Relationship of the adherence to the Mediterranean diet with health-related quality of life and treatment satisfaction in patients with type 2 diabetes mellitus: a post-hoc analysis of a cross-sectional study.

Nuria Alcubierre,Esther Rubinat,Eva Maria Navarrete-Muñoz,Marta Hernández,Jesus Vioque,Montserrat Martinez-Alonso,Minerva Granado-Casas,Alicia Traveset,Carmen Jurjo,Joan Valls,Maria Dolores Martínez-González,Didac Mauricio

doi:10.1186/s12955-016-0473-z

Abstract

ObjectiveThe main aim of this study was to assess the association between adherence to the traditional Mediterranean diet (MedDiet) and health-related quality of life (HRQoL) and treatment satisfaction in patients with type 2 diabetes mellitus (T2DM).MethodsThis cross-sectional study included 294 patients with T2DM (146 with diabetic retinopathy and 148 without retinopathy). HRQoL and treatment satisfaction were assessed with the Audit Diabetes-Dependent Quality of Life and Diabetes Treatment Satisfaction Questionnaires, respectively. Adherence to the MedDiet was evaluated with the relative Mediterranean Diet Score (rMED). The rMED was added to multivariate linear regression models to assess its relative contribution as a quantitative as well as a qualitative variable after recoding to maximize each of the model’s coefficients of determination to explain quality of life as well as treatment satisfaction dimensions.ResultsThe adherence to the Mediterranean diet showed no significant association with the overall quality of life score. However, rMED was associated with some HRQoL dimensions: travels, self-confidence and freedom to eat and drink (p = 0.020, p = 0.015, p = 0.037 and p = 0.015, respectively). Concerning treatment satisfaction, rMED was positively associated with its overall score (p = 0.046), and especially with the understanding of diabetes (p = 0.0004) and treatment recommendation (p = 0.036), as well as with the perceived frequency of hyperglycaemias (p = 0.039).ConclusionAdherence to the Mediterranean diet was associated with greater treatment satisfaction in patients with T2DM. Although we found no association with overall HRQoL, adherence to this dietary pattern was associated with some quality of life dimensions.

Highlights

Despite the fact that there is increasing scientific evidence on the role of the traditional Mediterranean Diet (MedDiet) as an indicator of physical and mental health and of healthy ageing in several population subgroups, there are very few data available on the relationship of the food intake pattern with quality of life and treatment satisfaction in patients with type 2 diabetes mellitus (T2DM) [1,2,3,4,5,6]
The bivariate analysis revealed that relative Mediterranean Diet Score (rMED) was significantly associated with the following health-related quality of life (HRQoL) dimensions: travels (p = 0.025 for differences among the three levels of rMED), self-confidence (p = 0.006 for differences among the two groups defined by rMED median), freedom to eat (p = 0.030 for differences among the two groups defined by rMED median), and freedom to drink (p = 0.005 for differences among the three levels of rMED)
The current study indicates that a high adherence to the MedDiet is associated with higher levels of overall treatment satisfaction in patients with T2DM, and with some specific dimensions of this outcome variable

Summary

Introduction

Despite the fact that there is increasing scientific evidence on the role of the traditional Mediterranean Diet (MedDiet) as an indicator of physical and mental health and of healthy ageing in several population subgroups (adolescents, university students, general population, elderly people, and subjects with high blood pressure), there are very few data available on the relationship of the food intake pattern with quality of life and treatment satisfaction in patients with type 2 diabetes mellitus (T2DM) [1,2,3,4,5,6]. Kahleova et al assessed the impact of two low calorie diet interventions (vegetarian diet vs conventional diabetes diet), to which a programme of aerobic exercise was added, on health-related quality of life (HRQoL), eating behaviour and mood of obese patients with T2DM [7]. In T2DM, maintaining quality of life and treatment satisfaction are important treatment goals for the patient and are increasingly important in health decisionmaking [9, 10]. Both outcome variables demonstrated their association with lower morbidity and mortality, greater treatment adherence and positive changes in lifestyle-related aspects [10, 11]

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