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Evaluation of Dietary Intakes and Nutritional Knowledge in Thai Patients with Type 2 Diabetes Mellitus.

ABSTRACT: Introduction:Most nutritional guidelines for diabetes management emphasize the importance of having individualized goals, away from a one-size-fits-all approach. However, there is a dearth of information on the dietary intakes and nutritional knowledge of Thai patients with type 2 diabetes mellitus (T2DM). This study is aimed at clarifying dietary intakes in relationship to glycemic control and at examining nutritional knowledge among Thai patients with T2DM. Materials and Methods:A cross-sectional study of outpatients with T2DM at Theptarin Hospital and Ramathibodi Hospital (Bangkok, Thailand) was performed to assess dietary intakes by food records. Diabetes nutritional knowledge and dietary self-care behavior was also evaluated. Results:A total of 304 Thai patients with T2DM (female 52.6%, mean age 57.4?±?10.9 years, body mass index (BMI) 27.3?±?4.8?kg/m2, and baseline A1C 7.2?±?1.3%) participated in the study. The mean daily calorie intake was 1427?±?425?kcal, and mean intake for each macronutrient was acceptable (carbohydrate 52%, protein 17%, and fat 31%). However, the intake of free sugar was much higher (12.1?±?5.8% of total daily energy intake) and dietary fiber intake (9 grams per day) was much lower than recommended. There were no correlations between dietary intake and glycemic control. A subset of patients (N = 213) completed the diabetes nutritional knowledge survey. There was no association between diabetes nutritional knowledge and the actual dietary self-care behavior. Conclusion:These results indicate that compliance of Thai patients with T2DM to dietary recommendations is not completely satisfactory, especially for free sugar and dietary fiber intakes. Addressing the reality of how patients with T2DM eat in their daily lives and their knowledge gaps would enable them to adhere to medical nutrition therapy.

SUBMITTER: Thewjitcharoen Y

PROVIDER: S-EPMC6317123 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe rapid increase in non-communicable chronic diseases in people of working age has had a major effect on health care utilization, productivity and economy. Lifestyle and diet are recognized as being major risk determinants involved. Disease prevention strategies need to be based on people's understanding of nutritional knowledge, attitudes and practice. This study evaluates the validity of a new nutritional knowledge and practice questionnaire specifically developed for assessing individuals of working age in a Thai population.MethodsThe questionnaire was constructed and based on previous relevant literature and its content validity was scrutinized by an expert panel. An exploratory factor analysis (EFA) was performed to reduce the number of questions included. Subsequently, data from a cross-sectional study of 1,032 participants were used to evaluate the reliability and validity of this questionnaire. The validity of the questionnaire constructed for assessing knowledge and attitude was evaluated using Confirmatory Factor Analysis (CFA). For the practice component, set criteria were applied to determine the final variables used.ResultsCFA of the nutritional knowledge component suggested that all the variables in the model fitted with the data (χ2 = 80.17, df = 66, p > 0.05, CFI = 0.99, RMSEA = 0.01, SRMR = 0.02). The CFA final model for the nutritional knowledge included three factors (food recommendation, nutrients related to diseases, and healthy diet) with a total of 14 questions. For nutrition attitude, CFA also revealed a good fit (χ2 = 178.14, df = 93, p < 0.001, CFI = 0.99, RMSEA = 0.03, SRMR = 0.03). The final CFA model for nutritional attitude included three factors (food choice, healthy diet and food recommendation) with a total of 16 questions. For practice items, the number of questions was reduced from 76 to 60.ConclusionsQuestionnaire development should use a logical, systematic and structured approach. Results from our evaluation process demonstrates the construction validity of the nutritional knowledge and practice questionnaire developed. This questionnaire can be further modified for use in other countries within the region.

Project description:BackgroundHypertension is present in more than 50% of patients with type 2 diabetes mellitus. Dietary salt restriction is recommended for the management of high blood pressure. Instructions on dietary salt restriction, provided by a dietitian, have been shown to help patients reduce their salt intake. However, appointments for the dietitians in hospitals are often already fully booked, making it difficult for patients to receive instructions on the same day as the outpatient clinic visit.AimThe aim of this trial is to test a new intervention to assess whether guidance on dietary salt restriction provided by physicians during outpatient visits is effective in reducing salt intake in patients with type 2 diabetes mellitus who have an excessive salt intake.MethodsIn this unblinded randomized controlled trial (RCT), a total of 200 patients, male or female, aged between 20?and 90?years, who have type 2 diabetes mellitus and consume excessive salt will be randomly assigned to two groups: an intervention group and a control group. In addition to being given routine treatment, participants in the intervention group will be given individual guidance on restricting their dietary salt intake by a physician upon enrollment. The control group will only be given routine treatment. Participants will be followed up for 24?weeks. The primary outcome will be dietary salt intake, which will be assessed at baseline and at 8, 16, and 24?weeks. The secondary outcomes, including body weight, body mass index, hemoglobin A1c level, blood pressure, blood glucose level, serum lipid profile, and urinary albumin excretion level, will be assessed at baseline and at 8, 16, and 24?weeks.DiscussionThe results of this RCT have the potential to provide a simple and novel clinical approach to reduce salt intake among patients with type 2 diabetes, making regular visits to their physician, in outpatient facilities. This protocol will contribute to the literature because it describes a practical intervention that has not been tested previously, and it may serve as guidance to other researchers interested in testing similar interventions.Trial registrationUniversity Hospital Medical Information Network (UMIN), UMIN000028809. Registered retrospectively on 24 August 2017. http://www.umin.ac.jp.

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Evaluation of Dietary Intakes and Nutritional Knowledge in Thai Patients with Type 2 Diabetes Mellitus.

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