Type 2 diabetes is an emerging concern in Kenya. This clustered-randomized trial of peri-urban communities included a theory-based and culturally sensitive intervention to improve diabetes knowledge, health beliefs, dietary intake, physical activity, and weight status among Kenyan adults. Those in the intervention group (IG) received a culturally sensitive diabetes education intervention which applied the Health Belief Model in changing knowledge, health beliefs and behavior. Participants attended daily education sessions for 5 days, each lasting 3 h and received mobile phone messages for an additional 4 weeks. The control group (CG) received standard education on COVID-19. Data was collected at baseline, post-intervention (1 week), and follow-up assessment (5 weeks). Linear mixed effect analysis was performed to assess within and across group differences. Compared to the control, IG significantly increased diabetes knowledge (p < 0.001), health beliefs including perceived susceptibility (p = 0.05), perceived benefits (p = 0.04) and self-efficacy (p = 0.02). IG decreased consumption of oils (p = 0.03), refined grains (p = 0.01), and increased intake of fruits (p = 0.01). Perceived barriers, physical activity, and weight status were not significantly different between both groups. The findings demonstrate the potential of diabetes education in improving diabetes knowledge, health beliefs, and in changing dietary intake of among adults in Kenya.
Objectives
To assess factors that contribute to the total diet quality and the associated body mass index (BMI) among adults.
Methods
A cross-sectional study was conducted to assess dietary quality using the Healthy Eating Index (HEI)-2015 among faculty and staff (N = 152) of a public university. The Food Frequency Questionnaire from the Health and Retirement Study was administered via Qualtrics. Dietary quality was determined using the HEI-2015. Weight, height, number of meals consumed away-from-home per week were self-reported. Descriptive statistics were used to analyze demographic characteristics, number of meals consumed away-from-home, dietary intake, and associated HEI score was calculated. Linear regression models were used to measure associations between the total diet quality, nutrient intakes and the number of away-from-home meals consumed with BMI.
Results
The average age of participants was 34.3 ± 12.3 years. A majority were female and white Americans (74.3%) and had post-secondary education (79.6%). Approximately, one-third of participants (32.2%) reported having a BMI equal or greater than 30 kg/m2. More than half of the participants exceeded the recommended limit for the consumption of saturated fats (69.7%), and sodium (52.6%); and a majority did not meet the minimum recommended intakes of dietary fiber (96.1%). The average HEI score was 66.34 on a 100-point scale. Only 14.5% had a good dietary quality with a HEI score equal or higher than 80. The number of away-from-home meals consumed per week were associated with an increased intake of trans fatty acids (P < .05), while, increased the consumption of trans fatty acids was associated with an increase in BMI (P < .001) in this study. On the contrary, an increase in the HEI score was associated with a reduction in BMI (P < .05).
Conclusions
This study found that a high percentage of participants had a low diet quality that was characterized by excessive intake of both saturated fats and sodium and inadequate intake of dietary fiber. In addition, the consumption of meals away-from-home was associated with an increase in the amount of trans fatty acids consumed. Concurrently, the consumption of trans fatty acids was associated with an increase in BMI. These results underscore the importance of eating meals prepared at home in an effort to control weight gain.
Funding Sources
TTU Transdisciplinary Research Academy.
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