Development of a brief evidence-based dietary assessment tool to promote healthy dietary change for people with Type 2 diabetes

• Main Author: England, Clare
• Published: University of Bristol 2014
• Subjects: 616.4
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.683701

Background Individualised dietary advice is essential for management of Type 2 diabetes (T2DM). In the DK dietary advice is often delivered by health professionals with limited nutrition training. It is not clear which dietary changes are most beneficial for adults with T2DM. Tools are needed to assist in providing individualised dietary advice. The aim of this thesis was to develop a brief dietary assessment tool, for use in the DK, for people with T2DM. Methods A questionnaire was developed. Item development was infonned by analysis of food diaries from people with T2DM who took part in a dietary intervention and a systematic review of existing measures. Items were refined via a Delphi study and a final scale was produced. A pilot test-retest reliability study and a comparison with food diaries were conducted in people with, or at high risk of, T2DM. Results Participants in the intervention reported dietary changes that produced a modest reduction in energy intake. Men and women changed their diets differently, but both made changes that limited impact on household members. Observed associations between changes to macronutrients and metabolic outcomes were clinically insignificant. The Delphi panel favoured food frequency and meal patterning questions. The pilot suggested that the resulting questionnaire had excellent test-retest reliability and showed similar agreement with food diaries and brief questionnaires developed internationally. Conclusion Dietary advice should focus on changes that reduce energy intake. This study found this advice should focus on reducing snack foods, high-energy drinks and portion sizes. However, more research is needed into which changes have the most benefit and why people choose to make the changes that they do make. A brief dietary assessment tool has been developed which shows promising test-retest reliability and comparability with food diaries. Evaluation of the tool in clinical practice is warranted.