MSc

A study on the dietary factors and diabetes was conducted in the city and suburbs of Trivandrum to assess the socio-economic and food consumption pattern of the families of diabetic patients, personal characteristics as well as dietary pattern of the diabetic patients and the effect of diet counseling which was imparted to selected case studies.

The results of the socio-economic and dietary survey conducted in 150 families of the diabetic patients, attending the diabetic clinic at Trivandrum Medical College, revealed that, most of the patients resided in the urban area and majority of them belonged to the higher socio-economic group. Regarding the expenditure on food, around 52 percent of the families spent less than 50 percent of their monthly income on food. Only a very few families (2.7 percent) spent more than 75 percent of their monthly income on food. 92 percent of the families studied were non vegetarians. The food purchasing habit of the families showed that cereals and pulses were purchased monthly, milk and fish daily, vegetables roots and tubers were purchased on a weekly basis by majority of the families. The frequency of purchase of processed and bakery food was considerably high. All the families used rice daily but majority of them did not included ragi in their daily dietaries. Frequent use of processed and refined foods was also observed by these families. Milk, fish, vegetables etc. were consumed daily by almost all the families. Oil, sugar, coconut, spices and condiments etc were also included daily in the diet of these families. Palmoil and coconut oil were the most commonly used cooking oils in these families. Almost all the families celebrated special occasions like birthdays, marriage, religious festivals etc. by preparing special food items.

The results of the food weighment survey with regard to the consumption pattern of various food groups and the nutrient in take showed that most of the items were consumed in excess of the recommended, especially milk and milk products and flesh foods. The intake of almost all the nutrients were found to be either adequate or more than the recommended, except for nicotinic acid which was low in the case of female members of the families. The calorie intake was found to be higher among the female members of the families than in the male members.

The results of the survey on personal characteristics and dietary pattern conducted among the diabetic patients showed that the prevalence of the disease was slightly greater in men. The age at onset of diabetes in majority of the patients was between 46 to 50 years. Most of the patients (63 percent) came in the age group of 41 to 55 years. Regarding the genetic pattern of the incidence of the disease, paternal inheritance was found to be greater. The occurance of hypertension among the diabetic patients was found to be high (22.7 percent). Among the patients studied 29.3 percent were found to be overweight. The incidence of obesity and hypertension was found to be more in the case female patients. The incidence of heart disease was found to be 8.7 percent. Alcoholism smoking and tobacco chewing were regular habits of some of these patients.

The diabetic patients studied did not have much knowledge about the role of diet in controlling diabetes. A few patients knew about the foods to be included and the foods to be avoided in their diets. Majority of the patients studied, had a liking for sweets and fried food items and they were in the habit of eating such foods without any restriction. Most of the patients were in the habit of taking hypoglycemic agents like fenugreek, bitter gourd etc. Palm oil and coconut oil were used as cooking medium by majority of these patients. Food items like cereals, milk and milk products, oils, coconut etc., were used daily by all the patients fish, vegetables etc. were also used daily by almost all the patients.

The diet counseling in the diabetic clinic was studied through observation and it was found that the diet counseling was given without the help of the dietitian. The diet planning was not according to individual needs of the patients. Most of the patients were not satisfied with the quantity of food as prescribed in the clinic.

The actual intake of major nutrients by the diabetic patients was assessed through food weighment survey and it was found that the calorie intake was higher in all the patients. The proportion of calories from fat was found to be high in almost all the patients and the proportion of calories from carbohydrate was considerably low in many patients.

The present study showed that educating the patients with regard to the diabetic diet is very important in the control of the disease. The diet counseling which was imparted by the investigator in selected case studied was found to be effective in achieving metabolic control of diabetes. This was evident from the biochemical studies conducted which showed a significant reduction in the blood and urine glucose, cholesterol and triglycerides. This implies that diet counseling and education of the patients regarding the significance of diet in diabetes is important in the control of the disease.