To investigate effects of an individual dietary education eating 'vegetables before carbohydrates' on glycemic control in Japanese patients with type 2 diabetes for 30 months. A total of 333 patients in either an educational group or control group were compared the impact on HbA1c, weight loss, serum lipids, and blood pressure at 30 months of follow-up retrospectively. All patients were scheduled for return visits at every 4 weeks with physical examination and patients in the educational group were routinely scheduled to see dietitians at every visit. Dietary practices and physical activity were assessed in educational group. At presentation, the educational group and the control group were comparable in sex, BMI and HbA1c. Improvements in HbA1c levels over 30 months were observed from 8.3 to 7.1% with the educational group (p<0.001) while no change was observed with the control group, and the values in the educational group were significantly lower than the control group after 3 to 30 months of study period. Patients of the educational group exhibited significant improvements in dietary practices with respect to intake of carbohydrate, fat and sugar sweetened foods. Simple meal plan emphasizing 'vegetables before carbohydrates' was effective on glycemic control in Japanese patients with diabetes for 30 months.

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This study illustrated that nutritional classes at a nursing home improved the eating habits of the residents and resulted in better connections and relationships between the facility and the neighborhood. Thirty-three female residents in good health (BMI 23 kg/m2), between 20 to 74 years old, were recruited from the 1 , 291 families that live in the vicinity of the nursing home. Four nutritional courses were conducted in the form of participatory and observational learning in October and November of 2008. Data was collected via questionnaires conducted before the classes started, after the classes were held, and 2 months after the classes ended. It was found that after the nutritional classes, consumption patterns were significantly different in a number of areas. The frequency of the intake of the following items showed an increase at the end of the study; green and yellow vegetables, other vegetables, and fruit, and maintained an increase at 2 months after the classes ended. Furthermore, at the end and 2 months after the classes ended there was a significant increase in the intake of vegetables and limiting calories from fat 2 months after the classes ended. There was an increase shown in the enjoyment of eating after the classes were held, and 2 months after the classes ended, which indicates an increase in the quality of life. There was a great difference in the frequency people checked their weight, at the end and 2 months after the classes ended. It was found that the nutritional classes had ripple effects by increasing communication both within the family and the community. Moreover it was found that the participants felt at ease with going to the Nursing home. These results indicate that the nutritional classes were found to have improved the relationship between the facility and the neighborhood by fostering a greater sense of connectivity. In addition, after the classes, participants were more mindful of their nutrition and diet.

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