Abstract
The study aims were to (i) identify determinants of Nutrition Facts Panel (NFP) use and (ii) describe the association between NFP use and dietary intake among Latinos with type 2 diabetes. Baseline cross-sectional data from a clinical trial were used to assess the association between NFP use and dietary intake. Diet was measured using two methods: (i) a diet quality score (the Healthy Eating Index-2010) derived from a single 24 h recall and (ii) dietary pattern (exploratory factor analyses) from an FFQ. Multivariable logistic and non-parametric quantile regressions were conducted, as appropriate. Settings Hartford County, Connecticut, USA. Latino adults (n 203), ≥21 years of age, with diagnosed type 2 diabetes, glycosylated Hb≥7 %, and without medical conditions limiting physical activity. Participants' education level, diabetes-related knowledge and English speaking were positively associated with NFP use. At the higher percentiles of diet quality score, NFP use was significantly associated with higher diet quality. Similarly, NFP users were more likely to consume a 'healthy' dietary pattern (P=0·003) and less likely to consume a 'fried snack' pattern (P=0·048) compared with NFP non-users. The association between reported NFP use and diet quality was positive and significantly stronger among participants who reported consuming a healthier diet. While NFP use was associated with a healthier dietary pattern, not using NFP was associated with a less-healthy, fried snack pattern. Longitudinal studies are needed to understand whether improving NFP use could be an effective intervention to improve diet quality among Latinos with type 2 diabetes.
Highlights
The β coefficients represent the difference between diet measures of Nutrition Facts Panel (NFP) users and NFP non-users at a specified percentile of the same diet measure
Food label use is associated with diet relative diagnosed with diabetes
Findings from the present study indicate that higher levels of formal education, diabetes-related knowledge and speaking English are independent factors associated with higher likelihood of NFP use in a low-income Latino population with poorly controlled type 2 diabetes and that NFP use is associated with healthier dietary choices
Summary
Secondary data analyses were conducted using crosssectional baseline data from 203 individuals enrolled in the community-based Diabetes among Latinos Best Practices Trial (DIALBEST)(22). To be included in the study, DIALBEST participants had to meet the following criteria: (i) Latinos aged ≥21 years; (ii) living in Hartford County, Connecticut; (iii) having physician-diagnosed type 2 diabetes; and (iv) HbA1c ≥ 7 %. Dietary data In the present study, participants’ food consumption was assessed using both an established index score and datadriven indicators (dietary patterns from factor analyses), which represent the two accepted analytical approaches for defining dietary patterns[29]. Dietary pattern Dietary intake patterns were generated from FFQ data that assessed participants’ usual habits of food intake in the past 12 months This questionnaire was previously tested[32] and validated[33] among Puerto Rican-dominant Latino communities. Bivariate analyses testing the association between continuous independent variables and NFP use were conducted using non-parametric Kruskal–Wallis tests, and median values with interquartile range are presented. The χ2 or Fisher’s exact test was conducted to test the bivariate associations of acculturation, education, monthly gross household income and employment status with speaking English
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