science to be used in real-world clinical health-care practice settings

Documents

Jeanne Dalen, Ph.D Associate Research Scientist Oregon Research Institute