Diabetes and healthy eating: a systematic review of the literature.

PURPOSE: The purpose of this study is to review the literature on healthy eating interventions within diabetes care. DATA SOURCES: The databases PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO were searched for the terms healthy eating or dietary and intervention and diabetes in the abstracts. In addition, electronic searches of the contents of Diabetes, Clinical Diabetes, Diabetes Care, Diabetes Spectrum, and Diabetic Medicine were conducted. STUDY SELECTION: Articles were included in the review if the participants were diagnosed with type 1 or type 2 diabetes, results from an intervention to promote dietary change were reported, measurements were taken from 2 time points (preintervention and postintervention), at least 1 outcome measured eating behavior, and the articles had been published between 1990 and the present date. DATA EXTRACTION: Data were extracted from the 23 studies found to be eligible. Studies were compared in terms of sample types and sizes, duration, and type and content of intervention. DATA SYNTHESIS: Comparisons were made between the characteristics of those studies that produced a statistically significant result and those that did not, for the different outcome measures.
CONCLUSIONS: For studies measuring the outcomes of weight, fat intake, saturated fat intake, and carbohydrates, there was a tendency for successful interventions to include an exercise dimension and group work. Some outcomes had a tendency to show significant changes in studies of longer duration (eg, serum cholesterol), whereas others were more likely to show significant changes in studies of shorter duration (eg, weight, fiber), suggesting that certain outcomes may be more difficult to maintain. Future research would benefit by ensuring that sample sizes are adequate to give sufficient power, and interventions should be designed that focus on the maintenance in addition to the initiation of eating behavior change.