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<title>The American Journal of Clinical Nutrition Volume 153 Issue 2 2023</title>
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<publisher>2023</publisher>
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<edition>Volume 153 Issue 2 2023</edition>
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<note>Background: The US Dietary Guidelines (USDG) form the basis of nutrition guidelines, but the research informing the 3 USDG dietary
patterns (Healthy US-Style [H-US], Mediterranean [Med], and vegetarian [Veg]) has been drawn largely from observational studies among
White populations.
Objectives: The Dietary Guidelines 3 Diets study was a 3-arm, 12-wk randomly assigned intervention among African American (AA) adults
at risk of type 2 diabetes mellitus that tested the 3 USDG dietary patterns.
Methods: The AAs (ages 18&ndash;65 y, BMI 25&ndash;49.9 kg/m2

, and BMI was measured in kg/m2

) with 3 type 2 diabetes mellitus risk factors were
recruited. Weight, HbA1c, blood pressure, and dietary quality (healthy eating index [HEI]) were collected at baseline and 12 wk. In
addition, participants attended weekly online classes that were designed using material from the USDG/MyPlate. Repeated measures, mixed
models with maximum likelihood estimation, and robust computation of standard errors were tested.
Results: Of the 227 participants screened, 63 were eligible (83% female; age 48.0  10.6 y, BMI 35.9  0.8 kg/m2

) and randomly assigned
to the Healthy US-Style Eating Pattern (H-US) (n 1&frasl;4 21, 81% completion), healthy Mediterranean-style eating pattern (Med) (n 1&frasl;4 22, 86%
completion), or healthy vegetarian eating pattern (Veg) (n 1&frasl;4 20, 70% completion) groups. Within-group, but not between groups, weight
loss was significant (2.4  0.7 kg H-US, 2.6  0.7 kg Med, 2.4  0.8 kg Veg; P 1&frasl;4 0.97 between group). There was also no significant
difference between groups for changes in HbA1c (0.03  0.05% H-US, 0.10  0.05% Med, 0.07  0.06% Veg; P 1&frasl;4 0.10), systolic BP (5.5
 2.7 mmHg H-US, 3.2  2.5 mmHg Med, 2.4  2.9 mmHg Veg; P 1&frasl;4 0.70), diastolic blood pressure (5.2  1.8 mmHg H-US, 2.0  1.7
mmHg Med, 3.4  1.9 mmHg Veg; P 1&frasl;4 0.41), or HEI (7.1  3.2 H-US, 15.2  3.1 Med, 4.6  3.4 Veg; P 1&frasl;4 0.06). Post hoc analyses showed
that the Med group had significantly greater improvements in HEI compared to the Veg group (difference 1&frasl;4 10.6  4.6; 95% CI: 19.7,
1.4; P 1&frasl;4 0.02).
Conclusions: The present study demonstrates that all 3 USDG dietary patterns lead to significant weight loss among AA adults. However,
none of the outcomes were significantly different between groups.
This trial was registered at clinicaltrials.gov as NCT04981847.
Keywords: diet patterns, diet quality, African American, dietary Guidelines, weight loss, type 2 diabetes, hypertension</note>
<subject authority=""><topic>Clinical Nutrition</topic></subject>
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