Discussion
obesity, hypertension, T2DM
OBESITY, POSITIVE, PRE-DIABETES, HYPERTENSION, TYPE 2 DIABETES, COMPLICATIONS
Findings from the current pre-post analysis study show that both T2DM health information and subsidized meal with vegetables and fruits, following the principles of a healthy plate model (IP2) and T2DM health information only (IP1), had equal effect. It was observed that age and income were modulating BMI and blood pressure outcomes among participants in IP2. Positive attitude on T2DM prevention measures increased significantly among participants of both arms. Knowledge on risk factors, symptoms, prevention measures, complications and recommended amount of food groups to eat per meal, increased significantly among participants of both arms.The current study shows that T2DM health information only as well as T2DM health information plus subsidized meal with vegetables and fruits, following the principles of a healthy plate model are effective in reducing cardio-metabolic risk factors including blood pressure, waist circumference and body mass index. Similar effect was also observed from South Africa [To demonstrate portion sizes with the right proportions of each food group in every meal and required ingredients, nutritionists developed the “healthy plate model” [Findings from this study show that age and income influenced the outcomes such as BMI and raised BP. Previous studies indicate that higher age and income accelerate cardio-metabolic risks due to long-term accumulation and increased control over resources. This in turn leads to increased risks of exposure to cardio-metabolic risk factors, including excessive alcohol consumption, low physical activity, and consumption of fatty and processed foods [Many studies have established a direct relationship between obesity and hypertension [This study showed an increase in positive attitude towards prevention measures for cardio-metabolic risks. It has also shown increased knowledge regarding risk factors, signs and symptoms and complications of type 2 diabetes as well as knowledge on the recommended amounts of different food groups. It can, therefore, be argued that the observed positive change on diastolic and systolic BP, BMI as well as waist circumference can be explained by an increase in knowledge and positive attitude which may be was translated into practice, hence influencing behavioral change. Similar findings were observed in a study in South Africa [In this study a negative effect was observed on blood glucose; this is contrary from what was observed in a meta-analysis that involved seven (7) cohort studies. Observed negative glucose results from this study also differ from another meta-analysis which concluded that optimal consumption of fruit or green leafy vegetables significantly reduces T2DM risks [However, the findings documented in this study on glucose may be linked to poor adherence to prevention measures especially at home, where it is usually a challenge to prepare a balanced diet, hence accelerating pre-diabetes [