Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada.
Department of Resource Economics and Environmental Sociology, University of Alberta, Edmonton, Alberta, Canada.
Can J Diabetes. 2018 Feb;42(1):78-87. doi: 10.1016/j.jcjd.2017.04.006. Epub 2017 Jun 22.
The purpose of this study was to determine predominant deviations from Canadian Diabetes Association (CDA) nutrition therapy guidelines for Canadians with type 2 diabetes as a prelude to developing relevant interventions. We hypothesized that lack of adherence to these guidelines would be associated with higher glycated hemoglobin (A1C) levels.
A cross-sectional trial was conducted to evaluate associations between dietary adherence to CDA and Health Canada guidelines and blood glucose control. Diet was assessed using 3-day diet records and a diabetes-specific validated questionnaire, the Perceived Dietary Adherence Questionnaire (PDAQ). A total of 80 adult participants with type 2 diabetes volunteered. The main outcome measures were A1C levels, adherence to dietary guidelines and food sources of nutrients. Simple and multiple linear regressions that tested the effects of adherence to dietary guidelines concerning A1C levels were conducted; p<0.05 was considered significant.
Participants: average age, 61.2±10.4 (standard deviation) years; 48 females and 32 males had A1C levels of 7.3%±1.3% (56±6.3 mmol/mol). Participants' reported mean daily intakes of sodium and saturated fat exceeded CDA nutrition therapy guidelines. Cured meats, fast foods and snack foods were all major contributors to intake of sodium and saturated fat. Saturated fat (r=0.341) and sodium intakes (r=0.296) and total PDAQ scores (r=-0.417) were correlated with A1C levels (p<0.05).
This study population had overall good adherence to several CDA nutrition therapy guidelines; however, sodium and saturated fat intakes exceeded these guidelines and should receive particular attention in interventions with patients who have type 2 diabetes. Adherence to diabetes dietary guidelines as assessed by PDAQ is associated with lower A1C levels.
本研究旨在确定加拿大 2 型糖尿病患者在遵循加拿大糖尿病协会（CDA）营养治疗指南方面的主要偏差，为制定相关干预措施奠定基础。我们假设，这些指南的不遵守与糖化血红蛋白（A1C）水平升高有关。
进行了一项横断面试验，以评估对 CDA 和加拿大卫生部指南的饮食依从性与血糖控制之间的关联。使用 3 天饮食记录和糖尿病特异性验证问卷（感知饮食依从性问卷，PDAQ）评估饮食。共有 80 名成年 2 型糖尿病患者自愿参加。主要观察指标为 A1C 水平、饮食指南的依从性和营养物质的食物来源。进行了简单和多元线性回归，以测试对饮食指南的依从性对 A1C 水平的影响；p<0.05 被认为具有统计学意义。
参与者：平均年龄 61.2±10.4（标准差）岁；48 名女性和 32 名男性的 A1C 水平为 7.3%±1.3%（56±6.3mmol/mol）。参与者报告的钠和饱和脂肪的日均摄入量超过了 CDA 营养治疗指南。腌肉、快餐和零食都是钠和饱和脂肪摄入量的主要来源。饱和脂肪（r=0.341）和钠摄入量（r=0.296）以及总 PDAQ 评分（r=-0.417）与 A1C 水平相关（p<0.05）。
本研究人群总体上对多项 CDA 营养治疗指南的依从性良好；然而，钠和饱和脂肪的摄入量超过了这些指南，应在干预 2 型糖尿病患者时特别注意。PDAQ 评估的糖尿病饮食指南的依从性与较低的 A1C 水平相关。
