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DETERMINING THE NUTRIENTS CHANGES AFTER UNDERGOING NUTRITIONAL COUNSELING AND COOKING ASSISTANCE AMONG T2DM OUTPATIENTS IN MALANG CITY, INDONESIA

1Undergraduate Program in Applied Nutrition and Dietetics, Department of Nutrition, Politeknik Kesehatan Kementerian Kesehatan Malang,, Indonesia

2Dietisien Profesional Education Study Program, Department of Nutrition, Politeknik Kesehatan Kementerian Kesehatan Malang, Indonesia, Indonesia

3Undergraduate Program in Applied Nutrition and Dietetics, Department of Nutrition, Politeknik Kesehatan Kementerian Kesehatan Malang, Indonesia

4 D3 Nutrition Study Program, Department of Nutrition, Politeknik Kesehatan Kementerian Kesehatan Malang, Indonesia

5 Department of Actuarial Science, Institut Teknologi Sepuluh Nopember, Indonesia

6 School of Nutrition and Health Science, College of Nutrition, Taipei Medical University, Taiwan

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Received: 3 Jan 2023; Published: 24 Jun 2023.

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Abstract

ABSTRACT

Background: Nutrition and diets are critical factors for T2DM patients to maintain health. Nutrition education are considered less effective because most patients have not implemented them. This research tries to develop program innovation by combining nutrition counseling and cooking assistance for T2DM outpatients. This study aimed to know the risk factors for T2DM  and determine the effectiveness of programmed nutrition education (NEP) on changes in nutrient intake in patients with T2DM.

Methods: A total of 70 participants registered as T2DM outpatients at Kedung Kandang primary healthcare center in Malang city. Subjects were recruited using a 'quota sampling' technique. The design of this study is a quasi-experiment study using a comparison of the control (n=32)-treatment group (n=38). This research was conducted from September to November 2018. Fifty minutes of intensive individual counseling and cooking assistance were provided to T2DM patients and families. The data were analyzed using independent sample t-test, Wilcoxon Mann Whitney U-test, and logistic regression. The patients’ 4-d dietary records of 3 normal days and 1 holiday/weekend were assessed after 24 hours.

Results: From this study it can be seen that intake of amino acid lysine was significantly higher in the  treatment group than the control group (p = 0.04). The intake of fiber, MUFA, and PUFA was greater in the intervention group, while sodium intake was lower in the intervention group. The risk factors of T2DM incidence were age (p = 0.036), education (p = 0.043), waist circumference (p = 0.015), and carbohydrate intake (p = 0.033).

Conclusion: T2DM patients treated with individual nutrition counseling and cooking assistance gained a higher intake of fiber, amino acid lysine, and unsaturated fatty acids. The most influential risk factors of T2DM incidence are age, education, waist circumference, and carbohydrate intake.

 Keywords: nutrition counseling, cooking assistance, nutritional intake, T2DM.

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Keywords: nutrition counseling, cooking assistance, nutritional intake, T2DM.

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  1. Neel J V. Diabetes mellitus: a “thrifty” genotype rendered detrimental by “progress”? Am J Hum Genet. 1962 Dec;14(4):353–62
  2. Su ST, Yeh CL, Hou YC, Pai MH, Yeh SL. Dietary glutamine supplementation enhances endothelial progenitor cell mobilization in streptozotocin-induced diabetic mice subjected to limb ischemia. J Nutr Biochem. 2017 Feb;40:86–94. https://doi.org/10.1016/j.jnutbio.2016.10.010
  3. Shetty SS, Kumari N S, Shetty PK. ω-6/ω-3 fatty acid ratio as an essential predictive biomarker in the management of type 2 diabetes mellitus. Nutrition. 2020;79–80:110968. https://doi.org/10.1016/j.nut.2020.110968
  4. Ikeda K, Sato T, Nakayama T, Tanaka D, Nagashima K, Mano F, et al. Dietary habits associated with reduced insulin resistance: The Nagahama study. Vol. 141, Diabetes Research and Clinical Practice. 2018. p. 26–34. https://doi.org/10.1016/j.diabres.2018.04.006
  5. American Diabetes Association. Nutrition recommendations and interventions for diabetes: A position statement of the American Diabetes Association. Diabetes Care. 2008;31(SUPPL. 1). https://doi.org/10.2337/dc08-S061
  6. Anderson AS. The Challenge of Implementing Dietary Advice. J Hum Nutr Diet. 2003;16(6):391–2. https://doi.org/10.1046/j.1365-277X.2003.00463.x
  7. Cox RH, Carpenter JP, Bruce FA, Poole KP, Gaylord CK. Characteristics of low-income African-American and Caucasian adults that are important in self-management of type 2 diabetes. J Community Health. 2004 Apr;29(2):155–70. https://doi.org/10.1023/B:JOHE.0000016719.89848.b1
  8. Albarran NB, Ballesteros MN, Morales GG, Ortega MI. Dietary behavior and type 2 diabetes care. Patient Educ Couns. 2006;61(2):191–9. https://doi.org/10.1016/j.pec.2005.03.008
  9. IDF. IDF Diabetes Atlas 8th edition. IDF Diabetes Atlas, 8th edition. Brussels Belgia; 2017. 1–150 p. Available from: file:///Users/ximeneacarballo/Downloads/IDF_DA_8e-EN-final.pdf
  10. Kementerian Kesehatan RI Badan Penelitian dan Pengembangan. RISKESDAS 2018, Kementerian Kesehatan. Ris Kesehat Dasar [Internet]. 2018;53(9). Available from: https://www.persi.or.id/images/2017/litbang/riskesdas_launching.pdf
  11. Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al. Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance. N Engl J Med. 2001;344(18):1343–50. https://doi.org/10.1056/NEJM200105033441801
  12. Araki E, Goto A, Kondo T, Noda M, Noto H, Origasa H, et al. Japanese Clinical Practice Guideline for Diabetes 2019. Vol. 11, Diabetology International. Springer Singapore; 2020. 165–223 p. : https://doi.org/10.1007/s13340-020-00439-5.
  13. Bashir A. AssociationAssociation between diet quality scores, adiposity, glycemic status and nutritional biomarkers among Indian population with type 2 diabetes mellitus. Clin Epidemiol Glob Heal. 2020;2–9. https://doi.org/10.1016/j.cegh.2019.04.007
  14. Ramlan R, Margawati A. Pengaruh konseling gizi dan laktasi intensif dan dukungan suami terhadap pemberian air susu ibu (asi) eksklusif sampai umur 1 bulan. J Gizi Indones (The Indones J Nutr. 2016; https://doi.org/10.14710/jgi.3.2.101-107
  15. Willey J, Wakefield M, Silver HJ. Exploring the diets of adults with obesity and type II diabetes from nine diverse countries: Dietary intakes, patterns, and quality. Nutrients. 2020;12(7):1–16. https://doi.org/10.3390/nu12072027
  16. Fu S, Li L, Deng S, Zan L, Liu Z. Effectiveness of advanced carbohydrate counting in type 1 diabetes mellitus: a systematic review and meta-analysis. Sci Rep. 2016 Nov;6:37067. https://doi.org/10.1038/srep37067
  17. Yuliani K, Kertia N, Lestari LA. Efek konsumsi yoghurt probiotik terhadap kadar low density lipoprotein pada penyandang diabetes mellitus tipe 2. J Gizi Indones. 2020; https://doi.org/10.14710/jgi.8.1.69-74
  18. Yun JS, Ko SH. Current trends in epidemiology of cardiovascular disease and cardiovascular risk management in type 2 diabetes. Vol. 123, Metabolism: Clinical and Experimental. 2021. https://doi.org/10.1016/j.metabol.2021.154838
  19. Bruce DG, Davis WA, Cull CA, Davis TME. Diabetes education and knowledge in patients with type 2 diabetes from the community: the Fremantle Diabetes Study. J Diabetes Complications. 2003;17(2):82–9. https://doi.org/10.1016/S1056-8727(02)00191-5
  20. National Health and Medical Research Council. Nutrition in Aboriginal and Torres Strait Islander peoples : an information paper. [Canberra]: National Health and Medical Research Council; 2000
  21. Abbott PA, Davison JE, Moore LF, Rubinstein R. Effective nutrition education for Aboriginal Australians: lessons from a diabetes cooking course. J Nutr Educ Behav. 2012;44(1):55–9. https://doi.org/10.1016/j.jneb.2010.10.006
  22. Seligman HK, Davis TC, Schillinger D, Wolf MS. Food insecurity is associated with Hypoglycemia and poor diabetes self-management in a low-income sample with diabetes. J Health Care Poor Underserved. 2010;21(4):1227–33
  23. Kim JH, Kim H, Hwang KH, Chang JS, Park KS, Cha SK, et al. WNK1 kinase is essential for insulin-stimulated GLUT4 trafficking in skeletal muscle. FEBS Open Bio. 2018;8(11):1866–74. https://doi.org/10.1002/2211-5463.12528
  24. Nan X, Lu H, Wu J, Xue M, Qian Y, Wang W, et al. The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study. BMC Geriatr. 2021;21(1):1–10. https://doi.org/10.1186/s12877-021-02090-4
  25. Ley SH, Hamdy O, Mohan V, Hu FB. Prevention and management of type 2 diabetes: dietary components and nutritional strategies. Lancet (London, England). 2014 Jun;383(9933):1999–2007. https://doi.org/10.1016/S0140-6736(14)60613-9
  26. Liu AY, Silvestre MP, Poppitt SD. Prevention of type 2 diabetes through lifestyle modification: is there a role for higher-protein diets? Adv Nutr. 2015 Nov;6(6):665–73. https://doi.org/10.3945/an.115.008821
  27. Leidy HJ, Clifton PM, Astrup A, Wycherley TP, Westerterp-Plantenga MS, Luscombe-Marsh ND, et al. The role of protein in weight loss and maintenance. Am J Clin Nutr. 2015 Jun;101(6):1320S-1329S. https://doi.org/10.3945/ajcn.114.084038
  28. Malik VS, Li Y, Tobias DK, Pan A, Hu FB. Dietary Protein Intake and Risk of Type 2 Diabetes in US Men and Women. Am J Epidemiol. 2016 Apr;183(8):715–28. https://doi.org/10.1093/aje/kwv268
  29. Nanri A, Mizoue T, Kurotani K, Goto A, Oba S, Noda M, et al. Low-carbohydrate diet and type 2 diabetes risk in Japanese men and women: the Japan Public Health Center-Based Prospective Study. PLoS One. 2015;10(2):e0118377. https://doi.org/10.1371/journal.pone.0118377
  30. Similä ME, Kontto JP, Valsta LM, Männistö S, Albanes D, Virtamo J. Carbohydrate substitution for fat or protein and risk of type 2 diabetes in male smokers. Eur J Clin Nutr. 2012 Jun;66(6):716–21. https://doi.org/10.1038/ejcn.2012.24
  31. Virtanen HEK, Koskinen TT, Voutilainen S, Mursu J, Tuomainen T-P, Kokko P, et al. Intake of different dietary proteins and risk of type 2 diabetes in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Br J Nutr. 2017 Mar;117(6):882–93. https://doi.org/10.1017/S0007114517000745
  32. Metzgar CJ, Nickols-Richardson SM. Determinants of weight gain prevention in young adult and midlife women: study design and protocol of a randomized controlled trial. JMIR Res Protoc. 2015 Mar;4(1):e36. https://doi.org/10.2196/resprot.4008
  33. Metzgar C, Nickols-Richardson S. Effects of nutrition education on weight gain prevention: A randomized controlled trial. Nutr J. 2016 Mar;15. https://doi.org/10.1186/s12937-016-0150-4
  34. Nayak BS, Sobrian A, Latiff K, Pope D, Rampersad A, Lourenço K, et al. The association of age, gender, ethnicity, family history, obesity and hypertension with type 2 diabetes mellitus in Trinidad. Diabetes Metab Syndr. 2014;8(2):91–5. https://doi.org/10.22236/arkesmas.v6i1.5829
  35. Susilawati, Rahmawati R. Hubungan Usia , Jenis Kelamin dan Hipertensi dengan Kejadian Diabetes Mellitus Tipe 2 di Puskesmas Tugu Kecamatan Cimanggis Kota Depok The Relationship Between Age , Sex And Hypertension With The Incidence Of Type 2 Diabetes Mellitus In Tugu Public Health. Arkesmas. 2021;6:15–22. https://doi.org/10.22236/arkesmas.v6i1.5829
  36. Qi Y, Koster A, van Boxtel M, Köhler S, Schram M, Schaper N, et al. Adulthood Socioeconomic Position and Type 2 Diabetes Mellitus-A Comparison of Education, Occupation, Income, and Material Deprivation: The Maastricht Study. Int J Environ Res Public Health. 2019 Apr;16(8). https://doi.org/10.3390/ijerph16081435
  37. Agardh E, Allebeck P, Hallqvist J, Moradi T, Sidorchuk A. Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis. Int J Epidemiol. 2011 Jun;40(3):804–18. https://doi.org/10.1093/ije/dyr029
  38. Pechey R, Monsivais P. Socioeconomic inequalities in the healthiness of food choices: Exploring the contributions of food expenditures. Prev Med (Baltim). 2016 Jul;88:203–9. https://doi.org/10.1016/j.ypmed.2016.04.012
  39. Sluijs I, van der Schouw YT, van der A DL, Spijkerman AM, Hu FB, Grobbee DE, et al. Carbohydrate quantity and quality and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) study. Am J Clin Nutr. 2010 Oct;92(4):905–11. https://doi.org/10.3945/ajcn.2010.29620
  40. Franz MJ. Carbohydrate and diabetes: is the source or the amount of more importance? Curr Diab Rep. 2001 Oct;1(2):177–86. https://doi.org/10.1007/s11892-001-0031-9
  41. Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA. 2002 May;287(18):2414–23. https://doi.org/10.1001/jama.287.18.2414
  42. Zhang FL, Ren JX, Zhang P, Jin H, Qu Y, Yu Y, et al. Strong Association of Waist Circumference (WC), Body Mass Index (BMI), Waist-to-Height Ratio (WHtR), and Waist-to-Hip Ratio (WHR) with Diabetes: A Population-Based Cross-Sectional Study in Jilin Province, China. J Diabetes Res. 2021;2021. https://doi.org/10.1155/2021/8812431
  43. Jeon J, Jung KJ, Jee SH. Waist circumference trajectories and risk of type 2 diabetes mellitus in Korean population: the Korean genome and epidemiology study (KoGES). BMC Public Health. 2019 Jun;19(1):741. https://doi.org/10.1186/s12889-019-7077-6
  44. Zhang M, Wang B, Liu Y, Sun X, Luo X, Wang C, et al. Cumulative increased risk of incident type 2 diabetes mellitus with increasing triglyceride glucose index in normal-weight people: The Rural Chinese Cohort Study. Cardiovasc Diabetol. 2017 Mar;16(1):30. https://doi.org/10.1186/s12933-017-0514-x
  45. McLaughlin T, Lamendola C, Liu A, Abbasi F. Preferential fat deposition in subcutaneous versus visceral depots is associated with insulin sensitivity. J Clin Endocrinol Metab. 2011 Nov;96(11):E1756-60. https://doi.org/10.1210/jc.2011-0615

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