Enhanced Eating Competence Is Associated with Improved Diet Quality and Cardiometabolic Profile in Finnish Adults with Increased Risk of Type 2 Diabetes.

Jussi Pihlajamäki,Santtu Mikkonen,Reija Männikkö,Pilvikki Absetz,Kirsikka Aittola,Marja Harjumaa,Tanja Tilles-Tirkkonen,Elina Järvelä-Reijonen,Leila Karhunen,Jaana Lindström,Timo Lakka,Ursula Schwab,Marjukka Kolehmainen

doi:10.3390/nu13114030

Abstract

Eating competence (EC) is characterized by positive attitudes towards food and eating, having regular meals, eating a variety of foods, and internally regulated eating. We investigated the associations of changes in EC with changes in lifestyle, anthropometrics and biomarkers of glucose and lipid metabolism in 2291 adults at increased risk of type 2 diabetes as part of the StopDia study conducted in primary healthcare. EC and diet quality were assessed with validated digital questionnaires. During the intervention, the participants received either (1) the digital lifestyle intervention, (2) the combined digital and face-to-face group-based lifestyle intervention, or (3) standard care. EC increased among the participants independent of the intervention type. Increase in EC was associated with an increase in diet quality, high-density lipoprotein (HDL) cholesterol, and with a decrease in body mass index and waist circumference, regardless of baseline EC. Of the subdomains of EC, the contextual skills, food acceptance and eating attitudes were associated with various of these changes. Our results thus suggest that EC could be a potential target in lifestyle interventions aiming to improve the cardiometabolic health of people at type 2 diabetes risk.

Highlights

Type 2 diabetes (T2D), a major health and economic burden in the world, can be prevented among those at increased risk with lifestyle interventions that include intensive nutrition and physical activity counselling [1,2,3,4]
We examined whether changes in eating competence (EC) were associated with changes in diet quality, physical activity, overall adiposity, abdominal adiposity or glucose and lipid metabolism
Our results show that EC slightly improved in adults with an increased risk of T2D who participated in the Stop Diabetes (StopDia) study, with no difference between the study groups

Summary

Introduction

Type 2 diabetes (T2D), a major health and economic burden in the world, can be prevented among those at increased risk with lifestyle interventions that include intensive nutrition and physical activity counselling [1,2,3,4]. The impact of these interventions depends on how well new lifestyle habits, including a health promoting diet, are adopted [5]. A novel approach to support healthy lifestyle could be to focus on eating competence (EC) as defined in the Satter Eating Competence Model [6,7,8,9]. Our previous study showed that being eating competent was strongly associated with a better diet quality, a decreased likelihood of being obese or having an increased waist circumference, metabolic syndrome or newly diagnosed T2D in adults at increased risk of T2D [9]. Previous findings have mainly been supported by cross-sectional studies

Methods

Discussion

Conclusion