LONGITUDINAL DIETARY OUTCOMES OF A LIFESTYLE INTERVENTION IN A PREDIABETIC PAKISTANI COHORT: A SUB-ANALYSIS OF THE IHEALTH-T2D TRIAL DIETARY RECORDS

Zohra Khanum; Syeda Tayyaba Batool; Awais Muhammad Butt; Umair Ashfaq; Hafiz Ubaid Ur Rahman; Khadija Irfan Khawaja

doi:10.65605/a-jmrhs.2026.v04.i01.pp1316-1322

Authors

Zohra Khanum Professor Zohra Khanum, Principal, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan. Author
Syeda Tayyaba Batool Dietician iHealth T2D Project, Pakistan. Author
Awais Muhammad Butt Medical Officer, Department of Endocrinology, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan. Author
Umair Ashfaq Assistant Professor of Endocrinology, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan. Author
Hafiz Ubaid Ur Rahman Assistant Professor, School of Food and Agriculture Sciences, University of Management and Technology, Lahore, Punjab, Pakistan. Author
Khadija Irfan Khawaja Professor of Endocrinology, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan. Author

DOI:

https://doi.org/10.65605/a-jmrhs.2026.v04.i01.pp1316-1322

Abstract

Background: The South Asian region is at the centre of the global diabetes Pandemic. The present study was designed to study the efficacy of a lifestyle intervention delivered by community health workers in community dwelling adults with pre-diabetes in Pakistan. Methods: We conducted a sub-study analysis of the dietary recall data from one intervention and one control trial site, to study the effect of lifestyle intervention on change in the macronutrient and energy intake from the baseline. Participants were cluster randomized to receive either the intensive lifestyle intervention or routine care. We only considered those patients who had the baseline record, plus one additional 24-hour recall, leaving 33 participants (22 in the intervention arm, 11 in the control arm). Results: The median age was 49 years and 24 (73%) were males. The primary outcome showed a reduction in median daily energy intake from the baseline in the intervention group compared to the control group: (-645 vs -81 kcal/day). The secondary outcome of change in median carbohydrate intake from the baseline in the intervention group compared to the control group showed a lesser effect (-68 vs -65 g/day). However, changes in the dietary and physical activity parameters failed to reach statistical significance due to large within group variability. Among the clinical parameters, there was no significant difference in change in HbA1c in both groups at the end of one year (median change -0.1% in both groups). There was a trend towards greater weight loss and reduction in BMI and waist circumference in the intervention group (median weight loss: -1.88 kg vs -1.45 kg in the control group), however the wide variability within the groups precluded statistical significance. Conclusion: Our data show a reduction in both daily energy and carbohydrate intake from baseline in the intervention group at one year, which underscores the importance of community health worker delivered dietary advice.