Long-term effects of the Mediterranean lifestyle program: a randomized clinical trial for postmenopausal women with type 2 diabetes

Deborah J Toobert^*¹ , Russell E Glasgow^*² , Lisa A Strycker^*¹ , Manuel Barrera Jr^*³ , Debra P Ritzwoller^*⁴ and Gerdi Weidner^*⁵

¹Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, USA

²Kaiser Permanente Colorado, Denver, Colorado 80231, USA

³Psychology Department, Arizona State University, Box 871104 Tempe, AZ 85287, USA

⁴Kaiser Permanente Colorado, Clinical Research Unit, 580 Mohawk Dr., Boulder, CO 80302, USA

⁵Preventive Medicine Research Institute, 900 Bridgeway, Sausalito, California 94965, USA

author email corresponding author email* Contributed equally

International Journal of Behavioral Nutrition and Physical Activity 2007, 4:1doi:10.1186/1479-5868-4-1


Published:	17 January 2007

Abstract

Background

Multiple-risk-factor interventions offer a promising means for addressing the complex interactions between lifestyle behaviors, psychosocial factors, and the social environment. This report examines the long-term effects of a multiple-risk-factor intervention.

Methods

Postmenopausal women (N = 279) with type 2 diabetes participated in the Mediterranean Lifestyle Program (MLP), a randomized, comprehensive lifestyle intervention study. The intervention targeted healthful eating, physical activity, stress management, smoking cessation, and social support. Outcomes included lifestyle behaviors (i.e., dietary intake, physical activity, stress management, smoking cessation), psychosocial variables (e.g., social support, problem solving, self-efficacy, depression, quality of life), and cost analyses at baseline, and 6, 12, and 24 months.

Results

MLP participants showed significant 12- and 24-month improvements in all targeted lifestyle behaviors with one exception (there were too few smokers to analyze tobacco use effects), and in psychosocial measures of use of supportive resources, problem solving, self-efficacy, and quality of life.

Conclusion

The MLP was more effective than usual care over 24 months in producing improvements on behavioral and psychosocial outcomes. Directions for future research include replication with other populations.