Examining Diet-Related Care Practices Among Adults with Type 2 Diabetes: A Focus on Glycemic Index Choices

Publication: Canadian Journal of Dietetic Practice and Research
25 October 2016

Abstract

We examined self-care dietary practices and usual intakes among adults with Type 2 diabetes in Alberta, Canada, using data from the Healthy Eating and Active Living for Diabetes study. Participants completed a modified Fat/Sugar/Fruit/Vegetable Screener and answered questions about the number of days per week they followed specific diabetes self-care dietary recommendations. Capillary blood samples were collected to assess glycemic control measured by hemoglobin A1c (HbA1c). ANOVA was used to examine differences in dietary self-care, intakes, and glycemic control across categories of days/week of practicing recommended dietary behaviour. Participants (n = 196) were 51% women, mean ± SD age 59.6 ± 8.5 years, with BMI 33.6 ± 6.5 kg/m2, and diabetes duration of 5.1 ± 6.3 years. Sixteen percent of participants were unfamiliar with low-GI eating and 28% did not include low-GI foods in their diet. Overall, lower mean intake of saturated fat, trans fat, added sugars, higher fibre, and greater GI were each associated with meeting diabetes-related dietary behaviours including: eating ≥5 servings of vegetables and fruit; avoiding processed high fat foods; and replacing high with low-GI foods (P < 0.05). No clear pattern was observed for low-GI eating and HbA1c.

Résumé

Nous avons examiné les habitudes alimentaires que décident d’adopter des adultes atteints de diabète de type 2 de l’Alberta, au Canada, ainsi que leurs apports alimentaires habituels à l’aide des données de l’étude de Saine alimentation et vie active pour les personnes atteintes de diabète. Les participants ont rempli un outil de dépistage modifié sur les gras, les sucres, les fruits et les légumes et ont répondu à des questions sur le nombre de jours par semaine où ils suivaient des recommandations alimentaires précises pour gérer leur diabète. Des échantillons de sang capillaire ont été recueillis pour évaluer la glycémie, mesurée par l’hémoglobine A1c (HbA1c). L’analyse de la variance a été utilisée pour examiner les différences dans l’alimentation adoptée pour soigner son diabète, les apports alimentaires et la glycémie dans l’ensemble des catégories de jours par semaine où le comportement alimentaire recommandé est adopté. Les participants (n = 196) comptaient 51 % de femmes, étaient âgés de 59,6 ±  8,5 ans (moyenne ± écart-type) et présentaient un IMC de 33,6 ± 6,5 kg/m2 et une durée du diabète de 5,1 ± 6,3 ans. Seize pour cent des participants ne connaissaient pas l’alimentation à faible IG et 28 % n’incluaient pas d’aliments à faible IG à leur alimentation. Dans l’ensemble, la consommation moyenne plus faible de gras saturés, de gras trans, de sucres ajoutés et d’aliments riches en fibres et à IG plus élevé était associée à l’adoption de comportements alimentaires liés au diabète, notamment : consommer 5 portions ou plus de fruits et de légumes; éviter les aliments riches en gras transformés et remplacer les aliments à fort IG par des aliments à faible IG (P < 0,05). Aucun modèle clair n’a été observé pour l’alimentation à faible IG et l’hémoglobine A1c.

Get full access to this article

View all available purchase options and get full access to this article.

Sources of financial support: The Healthy Eating and Active Living for Diabetes (HEALD) study was supported by grants from Alberta Health, the Lawson Foundation, and an Emerging Team Grant to the Alliance for Canadian Health Outcomes Research in Diabetes (ACHORD) (reference #: OTG-88588), sponsored by the Canadian Institutes for Health Research Institute of Nutrition, Metabolism, and Diabetes.
Conflicts of interest: The authors declare that they have no competing interest.

References

1
Canadian Diabetes Association. Clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes. 2013;37(Suppl. 1):S1–212.
2
Franz MJ, Monk A, Barry B, McClain K, Weaver T, Cooper N, et al., Effectiveness of medical nutrition therapy provided by dietitians in the management of non-insulin-dependent diabetes mellitus: a randomized, controlled clinical trial. J Am Diet Assoc. 1995;95(9):1009–17.
3
Huang MC, Hsu CC, Wang HS, and Shin SJ. Prospective randomized controlled trial to evaluate effectiveness of registered dietitian-led diabetes management on glycemic and diet control in a primary care setting in Taiwan. Diabetes Care. 2010;33(2):233–9.
4
Pastors JG, Warshaw H, Daly A, Franz M, and Kulkarni K. The evidence for the effectiveness of medical nutrition therapy in diabetes management. Diabetes Care. 2002;25(3):608–13.
5
Opperman AM, Venter CS, Oosthuizen W, Thompson RL, and Vorster HH. Meta-analysis of the health effects of using the glycaemic index in meal-planning. Br J Nutr.2004;92(3):367–81.
6
Brand-Miller J, Hayne S, Petocz P, and Colagiuri S. Low-glycemic index diets in the management of diabetes: a meta-analysis of randomized controlled trials. Diabetes Care. 2003;26(8):2261–7.
7
Johnson ST, Mundt C, Soprovich A, Wozniak L, Plotnikoff RC, and Johnson JA. Healthy eating and active living for diabetes in primary care networks (HEALD-PCN): rationale, design, and evaluation of a pragmatic controlled trial for adults with type 2 diabetes. BMC Public Health. 2012;12:455.
8
Toobert DJ, Hampson SE, and Glasgow RE. The summary of diabetes self-care activities measure: results from 7 studies and a revised scale. Diabetes Care. 2000;23(7):943–50.
9
Lalonde I, Graham M, Slovinec-D'Angelo M, Beaton L, Brown J, and Block T. Validation of the block fat/sugar/fruit/vegetable screener in a cardiac rehabilitation setting: poster# 9. J Cardiopulm Rehabil Prev. 2008;28(5):340.
10
Serafica RC, Lane SH, and Ceria-Ulep CD. Dietary acculturation and predictors of anthropometric indicators among Filipino Americans. SAGE Open. 2013;3(3).
11
Tapper K, Jiga-Boy G, Maio GR, Haddock G, and Lewis M. Development and preliminary evaluation of an internet-based healthy eating program: randomized controlled trial. J Med Internet Res. 2014;16(10):e231.
12
Burris J, Rietkerk W, and Woolf K. Relationships of self-reported dietary factors and perceived acne severity in a cohort of New York young adults. J Acad Nutr Diet. 2014;114(3):384–92.
13
NutritionQuest. Assessment tools and analysis services: questionnaires and screeners. Berkeley, CA: NutritionQuest; 2014 [cited 20 Mar 2015]. Available from: https://nutritionquest.com/assessment/list-of-questionnaires-and-screeners/.
14
Foster-Powell K, Holt SH, and Brand-Miller JC. International table of glycemic index and glycemic load values. Am J Clin Nutr. 2002;76(1):5–56.
15
Ley SH, Hamdy O, Mohan V, and Hu FB. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. Lancet. 2014;383(9933):1999–2007.
16
American Diabetes Association. Standards of medical care in diabetes—2011. Diabetes Care. 2011;34(Suppl. 1):S11–61.
17
Leiter LA, Berard L, Bowering CK, Cheng AY, Dawson KG, Ekoe JM, et al., Type 2 diabetes mellitus management in Canada: is it improving?Can J Diabetes. 2013;37(2):82–9.
18
Kalergis M, Pytka E, Yale JF, Mayo N, and Strychar I. Canadian dietitians’ use and perceptions of glycemic index in diabetes management. Can J Diet Pract Res. 2006;67(1):21–7.
19
Grant SM and Wolever TM. Perceived barriers to application of glycaemic index: valid concerns or lost in translation?Nutrients. 2011;3(3):330–40.

Information & Authors

Information

Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 78Number 1March 2017
Pages: 26 - 31

History

Version of record online: 25 October 2016

Authors

Affiliations

Hayford M. Avedzi
School of Public Health, University of Alberta, Edmonton, AB
Nonsikelelo Mathe
School of Public Health, University of Alberta, Edmonton, AB
Stephanie Bearman
School of Public Health, University of Alberta, Edmonton, AB
Kate Storey
School of Public Health, University of Alberta, Edmonton, AB
Jeffrey A. Johnson
School of Public Health, University of Alberta, Edmonton, AB
Steven T. Johnson
Centre for Nursing and Health Studies, Faculty of Health Disciplines, Athabasca University, Athabasca, AB

Metrics & Citations

Metrics

Other Metrics

Citations

Cite As

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

There are no citations for this item

View Options

Login options

Check if you access through your login credentials or your institution to get full access on this article.

Subscribe

Click on the button below to subscribe to Canadian Journal of Dietetic Practice and Research

Purchase options

Purchase this article to get full access to it.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF

View PDF

Full Text

View Full Text

Media

Media

Other

Tables

Share Options

Share

Share the article link

Share on social media