Abstract
Background: Globally, Type 2 Diabetes Mellitus is considered a major public health disease, influenced by nutrition and lifestyle patterns. The majority of people worldwide consume nutritionally poor, cereal-based diets. Therefore, assessing dietary diversity, macronutrient intake, and food costs is essential for better diabetes management.
Objective: To compare the dietary diversity of the Type 2 diabetic population with estimated dietary costs and other relevant parameters.
Methodology: A descriptive cross-sectional study was conducted among 150 adult Type 2 adult diabetic population. A pre-structured questionnaire was used to elicit information on dietary diversity using the Individual Dietary Diversity Score (IDDS), Food Variety Score (FVS) and diet cost estimation using semi-quantitative food frequency questionnaire. FVS was associated with nutrition status, Glycated Haemoglobin (HbA1c), macronutrient consumption, socio economic status and the average daily diet cost of the study population.
Results: The majority of the population were overweight. 50% of the population had low dietary diversity and had uncontrolled diabetes with HbA1c of 7-8%. Dietary diversity influenced the nutritional status of diabetic people. There was no difference between socioeconomic and living status, HbA1c and FVS. Females had higher per day cost when compared to males. Mean per day increased with the increase in the macronutrient consumption.
Conclusion: Diabetic patients often have low dietary diversity, which affects their nutritional status. Therefore, dietary diversity, along with diet cost, is integral to the effective nutritional care of the diabetic population.
References
World Health Organization. Diabetes [Internet]. WHO; 2023 April [Cited June 23, 2024]. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes
Pradeepa R, Mohan V. Epidemiology of type 2 diabetes in India. Indian J Ophthalmol. 2021;69(11):2932-2938. https://doi.org/10.4103/ijo.IJO_1627_21
Conklin AI, Monsivais P, Khaw K-T, Wareham NJ, Forouhi NG. Dietary Diversity, Diet Cost, and Incidence of Type 2 Diabetes in the United Kingdom: A Prospective Cohort Study. PLoS Med. 2016;13(7):e1002085. https://doi.org/10.1371/journal.pmed.1002085
Sood P, Bindra S. Modified Kuppuswamy socioeconomic scale: 2022 update of India. Int J Community Med Public Health. 2022;9(10):3841–3844. https://doi.org/10.18203/2394-6040.ijcmph20222581
Weir CB, Jan A. BMI Classification Percentile And Cut Off Points. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: http://www.ncbi.nlm.nih.gov/books/NBK541070/
Aneesh M, Patil RS. Diet diversity of urban households in India during the COVID-19 lockdown. Nutr Health. 2022 Dec;28(4):685–91. https://doi.org/10.1177/02601060211019676
Déré KAL, Djohan Y, Koffi KG, Manhan K, Nimaké AG, Tiahou GG. Individual Dietary Diversity Score for Diabetic and Hypertensive Patients in Cote d’Ivoire. IJN. 2016 Apr 8;2(1):38–47. https://doi.org/10.14302/issn.2379-7835.ijn-16-943
Kumar A, Gangwar R, Zargar AA, Kumar R, Sharma A. Prevalence of Diabetes in India: A Review of IDF Diabetes Atlas 10th Edition. Curr Diab Rev. 2024;20(1): e130423215752. https://doi.org/10.2174/1573399819666230413094200
World Health Organization. World Diabetes Day [Internet]. WHO;2019 [Cited June 23, 2024]. Available at: https://www.who.int/india/campaigns/world-diabetes-day
Zhang L, Chang H, Chen Y, Ruan W, Cai L, Song F, et al. Socio-Demographic Factors Associated with Rural Residents’ Dietary Diversity and Dietary Pattern: A Cross-Sectional Study in Pingnan, China. Nutrients. 2023 Jan;15(13):2955. https://doi.org/10.3390/nu15132955
Yerrapragada DB, Rao CR, Karunakaran K, Lee HSE. Cognitive Dysfunction Among Adults with Type 2 Diabetes Mellitus in Karnataka, India. Ochsner J. 2019;19(3):227–34. https://doi.org/10.31486/toj.18.0160
Doglikuu BID, Abubakari A, Yaseri M, Shakibazadeh E, Djazayery A, Mirzaei K. Association of household socioeconomic status, neighborhood support system and adherence to dietary recommendation among persons with T2DM, a facility-based cross-sectional study in Ghana. BMC Public Health. 2021 May 13;21(1):911. https://doi.org/10.1186/s12889-021-10963-x
Pullen R, Kent K, Sharman MJ, Schumacher TL, Brown LJ. A Comparison of Diet Quality in a Sample of Rural and Urban Australian Adults. Nutrients. 2021 Nov 13(11):4130. https://doi.org/10.3390/nu13114130
Mozaffari H, Hosseini Z, Lafrenière J, Conklin AI. The role of dietary diversity in preventing metabolic-related outcomes: Findings from a systematic review. Obesity Reviews. 2021;22(6): e13174. https://doi.org/10.1111/obr.13174
Gholizadeh F, Moludi J, Yagin NL, Alizadeh M, Nachvak SM, Abdollahzad H, et al. The relation of Dietary diversity score and food insecurity to metabolic syndrome features and glucose level among pre-diabetes subjects. Primary Care Diabetes. 2018 Aug 1;12(4):338–44. https://doi.org/10.1016/j.pcd.2018.03.003
Bounihi A, Saidi H, Bouazza A, Benbaibeche H, Azzouz M, Koceir EA. Dietary Diversity as a Risk Factor for Obesity in Algerian Patients with Type 2 Diabetes Mellitus. Healthcare. 2021 Sep;9(9):1229. https://doi.org/10.3390/healthcare9091229
Tiew KF, Chan YM, Lye MS, Loke SC. Factors Associated with Dietary Diversity Score among Individuals with Type 2 Diabetes Mellitus. J Health Popul Nutr. 2014 Dec;32(4):665–76.
Madlala SS, Hill J, Kunneke E, Kengne AP, Peer N, Faber M. Dietary Diversity and its Association with Nutritional Status, Cardiometabolic Risk Factors and Food Choices of Adults at Risk for Type 2 Diabetes Mellitus in Cape Town, South Africa. Nutrients, 2022;14(15):3191. https://doi.org/10.3390/nu14153191
de Oliveira O, Padhye NS, Bertoni AG, Jacobs DR Jr, Mozaffarian D. Everything in Moderation - Dietary Diversity and Quality, Central Obesity and Risk of Diabetes. PLoS ONE 10(10):e0141341. https://doi.org/10.1371/journal.pone.0141341
Aneesh M, Patil RS. Diet diversity of urban households in India during the COVID-19 lockdown. Nutr Health. 2022 Dec;28(4):685–91. https://doi.org/10.1177/02601060211019676
Monsivais P, Aggarwal A, Drewnowski A. Are socio-economic disparities in diet quality explained by diet cost? J Epidemiol Community Health. 2012 Jun 1;66(6):5305. https://doi.org/10.1136/jech.2010.122333
Bai Y, Alemu R, Block SA, Headey D, Masters WA. Cost and affordability of nutritious diets at retail prices: Evidence from 177 countries. Food Policy. 2021 Feb 1;99:101983. https://doi.org/10.1016/j.foodpol.2020.101983
Monsivais P, Perrigue MM, Adams SL, Drewnowski A. Measuring diet cost at the individual level: a comparison of three methods. Eur. J. Clin. Nutr, 2013;67:1220-1225.
Sarkar D, Walker-Swaney J, Shetty K. Food Diversity and Indigenous Food Systems to Combat Diet-Linked Chronic Diseases. Current Developments in Nutrition. 2020 Jan 1;4:3–11. https://doi.org/10.1093/cdn/nzz099
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2024 Revista Colombiana de Endocrinología, Diabetes & Metabolismo