Factors associated with adherence to recommended dietary regimen among adults with diabetes in Lebanon

Abstract

Background: Diabetes is a major health disease reaching epidemic levels in the Middle East Regions. It is associated with many complications that have an adverse effect on patient’s quality of life. Nutrition therapy is essential, where dietary modification and improved dietary habits are important for its management and control. Objective: This study aimed to assess the adherence to dietary recommendations of adult patients with Type 2 Diabetes Mellitus (T2DM) diagnosed since at least one year residing in north Lebanon and to explore factors associated with this adherence. Methods: A cross-sectional study was conducted among a convenient sample of 97 diabetic subjects recruited from diabetes outpatient clinics and primary health care center, in North Lebanon. Dietary adherence was assessed using Perceived Dietary Adherence Questionnaire (PDAQ), and data about sociodemographic, lifestyle, and disease related variables were collected using a well-structured background questionnaire. Data were analyzed using SPSS software and the significance level was set at p<0.05. Results: Sample mean age (SD) was 53.6 ± 8.5 years and 53.6% were males. While majority (53.6%) had moderate adherence, 41.2% had poor adherence to dietary recommendations. Adherence was highest for fruit and vegetable intake and avoiding foods high in sugar, and was lowest for eating fish and spacing carbohydrates during the day. Adherence to dietary recommendations was significantly associated with seeking care from outpatient clinics, being obese, low physical activity level, high stress level, somewhat recent diabetes diagnosis and having hypertension or renal disease as other comorbidities. Future Implications: Improvement in adherence to recommended diet is one way to achieve glycemic control in diabetes. Furthermore, promoting a more positive attitude towards proper dietary choices and habits can yield a good management for the disease.