(P22-059-24) Whole Foods for Prediabetes: Feasibility and Acceptability of a Dietary Guidelines-Based Intervention for Type 2 Diabetes Prevention in Families

Objectives: To describe the feasibility and acceptability of a weight-maintaining whole foods diet intervention in adults with prediabetes and their high risk for type 2 diabetes (T2D) offspring.

Methods: A 2-week single-arm pre-post experimental controlled-feeding study of a whole foods diet adapted from the 2020-2025 DGA was conducted for adults (25-59 years) with prediabetes and their biological offspring (6-17 years). Participants received 2 weeks of menus/grocery delivery, and weekly counseling by a registered dietitian. Feasibility was based on having a ≥50% family retention rate and ≥80% completion of outcome measures including adult-child anthropometrics (weight [kg], height [cm], body mass index [BMI] including BMI% and Z-scores for offspring, and waist circumference [cm]) and child diet quality estimated using the Healthy Eating Index (HEI-2020) from a random 14-day food diary entry. Acceptability was assessed during an optional focus-group session. Paired (dependent sample) t-tests were used to compare differences between baseline and 2-week anthropometrics measures, and child HEI-2020 total and sub-scores. Qualitative data were analyzed using thematic analysis to assess diet satisfaction and barriers and facilitators of diet adherence.

Results: Eight families enrolled (n=8 adults, n=12 offspring), and 7 families completed the study (12% attrition) including 100% of outcome measures. Adult participants maintained a stable weight (within ~6% body weight) from baseline to follow-up (83.2 to 79.8 kg/m², median difference -3.4 kg/m²). Offspring demonstrated a significant 24-point increase in 2015-HEI diet quality scores (median difference of 50 to 74; p=.01). Focus group participants (n=4 adults) reported being satisfied with the program and expressed a willingness to continue the protocol despite identified barriers.

Conclusions: Findings from this study suggest that a whole foods diet is a feasible and acceptable intervention for high-risk for T2D families.

Funding Sources: This project was supported by a T32 training grant through the Agency for Healthcare Research and Quality, a CTSA award No. UL1 TR002243 from the National Center for Advancing Translational Sciences, and the Vanderbilt University School of Nursing.