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Rx Nutrition Resource Center
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Disclosures: The authors report no relevant financial disclosures.
July 17, 2020
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Lifestyle factors predict likelihood of diet changes after type 2 diabetes diagnosis

Source/Disclosures
Disclosures: The authors report no relevant financial disclosures.
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Adults with an improved diet-quality score 3 months after a type 2 diabetes diagnosis were more likely to be nonsmokers and have a lower BMI and higher physical activity level vs. those who did not improve their diet, study data show.

“Early, tight glycemic control is associated with improved outcomes and reduced mortality for people with type 2 diabetes, regardless of how the disease is managed in the future,” Emily Burch, a doctoral student, dietitian and researcher with the Menzies Health Institute Queensland at Griffith University, Australia, and colleagues wrote in the study background. “It is therefore important to understand the changes that people with type 2 diabetes make to improve diet quality immediately after diagnosis.”

Among 225 adults newly diagnosed with type 2 diabetes: One-third improved DASH diet score 3 months after diagnosis. Diet improvement was associated with lower baseline diet quality, lower baseline BMI, higher baseline physical activity level and not smoking. Age, sex, education level and income were not associated with diet changes after diagnosis.

Burch and colleagues analyzed data from 225 Australian adults diagnosed with type 2 diabetes during the 6 months before recruitment (56% men; mean age, 59 years; 10.3% current smokers). Researchers monitored the cohort through five interviewer-administered telephone surveys at baseline and 3, 6, 9 and 12 months. Researchers collected diet and physical and health data at baseline and 3 months; diet quality was assessed using the Dietary Approaches to Stop Hypertension (DASH) tool to examine short-term changes in diet quality after diagnosis. Participants were stratified into two groups: those who improved their diet quality by 3 months, defined as an increase in DASH score of 3 or more, and those who improved by 2 or fewer points, maintained or experienced a decrease in score.

“An increase of 3 points was deemed as the smallest clinically significant change based on findings from a 20-year longitudinal study of over 40,000 adults that showed an increase of at least 3 points to significantly influence long-term glycemic control as assessed by HbA1c,” the researchers wrote.

Researchers evaluated associations between baseline demographics, health and diet-related characteristics and change in DASH score at 3 months.

Within the cohort, mean baseline DASH score was 24.4, in the midrange of possible scores between 8 and 40.

Researchers found that at 3 months, one-third of participants improved their DASH score by at least 3 points (n = 63), with 29 participants improving their score by at least 5 points. Compared with participants who did not experience a change in diet score, those who improved their score by at least 3 points had a lower baseline diet quality (P < .001), lower baseline BMI (P = .045), higher baseline physical activity levels (7.1% vs. 19.7%; P = .028) and were less likely to smoke (12% vs. 6.6%; P = .018). There were no between-group differences based on baseline demographic characteristics, including age, sex, education level and income.

The researchers noted that it is possible some participants made changes immediately after receiving a diabetes diagnosis but before completing the baseline survey.

“The fact that those who did not improve started the study with a higher DASH score supports this supposition,” the researchers wrote.

The researchers wrote that strategies targeted at better supporting smokers, those with low physical activity and higher BMI are needed, and future research should investigate how the diet-quality changes people make around time of diagnosis are related to long-term health outcomes.