Adjustment And Preliminary Application Of Chinese Dietary Balance Index In Patients With Type 2 Diabetes

ObjectiveThe purpose of the study is to adjusted Chinese Dietary Balance Index and tested for reliability and validity,as it could be applied to the dietary evaluation of patients with type 2 diabetes.Then,the index was used to evaluate the dietary quality of community type 2 diabetes patients,in order to quickly and accurately assessed the overall population dietary status,find out the dietary problems of patients in time,and provide guidance for improving the dietary intervention research of type 2 diabetes patients scientific basis.Method1.The composition and value of the Chinese Dietary Balance Index were adjusted based on the Chinese Dietary Guidelines for Type 2 Diabetes,the Diet Balance Pagoda and the latest epidemiological research evidence.Cluster sampling was used to select community type 2 diabetes patients.Semi-quantitative food frequency questionnaire was used to conduct dietary survey,and the reliability and validity of the index were verified by the the high-quality dietary recipes in the type 2 diabetes diet and nutrition instruction manual,general linear model,Mann-Whitney U test,and Spearman correlation analysis were used,Principal component analysis(PCA),Cronbach’s α.2.Patients with type 2 diabetes were selected from a community in a city.The general information and dietary status of the patients were investigated by using general information questionnaire and semi-quantitative food frequency questionnaire,and the dietary quality was evaluated by using the adjusted China Dietary Balance Index-16.A nutrition calculator was used to calculate the daily energy intake level and food intake of the patients,and SPSS24.0 was used for statistical analysis.Means and quantiles were used for statistical description of measurement data,and Wilcoxon or Kruskal-Wallis H rank sum test was used for comparison of measurement data.Result1.Adjustment of Chinese Dietary Balance Index: The adjusted China Dietary Balance Index was composed of 7 food group indexes and 1 food type index.The difference was that 4 food subgroup indexes are added,and the original added sugar index was further refined into edible sugar,sugary beverages and sugary cakes.In terms of index values,the value and score of vegetables and fruits were adjusted.The evaluation indicators used the total score,the positive score,the negative score,and the diet quality distance.2.The reliability and validity of the adjusted China Dietary Balance Index: The results showed that the better score of the index was related to the lower known dietary exposure risk factors(P<0.01),and the score of the index was more appropriate in the diet of patients with type 2 diabetes mellitus with different energy levels.The Index can distinguish between smoking or not and whether or not to participate in community diabetes health education lectures in the diet quality of type 2 diabetic patients(P<0.05).The low correlation between the score index and energy intake indicated that they could independently evaluate the diet quality of type 2 diabetes patients,and there was significant correlation between the score index and glycosylated hemoglobin,low-density lipoprotein cholesterol and high-density lipoprotein cholesterol(P < 0.05),indicating that they could predict the blood glucose level of patients.Principal component analysis showed that the index was multidimensional,and Cronbach coefficient α was 0.541.3.The status of dietary quality of patients with type 2 diabetes in the community:The dietary quality of the patients was in a state of low-level imbalance,accompanied by insufficient and excessive low-level dietary intake.The degree of excessive and unbalanced dietary intake in working patients with type 2 diabetes was higher than that in non working patients(P<0.05).The degree of excessive and unbalanced dietary intake in smoking group was higher than that in non-smoking group(P<0.05).The degree of insufficient dietary intake and dietary imbalance of type 2 diabetes patients who did not attended community health education lectures were higher than those who attended community health education lectures(P<0.05).According to the distribution of the adjusted Chinese Dietary Balance Index,the inadequate intake of vegetables,fruits,milk and beans was more serious,and only11.4% and 19.6% of the number of people reaching the recommended intake range respectively.31% and 22.9% of the population had moderate to severe excessive intake of cereals and condiments,respectively.The dietary patterns of the investigated population were mainly pattern E,pattern B and pattern D.Conclusion1.The adjusted Chinese Dietary Balance Index enriched the content of dietary balance index,and has good reliability and validity test results.In theory,it can comprehensively and quantitatively evaluated the dietary nutritional status of the patients with type 2 diabetes.2.The diet of type 2 diabetic patients is in a state of low imbalance and needs to be further improved.In the future nutrition education aimed at improving the quality of patients ’ diets,the content of Chinese Diabetes Dietary Guidelines can be further promoted,instruct patients to eat more vegetables and milk and beans,and combined with the use of oil and salt control auxiliary utensils to help patients eat rationally,thereby control blood sugar,improve the quality of life.