Carolyn Booth

November 29th 2014

NUTR 430
Diet: Diabetes Prevention Program (DPP)
Primary DPP guidelines:
Limit fat intake to 25% of daily calories
Aim for 1-2 lb weight loss per week (overall 7% weight loss in about six months)
Summary Anthropometrics:
Starting weight: 115 lb or 52.3 kg (Normal weight)
EEE: 1568 kcal to 1830 kcal per day
Protein needs: 41.84g/day
Fiber needs: 25g/day
Ending weight: 113 lb or 51.4 kg (2 lb or 0.9 kg weight loss)

Summary table:
Avg kcal intake
% carbs
% fat
% protein
Micronutrients >150%

Micronutrients <75%
Avg. daily fiber intake
Excluded item if applicable? y/n

Planned diet
1586 kcal
64%
27%
14% (54g)
Copper,
phosphorous,
vitamin C, vitamin
K, thiamin,
Potassium, iron,
vitamin D, vitamin
E, niacin, choline
33g
N

Diet consumed
1582 kcal
60%
29%
14% (56g)
Copper, Vitamin B6,
Vitamin B12, vitamin
C, vitamin K, folate,
Potassium, vitamin
D, vitamin E, choline
31g
N

Carolyn Booth
November 29th 2014
NUTR 430
The Diabetes Prevention Program (DPP) targets pre-diabetic and overweight populations
focusing on primary intervention. The DPP study was a randomized three-trial experiment with a
sample of 3,234 overweight participants. The DPP goals are to keep ones total calories from fat
at about 25% of ones daily intake and to have caloric restriction for 1-2 pound weight loss per
week (500-1000 calorie restriction per day). Ultimately, weight loss guidelines in the program
are aiming for a 7% reduction in weight in about six months. These diet guidelines are coupled
with the recommendation of 150 minutes of physical activity per week as well.
An aspect of the original DPP study was a diabetic pharmaceutical called metformin and
a placebo to serve as comparable trials for the dietary and physical activity intervention. The
metformin group took 850 mg twice a day. Both of these trials received dietary and physical
activity information, however, they did not receive any extensive motivational counseling to
supplement their treatments. The DPP itself is a form of medical nutrition therapy but the
guidelines are so broad and can apply to many typical diets with few adjustments.
The DPP has an extensive social network of professionals supporting participants
alongside the dietary and activity recommendations. Throughout the first six months of the
program participants engage in 16 follow-up sessions to meet with registered dietitians.
Participants also perform supervised physical activity twice a week throughout the trial sessions.
At participant sessions diet adherence is examined and motivational counseling is used to
identify barriers to achieving weight loss goals. Supervisors, counselors, and dietitians continue
working together and with participants less frequently following the initial six months to provide
longer-term support and help participants feel confident about the diet reducing diabetes risk.
Pre-diabetes correlates with high blood pressure (140/90mmHg), elevated low-density
lipoproteins and triglycerides, decreased high-density lipoproteins, and elevated blood glucose.

Carolyn Booth
November 29th 2014
NUTR 430
These symptoms align with being overweight and offer weight loss as an effective primary focus
for preventing the onset of diabetes. Low fat diets and overall caloric restriction encourage
weight loss. Limiting fat also strives to keep saturated fat intake below the recommended
maximum of 10% of total calories which further supports healthy blood lipid profiles and
reduced diabetes risk. Results of the DPP include a 58% reduction in the risk factors of diabetes.
A subsequent ten-year follow up study with 2,766 participants resulted in a risk reduction of 34%
in the lifestyle intervention group compared to the metformin group (18% risk reduction).
My experience of DPP guidelines on my diet showed me how much I already maintain a
diabetes prevention diet. The DPP mainly targets overweight individuals, with the lowest starting
weight in the sample chart being five pounds heavier than my starting weight. Through the week
I felt a little tired due to some caloric restriction but I also felt lighter. Unlike when digestion
pulls blood away from working muscles or the brain, I felt able to use available energy stores and
recognize my hunger better. I lost two pounds, even with the Thanksgiving feast. Inputting the
feast day into SuperTracker was fascinating, revealing a 300 kcal brunch and an 1800 kcal
dinner.
After the first few days I adjusted and felt more satisfied by smaller portions. I enjoyed
the ease of knowing what I planned to eat throughout the day. Planning campus dining center
meals into my diet helped greatly as did incorporating leftovers (ex. homemade vegetarian chili).
For clients, I would incorporate meals they are used to with small adjustments to meet DPP
guidelines. Although, further into the diet I began wanting to not follow my plan simply because
I was restricting myself and wanted to break free. When planning the menu, I was surprised at
how difficult it was to get enough potassium. I made several adjustments but still ended up low

Carolyn Booth
November 29th 2014
NUTR 430
in my actual intake. Additionally, vitamin D and E were consistently low. I regularly take a
vitamin D supplement but adding a different variety of nut could help with vitamin E levels.
Challenges to this diet are caloric restriction being uncomfortable, reduction of oils
altering satiety and mouthfeel, and the elimination of a variety of refined or ultra-processed food
items if a large part of ones diet. Regarding caloric restriction, I greatly appreciated noticing my
hunger as it gave me a sense of how little I usually feel hunger when eating my typical diet.
Hunger was not entirely comfortable though, especially in the mornings. A suggestion would be
easing into the diet and slowly reducing calories so the client is more comfortable with the
amount eaten. A technique I used was breaking snacks into small pieces to maximize my eating
time and feel more satisfied. Also, taking smaller bites during meals made the smaller portion
sizes actually feel like an appropriate amount. Furthermore, due to the holiday break I was much
less active than usual and likely did not achieve the 150 minutes of recommended physical
activity. Limiting my activity made the caloric restriction more comfortable, and I imagine
maintaining this diet through the busy work week would be a burden.
The DPP guidelines are reasonable short-term and long-term, though for long-term
adherence an important aspect would be initial transitioning into the diets caloric and fat
restriction. Depending on the busyness of ones lifestyle and taste preferences these changes can
burden individuals trying to feel confident about changing diet to improve health. The extensive
social support network of the official DPP program strives to encourage people, though access to
clinics may hinder ones exposure to motivational counseling. Although I only incorporated the
DPP diet guidelines into my lifestyle, my family served as my social support network. I brought
food home for the holiday break and shared my experiences and food with my family. They
supported my restrictions and incorporated my menu plan to encourage diet adherence. Overall,

Carolyn Booth
November 29th 2014
NUTR 430
this diet experience was valuable for understanding nuances of diet restrictions and being able to
find solutions to barriers and challenges which I can pass on to future clients.
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Carolyn Booth
November 29th 2014
NUTR 430
References:
National Diabetes Information Clearinghouse. (2013). Diabetes Prevention Program. NIH
National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from
http://diabetes.niddk.nih.gov/dm/pubs/preventionprogram/.
The Diabetes Prevention Program Research Group. (2009). 10-year follow-up of diabetes
incidence and weight loss in the Diabetes Prevention Program Outcomes Study. The Lancet,
374(9702):1677-1686. Retrieved from
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61457-4/fulltext.
The Diabetes Prevention Program Research Group. (2002). The Diabetes Prevention
Program (DPP) Description of lifestyle intervention. ADA Diabetes Care, 25(12):2165-2171.
Retrieved from http://care.diabetesjournals.org/content/25/12/2165.full.
Wing R, Gillis B. (1996). The Diabetes Prevention Programs Lifestyle Change Program.
DPP Resource Core. Retrieved from
http://www.cdc.gov/diabetes/prevention/recognition/curriculum.htm.

Carolyn Booth
November 29th 2014
NUTR 430
Experimental Diet Daily Journal

Name: Carolyn Booth

Experimental Diet: DPP

Day on Diet: 1

Date: 11/23/2014
3

Food and amount

Caloric intake: 1394kcal

Place/location of eating

Banana (one 7)
Almonds (15)
Oatmeal (1 cup)
Tbsp brown sugar)
Raisins ( cup)
Flax meal (1 Tbsp)

At Dads home
At Dads home
At Dads home
At Dads home
At Dads home
At Dads home

Hunger rating
before eating
1 = starving
5 = full
2
2
2
2
2
2

Bread 100% WW (1 slice)

Parmesan cheese (5 Tbsp, grated)
Garlic (3 cloves, raw)

Home, kitchen
Home, kitchen
Home, kitchen

3
3
3

Apple (one 3 diameter)

Banana/PeanutButter/Chocolate chip
homemade ice cream ( cup)
Dark chocolate bar ( of 3oz bar)

Home, bedroom
Home, bedroom

2
3

Home, bedroom

Vegetarian chili (1 cup)

Home, bedroom

Energy Level Rating for the day (normal = when not on this experimental diet)
___Normal

_X_Lower than normal

___Higher than yesterday

____Higher than normal

_X_Lower than yesterday

Carolyn Booth
November 29th 2014
NUTR 430

Impressions, observations, feelings, new perspectives for self and for future clients and what
their challenges might include. This is where you communicate what this experience is revealing
to you. Note any solutions you discover that help with diet adherence.
Although my energy was lower than previously, I felt lighter due to less heavy digestion
throughout the day. A low energy expenditure day made the caloric restriction fine. Feeling a
little uncomfortable from hunger was the main drawback, but also made me realize I hadnt felt
hunger very much in a long while. I feel more motivated to choose healthful and hearty options
when eating less food overall. I found myself pretty conscious of food throughout the day and
looking forward to the next meal. Using SuperTracker makes observing diet patterns very
convenient and straightforward.