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Patient empowerment and the Mediterranean diet as a possible tool to tackle prediabetes associated with overweight or obesity: a pilot study

  • Giovanna MuscogiuriEmail author
  • Luigi Barrea
  • Carolina Di Somma
  • Barbara Altieri
  • Martina Vecchiarini
  • Francesco Orio
  • Tiziana Spinosa
  • Annamaria Colao
  • Silvia Savastano
Original Article



The objective of this study was to investigate the effect of implementation of short-term patient empowerment as applied to Mediterranean diet (MD) adherence on metabolic and anthropometric parameters in prediabetic overweight or obese subjects.


The sample included 42 subjects with prediabetes, aged 18–75 years and with body mass index (BMI) > 25 kg/m2, who received dietary advice on MD by nutritionists during session groups every 2 weeks for 4 months. Data on energy caloric intake and macronutrient consumption were collected using a 7-day food diary record. Adherence to MD was investigated through the PREvención con DIeta MEDiterránea (PREDIMED) questionnaire. No advice was given regarding caloric restriction and physical activity. At baseline and at the end of the study, each subject underwent anthropometric, metabolic, and nutritional assessments.


Approximately 40.5% of subjects had achieved restoration of normal glucose tolerance by the end of the study. Fasting plasma glucose, glycated hemoglobin (HbA1C), BMI, waist circumference, blood pressure, visceral adiposity index, triglycerides, and total and LDL cholesterol levels were significantly decreased, while HDL cholesterol had significantly increased by the end of the study. The subjects significantly increased adherence to MD, as assessed by the PREDIMED questionnaire at follow-up. A reduction of prevalence of the metabolic syndrome was also reported. Interestingly, the PREDIMED score correlated with HbA1C values at follow-up, after adjusting for BMI and total caloric intake.


Implementation of short-term patient empowerment as applied to MD adherence was shown to improve anthropometric and metabolic parameters in prediabetic overweight or obese subjects. This is of considerable importance, given that diet must be the cornerstone of treatment in patients at high risk of developing type 2 diabetes.


Prediabetes Mediterranean diet Type 2 diabetes Overweight Obesity Empowerment 


Compliance with ethical standards

The work was conducted in accordance with the Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans and was approved by the Ethical Committee of the University of Naples “Federico II” Medical School (n. 05/14). The purpose of the protocol was explained to all patients, and written informed consent was obtained.


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Copyright information

© Hellenic Endocrine Society 2019

Authors and Affiliations

  • Giovanna Muscogiuri
    • 1
    Email author
  • Luigi Barrea
    • 1
  • Carolina Di Somma
    • 2
  • Barbara Altieri
    • 1
  • Martina Vecchiarini
    • 3
  • Francesco Orio
    • 4
  • Tiziana Spinosa
    • 5
  • Annamaria Colao
    • 1
  • Silvia Savastano
    • 1
  1. 1.Department of Clinical Medicine and SurgeryUniversity “Federico II”NaplesItaly
  2. 2.IRCCS SDN NapoliNaplesItaly
  3. 3.University “Federico II”NaplesItaly
  4. 4.University ParthenopeNaplesItaly
  5. 5.U.O. Assistenza Sanitaria di Base ASL Napoli 1 CentroNaplesItaly

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