Diabetes occurs in at least 13 million persons in the United States and is a major cause of morbidity and premature mortality. Diet is the cornerstone of diabetes management, and the purpose of this investigation was to examine dietary intakes and health practices among diabetic and nondiabetic individuals from a recently surveyed population-based sample from two communities in southeastern New England.
Data were collected during cross-sectional home health surveys conducted in random population samples of two New England communities during 1987–1988, 1989–1990, and 1992–1993. A food frequency questionnaire was completed by 1,897 of 2,077 eligible respondents who made up our study sample.
Statistical analyses suggest that diabetic individuals do not appear to be adhering to measures known to improve metabolic control (i.e., weight reduction and physical activity). Furthermore, both diabetic and nondiabetic individuals alike should be targeted for educational programs aimed at improving dietary intakes which lead to a reduction in consumption of total and saturated fatty acid.
Get full access to this article
View all access options for this article.
References
1.
TinkerL.F. (1994). Diabetes mellitus —A priority health care issue for women. J Am Diet Assoc., 94, 976–85.
2.
CampbellL.VBarthR.GosperJ.K.JuppJ.J.SimonsL.A.ChishomD.J. (1990). Impact of intensive educational approach to dietary change in NIDDM. Diabetes Care, 13, 841–47.
3.
National Institutes of Health (1987). Consensus development conference on diet and exercise in non-insulin-dependent diabetes mellitus. Diabetes Care, 10, 639–44.
4.
MogensenC.E.ChristensenC.K. (1984). Predicting diabetic nephropathy in insulin-dependent patients. New Engl J Med, 311, 89–93.
5.
The diabetic foot (1988). Neuropathy and peripheral vascular disease. In Diagnosis and Management of Diabetes Mellitus (OlsonC., ed.), pp. 163–171. Raven Press; New York.
6.
KannelW.B.McGeeD.L. (1979). Diabetes and cardiovascular diseases: The Framingham Study. J Am Med Assoc, 241, 2035–8.
7.
The Diabetes Control and Complications Trial Research Group (1993). The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New Engl J Med, 329, 977–86.
8.
American Diabetes Association (1994). Nutrition Recommendations and Principles for People with Diabetes Mellitus. J Am Diet Assoc, 94, 504–506.
9.
LasaterT.M.DePueJ.WellsB.L.GansK.M.BellisJ.CarletonR.A. (1990). The effectiveness and feasibility of delivering nutrition education programs through religious organizations. Health Promotion International, 5, 253–258.
10.
AbramsD.B.ElderJ.P.CarletonR.A.LasaterT.M.ArtzL.M. (1986). Social learning principles for organizational health promotion: an integrated approach. In Health and Industry: A Behavioral Medicine Perspective (CataldoM.CoatesT., eds.), pp. 28–51. John Wiley & Sons; New York.
11.
WatsonJ.F.DuFordS. (1992). Perceived and actual knowledge of diet by individuals with non-insulin-dependent diabetes. The Diabetes Educator, 18, 401–406.
12.
WingR.R. (1988). Exercise in a behavioral weight control programme for obese patients with type 2 (non-insulin-dependent) diabetes. Diabetologia, 31, 902–909.
13.
HortonE.S. (1991). Exercise and decreased risk of NIDDM. N Engl J Med, 325, 196–198.
14.
ErikssonK-F.LindgardeF. (1991). Prevention of type 2 (non-insulin-dependent) diabetes mellitus by diet and exercise. Diabetologia, 34, 891–989.
15.
CarletonR.A.LasaterT.M.AssafA.R.LefebvreR.C.McKinlayS.M. (1987). The Pawtucket Heart Programme: An experiment in population-based disease prevention. Rhode Island Med J, 70, 533–8.
16.
KishL. (1965). Survey sampling. John Wiley and Sons Inc., New York.
17.
DemingW.E. (1960). Sample Design in Business Research. John Wiley and Sons Inc., New York.
18.
BarbourM.M.HumeA.L.AssafA.R.CarletonR.A. (1993). The drug data base of the Pawtucket Heart Health Program: Development and description. Pharmacotherapy, 13(3), 239–243.
19.
McKenneyJ.L.CookB.C.AssafA.R.MacedoJ.M.CarletonR.A. (1990). Training protocols for health survey fieldwork. Health Education, 21, 12–16.
20.
BurtonB.T.FosterW.R. (1985). Health implications of obesity: An NIH Consensus Development Conference. J Am Diet Assoc, 85, 1117–1121.
21.
WillettW.C.SampsonL.StampferM.JRosnerB.BainC.WitschiJ.HennekensC.H.SpeizerF.E. (1985). Reproducibility and validity of a semi-quantitative food frequency questionnaire. Am J Epidemiol, 122, 51–65.
22.
WillettW.C.SampsonL.BrowneM.L.StampferM.J.RosnerB.HennekensC.H.SpeizerF.E. (1988). The use of a self-administered questionnaire to assess diet four years in the past. Am J Epidemiol, 127, 188–99.
23.
PattersonB.H.BlockG. (1988). Food choices and the cancer guidelines. Am J Public Health, 78, 282–6.
24.
SAS Institute Inc. (1989). SAS language and procedures: Usage, Version 6, First Edition. SAS Institute Inc., Cary, NC.
25.
EckL.H.Hackett-RennerC.KlesgesL.M. (1992). Impact of diabetic status, dietary intake, physical activity, and smoking status on body mass index in NHANES II. Am J Clin Nutr, 56, 329–33.
26.
LichtmanS.W.PisarskaK.BermanE.R.PestoneM.DowlingH.OffenbacherE.WeiselH.HeshkaS.MathewsD.E.HeymsfieldS.B. (1992). Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. New Engl J Med, 327, 1893–8.
27.
MelkusG.D.Type II Non-insulin-dependent diabetes mellitus (1993). Nursing Clinics of North America, 28, 25–33.
28.
MoyC.S.SongerT.J.LaPorteR.E.DormanJ.S.KriskaA.M.OrchardT.J.BeckerD.J.DrashA.L. (1993). Insulin-dependent diabetes mellitus, physical activity, and death. Am J Epidemiol, 137, 74–81.
29.
CloseE.J.WilesP.G.LocktonJ.A.WalmsleyD.OldhamJ.WalesJ.K. (1992). Diabetic diets and nutritional recommendations: What happens in real life? Diabetic Medicine, 9, 181–88.
30.
TsuneharaC.H.LeonnettiD.L.RujimotoW.Y. (1990). Diet of second-generation Japanese-American men with and without non-insulin-dependent diabetes. Am J Clin Nutr, 52, 731–8.
31.
American Diabetes Association (1987). Nutritional recommendations and principles for people with diabetes mellitus. Diabetes Care, 17, 519–22.
32.
GrundyS.M. (1991). Dietary therapy in diabetes mellitus. Is there a single best diet? Diabetes Care, 14, 796–801.
33.
KnappJ.A.HaffnerS.M.YoungE.A.StemM.P. (1988). A saturated fat/cholesterol avoidance scale: Sex and ethnic differences in a biethnic population. J Am Diet Assoc, 88, 172–177.
34.
StemM.P. (1991). Kelly West Lecture Primary prevention of type II diabetes mellitus. Diabetes Care, 14, 399–410.
35.
RimmE.B.GiovannucciE.LStampferM.JColditzG.A.LitinL.B.WillettW.C. (1992). Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol, 135, 1114–1126.
36.
WorsleyA.BaghurstK.I.LeitchD.R. (1984). Social desirability response bias and dietary inventory responses. Hum Nutr Appl Nutr, 38(1), 29–35.
37.
MadowW.G. (1988). Net differences in interview data on chronic conditions and information derived from medical records. National Center for Health Statistics; Series 2, No. 57: Vital and Health Statistics; Washington, DC.
38.
Centers for Disease Control and Prevention. Diabetes Surveillance (1993). Washington, DC: US Department of Health and Human Services, Public Health Service; Washington, DC.
39.
EpsteinF.H. (1984). Epidemiology of Type II diabetes. Some recent trends. In Diet, Diabetes, and Athersclerosis (PossaG.MicossiP.CatapanoA.L.PaolettiR., eds.), pp. 121–131. Raven Press; New York.
40.
HanefieldM.FischerS.SchmechelH.RotheG.SchulzeJ.DuoeH.SchwanebeckU.JuliusU. (1991). Diabetes Intervention Study. Multi-intervention trial in newly diagnosed NIDDM. Diabetes Care, 14, 308–17.
41.
UusitupaM.I.J.NiskanenL.K.SiitonenO.VoutilainenE.PyoralaK. (1990). 5-year incidence of atherosclerotic vascular disease in relation to general risk factors, insulin level, and abnormalities in lipoprotein composition in non-insulin-dependent diabetic and nondiabetic subjects. Circulation, 821, 27–36.
42.
StorleinL.H.JamesD.E.BurleighK.M.ChisholmD.J.KraegenE.W. (1986). Fat feeding causes widespread in vivo insulin resistance, decreased energy expenditure, and obesity in rats. Am J Physio, 251, E576–E583.
43.
ParkerD.R.WeissS.T.TroisiR.CassanoP.A.VokonasP.S.LandsbergL. (1993). Relationship of dietary saturated fatty acids and body habitus to serum insulin concentrations: the normative aging study. Am J Clin Nutr, 58, 129–36.
44.
O'DeaK. (1992). Obesity and diabetes in “the land of milk and honey”. Diabetes Metab Rev, 8, 373–388.
45.
StorleinL.H.KraegenE.W.JenkinsA.B.ChisholmD.J. (1988). Effects of sucrose vs starch diets on in vivo insulin action, thermogenesis and obesity in rats. Am J Clin Nutr, 47, 420–7.
46.
GreyN.KipnisD.M. (1971). Effect of diet composition of the hyperinsulinemia of obesity. New Engl J Medicine, 285, 827–31.
