Low-intensity group support improves diet, may cut diabetes risk in American Indian women

Even low-intensity group support helps motivate young American Indian women to hit the produce aisle, a new study suggests.

After participating, these women reported upping their intake of fruits and vegetables — a dietary change that can lower this population's increased risk of developing type 2 diabetes.

The study targeted urban American Indian women, ages 18 to 40, because more than half of American Indians live in cities and they often have limited access to diabetes-prevention services, said lead author Janice Thompson, Ph.D., of the University of Bristol in England.

In the study, published in the March issue of the American Journal of Preventive Medicine, women learned about diet and exercise strategies in monthly, two-plus hour sessions with trained American Indian facilitators. Of 200 original participants, 135 stayed with the study for the entire 18 months.

Sixty-four of the remaining participants experienced the group intervention. These women took 15-minute walks together, traded healthy recipes and practical exercise tips, and learned how to make smarter food shopping and restaurant choices.

They also set weight-loss and exercise goals, and discussed motivational examples like other American Indian women growing their own vegetables and bringing veggie dishes to tribal feasts.

The other 71 women, along with program participants, received medical check-ups every six months during the study period.

Besides eating more greens, group participants seemed to lose more weight immediately after the program than their control peers. However, after 18 months, weight loss in the group and control participants was similar.

At study's end, both group and control participants decreased their waist size and LDL, or “bad” cholesterol, reduced their television viewing, and cut back on calories, sugar and fat. Exercise levels remained stable.

Why the similar health benefit for both sets of women? It is likely because all they all became more health-conscious, given the study focus and regular clinic visits, Thompson said. “These were all highly motivated women — even those without the curriculum.”

Nevertheless, women in the group program had the health edge with their higher consumption of fruits and vegetables, Thompson said, suggesting that even a light, monthly group session can better prevent diabetes.

The group support makes the difference, said Kelly Acton, M.D., diabetes expert at the Indian Health Service, because “these women give each other positive feedback. One might say, ‘I don't like broccoli either, but here's this great green bean recipe.' It's the power of community.”