Monitoring Adherence to the Canadian Diabetes Association Nutrition Therapy Guidelines Using the Perceived Dietary Adherence Questionnaire and a 3-Day Food Record

Abstract

Nutrition therapy is fundamental in the treatment of type 2 diabetes (T2D). Despite its benefits, adherence to dietary recommendations is low. We evaluated adherence to the Canadian Diabetes Association Nutrition Therapy Guidelines (NTG) using a Perceived Dietary Adherence Questionnaire (PDAQ) and a 3-day food record (3-DFR). The PDAQ evaluated the frequency that people followed 9 different recommendations from the NTG during the preceding week. Participants (n=59) mean age in this cross-sectional study was 60±10 (SD). Participants followed all the recommendations an average of 4 days per week scoring a mean of 40±12 (maximum 63) in the PDAQ. Based on the 3-DFR, average intake of saturated fat (10±3%) and sodium (2800±1216 mg) were higher than recommended, whereas intake of monounsaturated fat was lower (9±3%). Other nutrients were within the recommended range. We associated individual components of the PDAQ with nutrient intakes from the 3-DFR (p=<0.05). Following Canada's Food Guide more days per week was associated with higher intake of fiber (r=0.489) and sugar (r=0.306). Eating the recommended servings of fruits and vegetables more days per week was associated with higher intake of carbohydrates (rs=0.262), fiber (rs=0.435), sugar (rs=0.415), and lower intake of saturated fat (rs= -0.351). Eating foods high in sugar (e.g. cookies) during more days was associated with higher intake of fat (rs=0.387) and saturated fat (rs=0.339). Participants' perceived adherence was associated with their actual nutrient intake. The PDAQ is simple to complete and easy to score, and represents a good indicator of adherence to NTG in T2D.