Dietary Diversity Score (DDS) as a tool for diet management in patients with type 2 diabetes
Abstract
Dietary diversity Score (DDS) is known as an indicator of food quality. This was a quasi-experimental study that determined the adequacy and means of energy consumption, carbohydrates, proteins, lipids, and saturated fats using five 24-hour recalls. Body weight, waist circumference (WC), and pre- and post-intervention HBA1c were measured, and DDS was calculated. A Food Plan Group (FPG) that had an individualized plan and a Dietary Diversity Group (DDG) that used the Dietary Diversity sheet to count food groups consumed per day were formed. Energy inadequacy was 30% in the FPG and 54% in the DDG (p=0.16). Carbohydrates inadequacy due to excess was 46.2% in the FPG and 50.0% in the DDG (p=0.14); protein was inadequate due to deficiency (92.3%) in 92% in the FPG and 69.2% in the DDG; there was low saturated fat consumption (p=0.06). Mean DDS in the FPG went from 5.0 to 6.0 (p=0.06) and in the DDG from 4.4 to 5.6 (p=0.01). Mean weight loss was −1.01 kg in the FPG and 0.33 in the DDG (p=0.05). WC decreased from 98.8 ± 11.0 cm to 96.5 ± 11.5 cm (p=0.01) in the FPG and from 99.1 ± 5.7 to 98.03 ± 4.7 (p=0.26) in the DDG. The Food Plan was more efficient; however, the efficacy of food group counting cannot be ruled out in the long term since it is easier than counting calories or portions.
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References
American Diabetes Association. 8. Obesity management for the treatment of type 2 diabetes: Standards of medical care in diabetesd-2019. Diabetes Care. 2019;42(January):S81–9.
Mozaffarian D. Dietary and Policy Prioritites for Cardiovascular Disease, Diabetes, and Obesity-A Comprehensive Review. Circulation. 2016;133(2):187–225.
Diario Oficial de la Federación. NORMA Oficial Mexicana NOM-015-SSA2-2010, Para la prevención, tratamiento y control de la diabetes mellitus. [Internet]. 2010 [cited 2018 Feb 26]. Available from: http://dof.gob.mx/nota_detalle.php?codigo=5168074&fecha=23/11/2010
Lerman G I, Brito C GX. Diabetes Mellitus y Nutrición. In: Kaufer-Horwitz M, Pérez-Lizaur AB, Arroyo P, editors. Nutriología Médica. 4a. Edició. Ciudad de México: Editorial Médica Panamericana; 2015. p. 668–93.
Diario Oficial de la Federación. NORMA Oficial Mexicana NOM-043-SSA2-2012, Servicios básicos de salud. Promoción y educación para la salud en materia alimentaria. Criterios para brindar orientación [Internet]. 2013 [cited 2018 Feb 26]. Available from: https://www.dof.gob.mx/nota_detalle.php?codigo=5285372&fecha=22/01/2013
Pérez-Lizaur AB, Palacios-González B, Castro-Becerra AL, Flores-Galicia I. Sistema Mexicano de Alimentos Equivalentes. 4a Edición. Ciudad de México: Ogali; 2014.
Sámano O LF. Abandono del tratamiento dietético en pacientes diagnosticados con obesidad en un consultorio privado de nutrición. Nutr Clin y Diet Hosp. 2011;31(1):15–9.
Kennedy G, Ballard T, Dop M. Guía para medir la diversidad alimentaria a nivel individual y del hogar. Roma, Italia; 2013.
Swindale A, Bilinksy P. Puntaje de Diversidad Dietética en el Hogar (HDDS) para la Medición del Acceso a los Alimentos en el Hogar: Guía de Indicadores [Internet]. Washington, DC; 2006. Available from: https://www.fantaproject.org/sites/default/files/resources/HDDS_v2_Spanish_2006_0.pdf
Habte TY, Krawinkel M. Dietary Diversity Score: A Measure of Nutritional Adequacy or an Indicator of Healthy Diet?. J Nutr Heal Sci. 2016;3(3):15–7.
Arimond M, Wiesmann D, Becquey E, Carriquiry A, Daniels MC, Deitchler M, et al. Simple Food Group Diversity Indicators Predict Micronutrient Adequacy of Women ’ s Diets in. J Nutr. 2010;140(11):2059–69.
Kant AK, Schatzkin A, Ziegler RG. Dietary diversity and subsequent cause-specific mortality in the NHANES I epidemiologic follow-up study. J Am Coll Nutr. 1995 Jun;14(3):233–8.
Arsenault JE, Yakes EA, Islam MM, Hossain MB, Ahmed T, Hotz C, et al. Very Low Adequacy of Micronutrient Intakes by Young Children and Women in Rural Bangladesh Is Primarily Explained by Low Food Intake and Limited Diversity 1 – 3. J Nutr. 2013;143(2):197–203.
Claesson MJ, Jeffery IB, Conde S, Power SE, O’Connor EM, Cusack S, et al. Gut microbiota composition correlates with diet and health in the elderly. Nature [Internet]. 2012 Jul 13;488:178. Available from: https://doi.org/10.1038/nature11319
. Conklin AI, Monsivais P, Khaw K, Wareham NJ. Dietary Diversity , Diet Cost , and Incidence of Type 2 Diabetes in the United Kingdom : A Prospective Cohort Study. PLOS Med [Internet]. 2016;13(7):1–16. Available from: http://dx.doi.org/10.1371/journal.pmed.1002085
American Diabetes Association. 6. Glycemic Targets: Standards of Medical Care in Diabetes d 2019. Diabetes Care. 2019;42(January):61–70.
Hernández-Ávila M, Rivera-Dommarco J, Shamah-Levy T, Cuevas-Nasu L, Gómez-Acosta LM, Gaona-Pineda EB, et al. Informe final de resultados. Encuesta Nacional de Salud y Nutrición de Medio Camino 2016. 2016.
Verger EO, Ballard TJ, Dop MC, Martin-Prevel Y. Systematic review of use and interpretation of dietary diversity indicators in nutrition-sensitive agriculture literature. Glob Food Sec [Internet]. 2019;20(November 2018):156–69. Available from: https://doi.org/10.1016/j.gfs.2019.02.004
Slavin JL, Lloyd B. Health benefits of fruits and vegetables. Adv Nutr. 2012;3(4):506–16
Rivera JA, Pedraza LS, Aburto TC, Batis C, Sánchez-Pimienta TG, González de Cosío T, et al. Overview of the Dietary Intakes of the Mexican Population: Results from the National Health and Nutrition Survey 2012. J Nutr. 2016;146(9):1851S-1855S.
Rivera-Dommarco JA, Sánchez-Pimienta T. Uso del recordatorio de 24 horas para el estudio de distribuciones de consumo habitual y el diseño de políticas alimentarias en América Latina. Arch Latinoam Nutr. 2015;65(Suppl. 1):58–9
Shamah-Levy T, Rodríguez-Ramírez S, Gaona-Pineda EB, Cuevas-Nasu L, Carriquiry AL, Rivera JA. Three 24-Hour Recalls in Comparison with One Improve the Estimates of Energy and Nutrient Intakes in an Urban Mexican Population. J Nutr. 2016;146(5):1043–50.
Hakeem R, Shiraz M, Riaz M, Fawwad A, Basit A. Association of Dietary Patterns with Glycated Haemoglobin among Type 2 Diabetics in Karachi, Pakistan. J Diabetol. 2018;9(2):59–64.
Schwingshackl L, Chaimani A, Hoffmann G, Schwedhelm C, Boeing H. A network meta-analysis on the comparative efficacy of different dietary approaches on glycaemic control in patients with type 2 diabetes mellitus. Eur J Epidemiol [Internet]. 2018;33(2):157–70. Available from: https://doi.org/10.1007/s10654-017-0352-x
Flores M, Macias N, Rivera M, Lozada A, Barquera S, Rivera-Dommarco J, et al. Dietary Patterns in Mexican Adults Are Associated with Risk of Being Overweight or Obese. J Nutr. 2010;140(10):1869–73.
Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO). El estado mundial de la agricultura y la alimentación [Internet]. Roma, Italia: FAO; 2017. 1–201 p. Available from: http://www.fao.org/3/a-I7658s.pdf
Moreno-Altamirano L, Silberman M, Hernández-Montoya D, Capraro S, Soto-Estrada G, García-García JJ, et al. Diabetes tipo 2 y patrones de alimentación de 1961 a 2009: Algunos de sus determinantes sociales en México. Gac Med Mex. 2015;151(3):354–68
Ulven SM, Christensen JJ, Nygård O, Svardal A, Leder L, Ottestad I, et al. Using metabolic profiling and gene expression analyses to explore molecular effects of replacing saturated fat with polyunsaturated fat-a randomized controlled dietary intervention study. Am J Clin Nutr. 2019;109(5):1239–50.
Azadbakht L, Esmaillzadeh A. Dietary diversity score is related to obesity and abdominal adiposity among Iranian female youth. Public Health Nutr. 2010;14(1):62–9.
Gholizadeh F, Moludi J, Lotfi Yagin N, Alizadeh M, Mostafa Nachvak S, Abdollahzad H, et al. The relation of Dietary diversity score and food insecurity to metabolic syndrome features and glucose level among pre-diabetes subjects. Prim Care Diabetes. 2018 Aug;12(4):338–44.
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