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. 2021 May 17;21(1):99.
doi: 10.1186/s12902-021-00750-5.

Eating behavior among persons with type 2 diabetes mellitus in North Ethiopia: a cross-sectional study

Hagos Amare Gebreyesus  1   2 , Girmatsion Fisseha Abreha  3 , Sintayehu Degu Besherae  3 , Merhawit Atsbha Abera  3 , Abraha Hailu Weldegerima  3 , Eshetu Girma Kidane  4 , Afework Mulugeta Bezabih  3 , Tefera Belachew Lemma  5 , Tsinuel Girma Nigatu  6   7
Affiliations

Eating behavior among persons with type 2 diabetes mellitus in North Ethiopia: a cross-sectional study

Hagos Amare Gebreyesus et al. BMC Endocr Disord. .

Abstract

Background: Diet is central to the management of type 2 diabetes mellitus (T2DM). Depending on the stage of the disease at which the recommended diet is initiated, optimal adherence can reduce HbA1c by about 1 to 2%. However, evidence on eating behavior is generally scarce including in Ethiopia. The present study aimed to assess the eating behavior of adults with T2DM in North Ethiopia.

Methods: This cross-sectional study was conducted among 421 adults with T2DM from September to November 2019. Socio-demographic variables were collected using structured questionnaires; an asset-based wealth index was used to determine socioeconomic status. Three dimensions of eating behavior were assessed using Likert-type items: food selection, meal planning and calorie recognition. Raw Likert scores in each dimension were transformed to percent scales to maximum (%SM). Participants' behavior in each dimension was categorized into healthy and unhealthy taking 66.7% SM score as a cutoff. Overall eating behavior was determined by aggregating ranks scored in the three dimensions. Correlates of overall eating behavior were identified using Chi-square test and multinomial logistic regression with statistical significance set at P-value < 0.05.

Result: Only 1% of the participants had overall healthy eating behavior. Yet, overall unhealthy eating was apparent in 54.4%. By dimensions, healthy eating behaviors in food selection, meal planning and calorie recognition were seen in 43.5, 7.4 and 2.9% participants, respectively. Factors that were positively associated with having healthy eating behavior in one dimension relative to unhealthy in all were: receiving nutrition education [AOR 1.73; CI 1.09, 2.74], female gender [AOR 1.78; CI 1.03, 3.08] & being in 26-44 age category [AOR 3.7; CI 1.56, 8.85]. But, being in the poor [AOR 0.42; CI 0.16, 1.32] or average [AOR 0.54; CI 0.19, 1.55] socioeconomic strata were negatively associated. However, only receiving nutrition education [AOR 3.65; CI 1.31, 10.18] was significantly associated with having healthy behavior in two eating dimensions over unhealthy in all.

Conclusion: In North Ethiopia, the overall eating behavior of adults with T2DM is extremely poor. Diverse and integrated approaches including nutrition education during consultation should be implemented to address the gap.

Keywords: Eating behavior; North Ethiopia; T2DM.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Eating behavior of adults with type 2 diabetes by eating behavior dimensions (n = 421). Note: Healthy = Participants whose % SM score is > = 66.7 (their responses rated agree, strongly agree or a mix of the two) in a given dimension of eating behavior, Unhealthy = Participants whose % SM score is < 66.7 (their responses rated strongly disagree, disagree or a mix of the two) in a given dimension of eating behavior
Fig. 2
Fig. 2
Overall eating behaviors of adults with type 2 diabetes (n = 421). Note: Overall healthy = having a %SM score of > = 66.7 in 3 of the dimensions of eating behavior, Healthy in 2 = having a %SM score of > = 66.7 in two dimensions, Healthy in 1 = having a %SM score of > = 66.7 in one dimension & overall unhealthy = having a %SM score of < 66.7 in all three dimensions
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