Barriers and enablers to make lifestyle changes among type 2 diabetes patients: a review

Type 2 diabetes is a non-communicable disease that affects most people around the world and is generally the result of excessive food intake and physical inactivity. Therefore, the purpose of this review was to identify facilitators and barriers for lifestyle modifications among type 2 diabetes patients. We combined quantitative and qualitative studies for this systematic narrative review. A literary search was carried out using EBSCO, HighWire Press, Medline, PsycInfo, PubMed and Scopus. Narrative review was used to extract results from quantitative studies, while thematic synthesis was used to extract results from qualitative studies. Twenty-three studies were included in this review, with a total of 2287 participants from Western, Arab and Asian populations. The two main themes generated from this review are intrinsic factors and extrinsic factors that can either be facilitators or barriers to implementing lifestyle change. Among the barriers faced by the participants are established food habits, lack of self-efficacy, lack of motivation, lack of social support, inadequate knowledge, low socio-economic status, food culture and poor time management. In contrast, the facilitating factors generated are strong self-efficacy, high motivation, good habits, and sufficient knowledge. In general, patients with diabetes observed more barriers than facilitators to implementing healthy lifestyle changes

Effect of diet counseling on knowledge, attitude and practice and quality of life of diabetic patients in Kuantan, Malaysia

This research was intended to assess the impact of dietary counseling for diabetic patients. By giving the advice to control the blood sugar, does it improve the wellness of the diabetic patients? This research was conducted from January until December 2011 with the aim to study the factors associated with knowledge, attitude and practice (KAP) and quality of life (QOL) of type 2 diabetic patients, and the effect of dietary counseling on their KAP and QOL. A total of 63 respondents were involved in this intervention study, including 31 respondents from the intervention group and 32 respondents from the control group. The intervention group was selected by purposive sampling based on doctor’s referral for diet counseling of the respondents, while a convenience sampling method was used for the control group. Based on the baseline results of both groups, a significant correlation was found between knowledge with duration of having DM (p=0.019) and race (p=0.002). Race and educational level were found to have significant correlation with attitude where the p=0.001 and p=0.037, respectively. Significant difference was only found in race for practice scores (p=0.019). There was a significant correlation found between QOL and age (p=0.031). Further analysis comparing the pre and post intervention result shows that the total scores for KAP and QOL in the intervention group was improved after the diet counseling given, as compared to the control group, but the difference was not significant statistically. In conclusion, better methods might need to be developed for more effective health education and counseling to better improve diabetic patients’ KAP and QOL, thus reducing the complications of the disease

Adhering to lifestyle change recommendations via the transtheoretical model: a mixed methods study among type 2 diabetes patients

Abstract Purpose – This paper aims to identify and explore the factors affecting type 2 diabetes mellitus (T2DM) patients’ adherence to lifestyle change recommendations, with the guidance of the trans-theoretical model (stages of change). Design/methodology/approach – This study was conducted in two parts. In Part A, 163 randomly selected participants were asked to complete a cross-sectional survey. Data regarding demographics, stages of change and levels of confidence to engage in lifestyle changes were collected. In Part B, in-depth interviews were conducted among 30 individuals, aged between 30 and 65 years, had been diagnosed with T2DM and had seen dietitian at least once. Purposive sampling was used to recruit participants with different sociodemographic characteristics. Findings – Part A showed that most of the participants were in the pre-action group (60%), with a higher mean HbA1c (8.9%) as compared to the action group (40%) which had a mean HbA1c of 6.9%. Part B further revealed the pre-action group and action group identified four key themes concerning lifestyle changes adherence: stumbling block; self-care belief; knowledge implementation; and selfempowerment. Practical implications – Health-care providers should identify patients’ stages of change before lifestyle changes implementation. Originality/value – This study highlighted that many factors might influence a T2DM patient’s adherence to lifestyle change recommendations. Determining the stages of change and self-confidence of T2DM patients is needed to ascertain long-term adherence

Fasting in Islam: A combination of spiritual elevation and prevention of diseases

The obligatory fasting of Ramadan is not only an Islamic ritual to enhance the God-consciousness (called Taqwa), it may also lead to improvement of health status of fasting person. In other words, it is a complete overhauling instrument of Muslims soul/body in terms of faith and health. This can be termed as “Islamic fasting: a combination of spiritual elevation and prevention of diseases”. Fasting plays an important role in the improvement of hyperlipidemia, obesity (fat loss), diabetes, cognition, cell functions, immunological factors, inflammation, stress and lifespan etc. This article is an effort to review and discuss research carried out during the holy month of Ramadan on various aspects of human health

Adhering to lifestyle change recommendations via the trans-theoretical model: a mixed-methods study among type 2 diabetes patients

Purpose – This paper aims to identify and explore the factors affecting type 2 diabetes mellitus (T2DM) patients’ adherence to lifestyle change recommendations, with the guidance of the trans-theoretical model (stages of change). Design/methodology/approach – This study was conducted in two parts. In Part A, 163 randomly selected participants were asked to complete a cross-sectional survey. Data regarding demographics, stages of change and levels of confidence to engage in lifestyle changes were collected. In Part B, in-depth interviews were conducted among 30 individuals, aged between 30 and 65 years, had been diagnosed with T2DM and had seen dietitian at least once. Purposive sampling was used to recruit participants with different sociodemographic characteristics. Findings – Part A showed that most of the participants were in the pre-action group (60%), with a higher mean HbA1c (8.9%) as compared to the action group (40%) which had a mean HbA1c of 6.9%. Part B further revealed the pre-action group and action group identified four key themes concerning lifestyle changes adherence: stumbling block; self-care belief; knowledge implementation; and self empowerment. Practical implications – Health-care providers should identify patients’ stages of change before lifestyle changes implementation. Originality/value – This study highlighted that many factors might influence a T2DM patient’s adherence to lifestyle change recommendations. Determining the stages of change and self-confidence of T2DMpatients is needed to ascertain long-term adherence

The feasibility and effectiveness of telenutrition for remote dietary consultation: a systematic review and meta-analysis protocol

Aims and Design: Telenutrition offers a potentially useful health improvement approach by providing patients with remote online dietary counselling and disease management services. This review protocol will examine how feasible and effective providing online dietary consultation could be through telenutrition. Data Sources: Adhering to the PRISMA-P, articles from the Cochrane Library, PubMed, Google Scholar, EBSCo, and Scopus databases will be searched using PICOS (population, intervention, comparator, outcome, and study design). Review Methods: The inclusion criteria will be an RCT study design and intervention involving telehealth and telenutrition services, published in English between 1997 and 2022 and in full-text form. The overall risk of bias will be assessed using the Risk of Bias tool developed by the Cochrane Collaboration and the RevMan 5.0 computer program. The latter will be utilised to conduct a meta-analysis. The chosen studies’ heterogeneity will be assessed using a random-effects model and the I2 statistic. Each intervention’s efficacy will be indicated through the statistical significance of the between-group difference (p-value <0.05). The quality of the methodology will be assessed by measuring the RCT design using the Jadad scale, while the evidence quality will be determined using the GRADE system. Results: This review protocol will summarise evidence regarding the feasibility and effectiveness of employing telenutrition for remote dietary consultation. Conference presentations and peer-reviewed journal publications will be how the findings are disseminated. Conclusion and impact: The findings may help to guide the effective implementation of remote dietary consultation services for patients. Trial Registration No: CRD4202234070

A systematic review of maternal dietary intake and its association with childhood stunting

The first 1,000 days of a child’s life is a critical period of development in preventing childhood stunting. Despite various intervention programs, the global prevalence remains high. Maternal nutrition during pregnancy and exclusive breastfeeding plays an important role in infant development; thus, a systematic review of the relationship between maternal dietary intake and childhood stunting was conducted. The Web of Science, Scopus, PubMed, and Google Scholar electronic databases were used. Articles related to maternal nutrition and supplement intake with children's anthropometry data were included. Eleven studies met the inclusion criteria and seven were included after quality assessment. The studies were reviewed thematically as the statistical analysis was not possible due to data heterogeneity. The Appraisal Tool for Cross-Sectional Studies (AXIS) and Critical Appraisal Skills Program tools were used to assess the quality of the included studies. The findings demonstrated that pregnant women need to eat a diverse diet with the inclusion of at least five food groups to fulfill the nutritional requirement. Daily protein intake between 0.8 and 1.1g/kg body weight is recommended for positive birth weight and height outcomes. Supplementation of vitamin A, vitamin C, iron, zinc, vitamin D, and calcium, was also shown to improve pregnancy outcomes. However, future studies should consider confounding factors such as hygiene level and clean water availability to determine the transparent effect of nutrition on childhood stunting. More longitudinal studies are required to ascertain the relationship between maternal dietary intake and childhood stunting, especially in Malaysi

The development and validation of perceived adherence lifestyle modification questionnaire (PALM-Q) among type 2 diabetes mellitus patients

The aim of this study was to develop and validate a questionnaire identifying the perceived adherence status among T2DM patients. This study used the exploratory sequential mixed method. Phase 1 of the study involved nine experts from the related field for the content validation, seven diabetes patients for the cognitive interview and 50 diabetes patients for pilot testing. In Phase 2, we collected 355 diabetes patients for construct validity assessment. Whereas 155 diabetes patients for the criterion validity and cut-off point development. The initial items pool was 43 items with five sections: section A; emographic data; section B; knowledge, section C; barrier and section D; motivation. Using the Rash Measurement Model (RMM), the item reliability obtained was 0.7, which indicates a good reliability value. Furthermore, the criterion validity between the PALM-Q and HbA1c results found a good negative correlation of − 0.6. The questionnaire is able to categorize the perceived adher�ence level into three categories: presume perceived adherence, unpredictable perceived adherence, and perceived non-adherence. The PALM-Q is valid and reliable as a useful screening tool to assess the perceived adherence to lifestyle changes

Knowledge and awareness of obesity-related female fertility risks among IIUM Kuantan female students

Introduction: Overweight and obesity have significant health problems that may lead to the different prevalence of reproductive risks among women. This study aimed to assess the knowledge and awareness of obesity-related female reproductive risks among IIUM Kuantan female students. Methods: A cross-sectional study with convenience sampling was conducted in the International Islamic University Malaysia Kuantan Campus involving students from six faculties. An online survey questionnaire consisting of 3 sections; (1) socio-demographic background, (2) knowledge and awareness of obesity, (3) awareness on obesity-related female reproductive risks, was completed by 98 female students in their reproductive age (18 to 35 years old). Results: The data were analyzed using SPSS IBM Statistics 22 for the descriptive analysis and Spearman's correlation analysis. The data shows that 70% of the respondents have a high knowledge of general obesity. Most respondents 42 (42.9%) have a moderate awareness of obesity-related female reproductive risks. A total of 27 respondents (27.6%) had a high awareness level, 42 respondents (42.9%) had a moderate level of awareness, and 29 respondents (29.65%) had a low awareness level of obesity-related female reproductive risks. There is a moderate positive correlation between the knowledge of obesity and awareness of obesity-related female reproductive risks is (r=0.536, p value <0.01). Conclusion: Most participants were knowledgeable and aware of the cardiometabolic risk factor of obesity. However, the level of awareness of obesity-related reproductive risks was low among participants. Thus, public education is necessary to increase understanding and awareness of the reproductive risk and consequences of obesity toward female reproductive risks