1477-P: Assessing “Small Wins in Meal-Level Diabetes Plate Behaviors in a Nutrition Education and Food Security Intervention

Introduction and Objective: Meal-level behaviors aligned with the ADA Diabetes Plate (DP) are widely used in nutrition education, yet little is known about how they change during interventions. We examined whether participation in a culturally tailored diabetes nutrition education curriculum (What Can I Eat? [WCIE] and/or a food security resource [FSR]) was associated with shifts in three DP “Small Wins” components: proportion of carbohydrate, protein, and non-starchy vegetables. Methods: A pilot three-arm randomized controlled trial enrolled 67 adults living with T2D randomized to WCIE+FSR, WCIE alone, or FSR alone for 12 weeks. Registered dietitian nutritionists conducted two 24 hour dietary recalls at baseline and 12 weeks. Meals were coded using a DP adherence protocol assigning scores from 0 (below target), 1 (at target), to 2 (above target) for each component and averaged per participant. Pre post differences by arm were tested using Kruskal-Wallis and within-person changes using Wilcoxon signed-rank tests. Results: Participants showed variability in intake, with some meals meeting or exceeding targets and others near zero. Baseline carbohydrate scores were similar across arms (FSR Only: 1.00 ± 0.55; WCIE Only: 1.02 ± 0.45; WCIE+FSR: 1.10 ± 0.41) and remained stable at post (0.85-1.21), with no significant between-group differences (p = 0.056) or within-person changes (p = 0.63). Protein scores were consistent (baseline 1.03-1.11; post 1.01-1.10). Vegetable scores were low, with 56% of meals containing none at baseline and 60% at post. No arm showed meaningful pre-post change. Conclusion: Meal-level DP “Small Wins” components remained stable across groups. Findings reflect variability, high baseline engagement, and limited statistical power. Refining DP-aligned measures, particularly through composite Small Wins indicators, may enhance future evaluations of DP-focused interventions. Disclosure S.A. Stotz: None. L.E. Hebert: None. K. Begay: None. T. Hicks: None. S. Palmer: None. I. Barry: None. M. Coca: None. D. Hanumanula: None. S. Krawczyk: None. M. Dennison: None. N. Begick: None. A. Trice: None. S. Berkowitz: Research Support; Current; Blue Cross Blue Shield North Carolina. L. Jiang: None. S.M. Manson: None. C. Byker Shanks: None. Funding American Diabetes Association (11-22-ICTSN-10), National Institutes of Health(K01DK128023)