Knowledge and perceptions about diet and physical activity among Sri Lankan adults with diabetes mellitus: a qualitative study

Abstract

BackgroundDiabetes mellitus (DM) is a rapidly growing health concern in Sri Lanka. Diet and physical activity are important modifiable risk factors affecting the incidence, severity and management of DM. The present study aims to evaluate the knowledge and perceptions about dietary patterns and physical activity among a group of adults with DM in Sri Lanka using qualitative research methods.MethodsFifty adults from a cohort of diabetic patients attending the medical clinics at the National Hospital of Sri Lanka were invited for the study. Data were collected via 10 Focus Group Discussions. Verbatim recording and documenting emotional responses were conducted by two independent observers. Directed content analysis of qualitative data was done with the help of NVIVO v10.0.ResultsMean age was 61.2 ± 9.9 years and 46 % were males. Mean duration of diabetes was 10.4 ± 7.5 years. All were aware of the importance of diet in the management of DM. But most had difficulty in incorporating this knowledge into their lives mostly due to social circumstances. The majority described a list of ‘good foods’ and ‘bad foods’ for DM. They believed that ‘good’ foods can be consumed at all times, irrespective of quantity and ‘bad’ foods should be completely avoided. Many believed that fruits were bad for diabetes, while vegetables were considered as a healthy food choice. The majority thought that there were ‘special’ foods that help to control blood glucose, the most common being curry leaves and bitter-gourd. Most study participants were aware of the importance of being physical active. However, there was lack of consensus and clarity with regards to type, duration, timing and frequency of physical activity.ConclusionsDespite understanding the importance of dietary control and physical activity in the management of diabetes, adherence to practices were poor, mainly due to lack of clarity of information provided. There were many myths with regards to diet, some of which have originated from health care professionals. More evidence is needed to support or refute the claims about ‘special’ foods that the participants believe as being good for diabetes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2518-3) contains supplementary material, which is available to authorized users.

Distress and its association with self-care in people with type 2 diabetes

“…Besides, failures in the provision of information were associated to low adherence to drug treatment, lack of regular physical exercise, and consumption of foods with high sugar content. These findings are coherent with previous studies which mentioned that not having received or understood the information about portions and the frequency of meals may be associated with low adherence to diet in diabetic patients (Ranasinghe et al, 2015;Cheng et al, 2016;Parajuli, Saleh, Thapa & Ali, 2014). Thence, it is important that the information provided to the diabetic patient has clear recommendations for self-care, expressed in a kind of language that the patient may fully understand.…”

Dietary Habits of Type 2 Diabetes Patients: Variety and Frequency of Food Intake

“…Accordingly the sugar intake of the diabetes patients in the present study was in accordance with the guidelines [14]. This “sugar” restriction could be due to the advice by health care professionals [9]. Seventy-two percent of diabetes patients in a study conducted in 2015 believed that diabetes arises due to high sugar intake during earlier stage in life and thus have completely avoided sugar consumption [9].…”

“…Thus the animal product consumption which will contribute to saturated fat and cholesterol intake could be a minor risk factor for the development of further complications in this population. Thirty-seven out of 50 participants, of a study conducted in 2015, were unaware of their protein intake and some were under the impression that they should discontinue meat consumption [9]. The practice of nonfat milk consumption was significantly low which was mainly due to less palatability.…”

“…A more recent study revealed that although most of the Sri Lankan diabetes patients restrict sugar intake, they consume improper sugar alternatives (i.e., dates) in normal portion or in higher amounts without restriction. Even with the knowledge of adverse effects of sugar consumption, some of the study participants (18 out of 50) had difficulty in controlling the intake of sugar containing foods [9]. …”

Assessment of degree of awareness about diet, physical exercise, and lifestyle modifications among diabetic patients

“…[6] Changes in dietary patterns and physical activity levels coupled with the genetic predisposition are probably the main reasons driving the current diabetes epidemic in the South Asian region. [7] In Tamil Nadu, people in rural areas mainly consume rice as staple diet. [6] Due to numerous sociocultural issues, protein consumption pattern varies among population between vegetarians and non-vegetarians.…”