An appraisal of food serving characteristics among patients with type 2 diabetes mellitus attending a tertiary care diabetes facility in Sri Lanka
Keywords:Type 2 diabetes mellitus, Dietary survey, Portion sizes
Introduction: The primary objective of the present study was to identify food consumption characteristics among adult type 2 diabetic patients in Sri Lanka.
Materials and Methods: One hundred and twenty three randomly selected adult type 2 diabetic patients attending a tertiary care diabetes facility in Sri Lanka were studied in a cross sectional survey. Starch, fruits, vegetables, meat or alternative, pulses, dairy and added sugar consumption assessed according to standard methods using a 24-hour dietary recall.
Results: Forty six percent of participants exceeded the national recommendation of 4.5 to 9 servings of starch per day for patients with diabetes. Mean daily consumption of starch was 10.5 servings.Â Only 26% and 45% of participants consumed the recommended 2 servings of fruits and 3 servings of vegetables per day. Thirty three percent and 8% did not consume any fruits or vegetables respectively. Dairy products were consumed by 25% only. Added sugar was not used by 99% of participants. The mean proportions of total Carbohydrates, proteins and fats comprising total energy intake were 68.1%, 11.5% and 20.2% respectively.
Discussion: Medical nutrition therapy in diabetes recommends a mixed diet with carbohydrates from a variety of sources such as cereals, fruits and vegetables. Although Sri Lankan patients with diabetes consume less starch and more fruits and vegetables compared to non-diabetic counterparts, Â a substantial proportion still fail to meet the recommendations.
Katulanda P, Constantine GR, Mahesh JG, Sheriff R, Seneviratne RD, Wijeratne S, et al. Prevalence and projections of diabetes and pre-diabetes in adults in Sri Lanka--Sri Lanka Diabetes, Cardiovascular Study (SLDCS). Diabetic medicine : a journal of the British Diabetic Association. 2008;25(9):1062-9.
Illangasekera U, Rambodagalla S, Tennakoon S. Temporal trends in the prevalence of diabetes mellitus in a rural community in Sri Lanka. The journal of the Royal Society for the Promotion of Health. 2004;124(2):92-4.
Wijewardene K, Mohideen MR, Mendis S, Fernando DS, Kulathilaka T, Weerasekara D, et al. Prevalence of hypertension, diabetes and obesity: baseline findings of a population based survey in four provinces in Sri Lanka. The Ceylon medical journal. 2005;50(2):62-70.
Abeywardena MY. Dietary fats, carbohydrates and vascular disease: Sri Lankan perspectives. Atherosclerosis. 2003;171(2):157-61.
Hu EA, Pan A, Malik V, Sun Q. White rice consumption and risk of type 2 diabetes: meta-analysis and systematic review. BMJ. 2012;344:e1454.
Division N. Food based dietary guidelines for Sri lanka, 2nd Ed, colombo. In: Nutrttion division MoH, editor. 2011.
US Department of Agriculture .(1992) The Food Guide Pyramid Home and Garden Bulletin: no 252. TfgpHagbn, editor. washington DC: USDA Centre for Nutrition Policy and Promotion.
Jayawardena R, Byrne NM, Soares MJ, Katulanda P, Hills AP. Food consumption of Sri Lankan adults: an appraisal of serving characteristics. Public health nutrition. 2013;16(4):653-8.
Somasundaram NP WC, De Silva S, Siribaddana S Clinical guidelins: The endocrine society od Sri Lanka. Sri Lanka Journal of Diabetes, endocrinology and Metabolism. 2013(3):45-57.
Diabetes.co.uk. The Diabetes Food Pyramid 2015. Available from: http://www.diabetes.co.uk/food/diabetes-food-pyramid.html.
Cleveland LE, Cook DA, Krebs-Smith SM, Friday J. Method for assessing food intakes in terms of servings based on food guidance. Am J Clin Nutr. 1997;65(4 Suppl):1254S-63S.
D.P.C. Swarnasiri PJS, editor Quality evaluation of localy available rice in local market. Institiute of post harvest technology Sri Lanka symposium 2012; 2012; Anuradhapura Sri Lanka.
US Depatment of Health and Human Services (2014). Eating and Diabetes . Available from: http://diabetes.niddk.nih.gov/DM/PUBS/eating_ez/index.aspx.
Evert AB, Boucher JL, Cypress M, Dunbar SA, Franz MJ, Mayer-Davis EJ, et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes care. 2013;36(11):3821-42.
force ADMCPT. AACE medical guidelines for the clinical practice for the management of diabetes mellitus. Endocr Pract. 2007;13:1-27.
Mann JI, De Leeuw I, Hermansen K, Karamanos B, Karlstrom B, Katsilambros N, et al. Evidence-based nutritional approaches to the treatment and prevention of diabetes mellitus. Nutrition, metabolism, and cardiovascular diseases : NMCD. 2004;14(6):373-94.
Canadian Diabetes Association . Canadian Diabetes Association 2008 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes. 2008;32:S40-6.
Katulanda P, Jayawardena MA, Sheriff MH, Constantine GR, Matthews DR. Prevalence of overweight and obesity in Sri Lankan adults. Obesity reviews : an official journal of the International Association for the Study of Obesity. 2010;11(11):751-6.
Horikawa C, Yoshimura Y, Kamada C, Tanaka S, Tanaka S, Takahashi A, et al. Dietary intake in Japanese patients with type 2 diabetes: Analysis from Japan Diabetes Complications Study. Journal of diabetes investigation. 2014;5(2):176-87.
Ma Y, Olendzki BC, Hafner AR, Chiriboga DE, Culver AL, Andersen VA, et al. Low-carbohydrate and high-fat intake among adult patients with poorly controlled type 2 diabetes mellitus. Nutrition. 2006;22(11-12):1129-36.
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