Self-Reported Dietary Management Behaviors and Dietary Intake among Chinese Adults with Diabetes: A Population-Based Study

Yixu Liu, Dongmei Yu, Jiayou Luo, Shuya Cai, Ping Ye, Zhenzhen Yao, Miyang Luo, Liyun Zhao, Yixu Liu, Dongmei Yu, Jiayou Luo, Shuya Cai, Ping Ye, Zhenzhen Yao, Miyang Luo, Liyun Zhao

Abstract

Few studies have analyzed the implementation of dietary management in Chinese adults with diabetes. Thus, we assessed and compared dietary intake and diet quality between diabetic patients with and without dietary management behaviors (DPDM vs. NDPDM), and evaluated the adherence to dietary guidelines in both groups of patients. The data were obtained from the 2002, 2010-2013, and 2015 China National Nutrition Survey. A total of 69,583, 67,177, and 96,631 subjects participated in the 2002, 2010-2013, and 2015 survey rounds, respectively. The dietary intake data were measured using 3-day 24 h dietary recalls and weighed records of household condiments. The China Healthy Diet Index (CHDI) was used to evaluate diet quality. The study included 6229 patients with diabetes, of which 78% had dietary management behaviors. The diabetic patients with dietary management behaviors showed higher percentages of energy from high-quality carbohydrates, animal protein, saturated fatty acids, and unsaturated fatty acids and lower percentages from low-quality carbohydrates and plant protein than NDPDM. The diabetic patients with dietary management behaviors also had lower intakes of cereals and tubers and higher intakes of vegetables than NDPDM. The total CHDI score of DPDM was higher than NDPDM (56.3 ± 12.7 vs. 54.1 ± 12.3). The proportion of DPDM meeting the recommended intake for different food items ranged from 3.3% to 42.8% and from 3.0% to 39.2% in NDPDM. The diabetic patients with dietary management behaviors showed better adherence to dietary guidelines and higher diet quality scores than NDPDM, while the overall adherence was poor in both groups of patients. Our findings suggested that measures are needed to promote and refine dietary management behaviors, which can help to improve disease management in diabetic patients.

Keywords: China; diabetes; diet quality; dietary adherence; dietary intake; dietary management; dietary recommendations.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow of inclusion into the study.
Figure 2
Figure 2
Percentage of adults with diabetes complying with the dietary recommendations in the three rounds of China National Nutrition Surveys. Dietary recommendations in the Dietary Guidelines for Chinese Residents (2016): 250–400 g/day cereals and tubers; 25–35 g/day soybeans and nuts; 300–500 g/day vegetables; 200–350 g/day fruits; 40–75 g/day livestock and poultry meats; 40–50 g/day eggs; 40–75 g/day aquatic products; 25–30 g/day oil; >300 g/day dairy products; <6 g/day salt. Dietary recommendations in the Guidelines for the Prevention and Treatment of Type 2 Diabetes Milieus in China (2020 Edition): 50–65 E% CHO, 15–20 E% protein, and 20–30 E% fat; >14 g/1000 kcal fiber. Abbreviations: CHO, carbohydrate; E%, percentage of energy; DM: yes, dietary management: yes; DM: no, dietary management: no.

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