Introduction

Lifestyle changes, especially dietary changes and physical activity, are important in the management of type 2 diabetes (T2D). However, changing one’s lifestyle can be difficult to achieve. A fasting-mimicking diet (FMD) is a novel dietary program for patients with T2D that is applied intermittently. This program gives no instructions on other lifestyle changes. In this qualitative study we investigate experiences with self-induced lifestyle changes in patients with T2D who followed a FMD.

Methods

In the Fasting In diabetes Treatment (FIT) trial, participants received a FMD for five consecutive days every month during one year. A qualitative study with focus groups of 3-4 participants of the FIT study was carried out, using a semi structured questionnaire, until data saturation was reached. A thematic analysis was performed using the Capability, Opportunity, Motivation – Behaviour model combined with the Theoretical Domains Framework.

Results

Twenty participants of the FIT trial were included. Four participants did not adhere to the FMD for one year. Thematic analyses revealed that following a FMD program increased awareness of the importance of a healthy lifestyle (corresponds to ‘motivation’ in the COM-B model). Participants did not only change their eating habits, but also spontaneously changed their physical activity. Additional barriers and facilitators for lifestyle changes in addition to a FMD were identified, for example experiencing health improvements as a facilitator (‘motivation’) and social activities as a barrier (‘opportunity’).

Conclusion

Following a FMD program during one year increases awareness of the importance of lifestyle changes in patients with T2D, that could lead to improving dietary habits in between the FMD periods and increasing overall activity. An intermittent dietary intervention can therefore be a starting point for further lifestyle changes. Health care professionals might positively influence further lifestyle changes in addition to a FMD diet, by paying attention to the identified barriers and facilitators.