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Nutrition in acute and chronic diseases

Using dietary serving scores to assess adequacy of dietary intake and associated factors among adult patients with type 2 diabetes in Kampala: a cross-sectional study

European Journal of Clinical Nutrition volume 75, pages 555–563 (2021)Cite this article

Subjects

Abstract

Background/Objectives

Adequate dietary intake for type 2 diabetes mellitus (T2DM) patients is central in preventing or delaying onset of diabetes related complications. This study used dietary serving scores (DSS) to determine the adequacy of dietary intake and associated factors among patients with T2DM in Kampala.

Subjects/Methods

A facility based cross-sectional study among adult T2DM patients attending diabetes clinics attached to health care facilities in Kampala was conducted. Semi structured demographic and 7-day Food Frequency Questionnaires (FFQ) were used to collect data on sociodemographic characteristics, environmental factors and dietary intake respectively. Dietary intake was computed using Dietary Serving Scores (DSS) and was grouped into two: “adequate dietary intake (DSS of 78 and above)” and “inadequate dietary intake (DSS below 78)”. Multiple linear regression was used to assess correlates of dietary intake.

Results

Out of the 400 participants, only 49 (12.25%; 95% CI: 9.04, 15.46) were classified as having adequate dietary intake. After adjusting for potential confounders, unmarried individuals (β = −2.367; p = 0.024) and those who are salaried (β = −3.162; p = 0.012) or self-employed (β = −4.214; p = 0.001) had significantly lower mean DSS compared to their respective counterparts. T2DM patients who attended Nsambya hospital diabetes clinic had significantly higher mean DSS (β = 3.698; p = 0.022) compared to those who receive treatment in Lubaga hospital.

Conclusions

The prevalence of adequate dietary intake among patients with T2DM attending health facilities in Kampala is very low. More efforts are needed to educate patients on better dietary choices aligned with disease management.

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Data availability

Datasets generated and analysed during the study are not publicly available due to terms of participant consent but are available in anonymised form from the corresponding author on reasonable request.

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Acknowledgements

We thank the staff of Mulago, Lubaga, Nsambya, Kisenyi and Naguru hospitals for their support and cooperation during the period of data collection. We further extend our appreciation to the staff of Makerere University School of Public Health for their support during the study. We would also like to extend our thanks to the study participants and research assistants for their time and cooperation during the period of data collection. Statistical support from Dr. Finian Bannon of the Centre for Public Health, Queen’s University Belfast, is highly appreciated.

Funding

This study received funding from Germany Academic Exchange service (DAAD) as a contribution towards research for SK. The funders had no role in any aspect of the study i.e. study design, data collection, data analysis and interpretation and the decision to publish or preparing and submission of the manuscript.

Author information

Author notes

  1. These authors contributed equally: Susan Kisaakye, Nicholas Matovu

Authors and Affiliations

  1. Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda

    Susan Kisaakye, Nicholas Matovu & Richard Kajjura

  2. Centre for Public Health, Queens University Belfast, Institute of Clinical Sciences Block B, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK

    Nicholas Matovu

  3. Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda

    David Guwatudde

Authors
  1. Susan Kisaakye
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  2. Nicholas Matovu
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  4. Richard Kajjura
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Contributions

SK, DG and RK contributed to the conceptualisation and design of the study; SK and NM designed research tools and assisted in data collection; SK and NM analysed and interpreted the data. SK and NM wrote the first draft of the manuscript. DG and RK reviewed the manuscript for important intellectual content. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Nicholas Matovu.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Approval to conduct the study was sought from MakSPH Health Higher Degrees Research and Ethics Committee. Permission to collect data was sought from the five health facilities.

Informed consent

Verbal and written informed consent in the local language was obtained from the respondents and collected information was kept confidential. The investigator provided an explanation of the purpose, risks and benefits of the study to the participants.

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Kisaakye, S., Matovu, N., Guwatudde, D. et al. Using dietary serving scores to assess adequacy of dietary intake and associated factors among adult patients with type 2 diabetes in Kampala: a cross-sectional study. Eur J Clin Nutr 75, 555–563 (2021). https://doi.org/10.1038/s41430-020-00731-2

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