Changes in body composition and adiposity following an eight-week health-promotion intervention among adolescents and young adults with type 1 diabetes in Wakiso, Uganda: A controlled before-and-after study

Background: Nutrition education and physical activity support are important components of type 1 diabetes mellitus (T1DM) care, but their association with body composition outcomes in routine Ugandan diabetes services remains uncertain. We evaluated a culturally tailored health promotion programme among adolescents and young adults living with T1DM. Methods: We conducted a trial study in Wakiso Health Centre IV, Uganda. Sixty participants aged 13 to 26 years were allocated through an alternating clinic-week schedule to an intervention group or usual-care control group, with 30 participants per group. The eight-week Active Hearts, Healthy Lives programme combined nutrition education, personalised dietetic counselling, physical activity support, and practical self-management activities. Anthropometric and bioelectrical impedance measurements were obtained at baseline and six months after baseline. Separate linear regression models compared follow-up outcomes, adjusting for the corresponding baseline measurement, age, and sex. Results: Participants had a mean age of 19.45 years (SD 3.02), and 33 (55.0%) were female. Compared with controls, the intervention group had lower adjusted fat mass and BMI and higher fat-free mass and muscle mass. These differences reflected modest changes among intervention participants alongside increased fat mass and decreased fat-free mass and muscle mass among controls. Conclusion: Participation in the programme was associated with differences in estimated body composition at six months. Larger randomised evaluations incorporating clinical and functional outcomes are needed to establish whether the programme provides meaningful health benefits.