Na-Yeon Noh; So-Young Nam; Hee-Suk Kang; Ji-Eun Lee; Soo-Kyung Lee

doi:10.5720/kjcn.2013.18.2.101

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Original Article
Nutrition Knowledge, Dietary Attitude, and Dietary Behavior among Children and Adolescents with Type 1 Diabetes: Na-Yeon Noh, So-Young Nam, Hee-Suk Kang, Ji-Eun Lee, Soo-Kyung Lee; Korean Journal of Community Nutrition 2013;18(2):101-111.
DOI: https://doi.org/10.5720/kjcn.2013.18.2.101
Published online: April 30, 2013

Department of Food and Nutrition, Inha University, Incheon, Korea.

¹Department of Pediatrics, Inha University Hospital, Incheon, Korea.

²Department of Pediatrics, School of Medicine, Inha University, Incheon, Korea.

Corresponding author: Soo-Kyung Lee, Department of Food and Nutrition, Inha University, 100 Inharo, Namgu, Incheon 402-751, Korea. Tel: (032) 860-8121, Fax: (032) 860-8120, skleenutrition@inha.ac.kr

• Received: January 3, 2013 • Revised: March 15, 2013 • Accepted: April 1, 2013

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Abstract
NOTES
REFERENCES

Abstract

Type 1 diabetes is on the rise worldwide. Although nutrition education for patients with diabetes has become a routine practice, specifics and impacts of such educations need to be more researched. This study examined the status of nutrition knowledge, dietary attitude, and dietary behavior among children and adolescents with type 1 diabetes (9-19 year-old) and explored factors influencing dietary behaviors related to diabetes by applying the Theory of Planned Behavior. Face-to-face interviews, using a pre-tested structured questionnaire, were conducted with 32 participants (11 boys and 21 girls) with type 1 diabetes followed by a diabetes clinic in a university hospital. This study found that the level of nutrition knowledge related to diabetes was generally low at 4 points out of a possible 10, however, the dietary attitude related to diabetes was found to be generally good at 26 points out of a possible 30. Participants were motivated to follow medical staff recommendations the most; however, their family was also important. Perceived behavioral control was low especially for eating-out and portion control. The dietary behavior related to blood glucose control showed low at 13 points out of a possible 20. Regression analysis showed that perceived behavioral control (p < 0.001) was significantly related to the dietary behavior related to blood glucose control. This rare study with children and adolescents with type 1 diabetes showed that nutrition education should include a component to improve perceived behavioral control through high-risk situation management.
Keywords: Type 1 diabetes; children; adolescent; Theory of Planned Behavior

NOTES

This study was conducted with Inha University grant for SK Lee.

REFERENCES

1. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991; 50: 179-211.
2. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2012; 35: Suppl 1. S11-S63.
3. Choe SJ, Park HR, Park DY, Ahn HS. A study on the sociopsychological factors influencing the dietary compliance of diabetics by using focus group interview. Korean J Community Nutr. 2000; 5(1): 23-35.
4. Chun JH, Jung SB, Sohn HS. Self-care and related factors in patients with diabetes. J Korean Diabetes Assoc. 1999; 23(2): 193-206.
5. Chung SO, Song OK, Ko JM, Wi JH, Lee TH, Yum JH, Cho DK, Son JH, Nam HW, Yoo HJ, Lee YN, Kim SG, Moon HK, Kim ES. The effects of teaching methods on the dietary compliance and hemoglobin a1c level in patients with diabetes mellitus. J Korean Diabetes Assoc. 2000; 24: 560-573.
6. Holli BB, Calabrese RJ, Maillet JO. Communication and education skills for dietetics professionals. 2003; Philadelphia: Lippincott Williams & Wilkins.
7. Kang HJ, Shin EM, Kim KW. Evaluation of nutrition education for diabetes mellitus management of older adults. Korean J Community Nutr. 2009; 14(6): 734-745.
8. Karvonen M, Tuomilehto J, Libman I, LaPorte R. A review of the recent epidemiological data on the worldwide incidence of type 1 (insulin-dependent) diabetes mellitus. Diabetologia. 1993; 36(10): 883-892.PubMed
9. Kim KW, Shin EM. Using the theory of planned behavior to explain dairy food consumption among university female students. Korean J Community Nutr. 2003; 8(1): 53-61.
10. Kim HS, Park CS. Self-care and physical symptom by gender in Korean type 2 diabetic patients. Korean J Women Health Nurs. 2003; 9(3): 270-276.
11. Kim HY, Kang MH. Assessment of nutritional status. 2008; Seoul: Shinkwang pub; 86-87.
12. Kim JH, Kim SM. A study on effects of short-term nutritional education on diabetic pediatric patient. J East Asian Soc Diet Life. 2000; 10(1): 21-36.
13. Knip M. Descriptive epidemiology of type 1 diabetes-is it still in? Diabetologia. 2012; 55(5): 1227-1230.
14. Korea Center for Disease Control and Prevention & The Korean Pediatric Society. 2007 Korean National Growth Charts. 2007.
15. Lee HW, Park HS. The variables affecting diabetic patient's self-care behaviors: An application of theory of planned behavior. Korean J Advert Public Relat. 2010; 12(4): 327-362.
16. Lee JR. Lifestyle modification and diabetes management. J Korean Diabetes. 2011; 12(4): 215-218.
17. Lee YW, Hwang WS, Choe SJ, Lee DH, Kim DH, Lee EH, Hong EG, Noh HY, Chung YS, Lee KW, Kim HM. The effect of intensive education on glycemic control in type 2 diabetic patients. J Korean Soc Endocrinol. 2003; 18: 63-72.
18. National Health Insurance Corporation. 2012; cited 2012 June 26. Available from http://www.nhic.or.kr.
19. NIDDK. National Diabetes Statistics. 2011; cited 2012 July 26. Available from http://diabetes.niddk.nih.gov.
20. Oh JY, Kim SB. Development and effect's analysis of nutrition education program for diabetes mellitus at community health center-focused on individual daily energy requirements and food exchange units-. Korean J Community Nutr. 2010; 15(4): 485-497.
21. Park DY. The effect of social support on compliance to dietary regimen in noninsulin-dependent diabetes mellitus. Korean J Hum Ecol. 2001; 4(1): 108-120.
22. Park DY, Choe SJ, Park HR, Ahn HS. A study on the sociopsychological factors influencing the dietary compliance of diabetics using questionnaire. Korean J Community Nutr. 2000; 5(1): 36-49.
23. Park SY, Kim HR. A study on dietary compliance and related variables in non insulin dependent diabetes mellitus patients. Korean J Nutr. 1994; 27(4): 356-367.
24. Park YS, Lee JW, Seo JS, Lee BK, Lee HS. Nutrition education and counseling. 2006; Paju: Kyomoonsa; 2-4.
25. Seo HS, Lee SK, Nam SY. Factors influencing fast food consumption behaviors of middle-school students in Seoul: An application of theory of planned behaviors. Nutr Res Pract. 2011; 5(2): 169-178.PubMed PMC
26. Shim WS, Hong SB, Choi YS, Choi YJ, Ahn SH, Min KY, Kim EJ, Park IB, Nam MS, Kim YS. Development of two parallel diabetes knowledge tests. J Korean Diabetes Assoc. 2006; 30(6): 476-486.
27. Shin CH. Epidemiologic characteristics of type 1 diabetes in children aged 14 years or under in Korea, 1985-2000. Korean J Pediatr. 2008; 51(6): 569-575.
28. Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, Deeb L, Grey M, Barbara A, Holzmeister LA, Clark N. Care of children and adolescents with type 1 diabetes. Diabetes Care. 2005; 28(1): 186-212.
29. Silink M. Childhood diabetes: a global perspective. Horm Res. 2002; 57: Suppl 1. 1-5.
30. Smart C, Aslander-van Vliet E, Waldron S. Nutritional management in children and adolescents with diabetes. Pediatr Diabetes. 2009; 10(Suppl 12): 100-117.
31. Spiegel G, Bortsov A, Bishop FK, Owen D, Klingensmith GJ, Mayer-Davis EJ, Maahs DM. Randomized nutrition education intervention to improve carbohydrate counting in adolescents with type 1 diabetes study: Is more intensive education needed? J Acad Nutr Diet. 2012; 112: 1736-1746.
32. The Korean Nutrition Society. Dietary reference intakes for Koreans. 2010; Seoul: The Korean Nutrition Society.

Table 1

General characteristics of the subjects

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) N (%)

3) Fisher's exact test

4) Mean ± SD

5) Mann-Whitney U test

6) Single-parent family

Table 2

Anthropometric and clinical characteristics of the subjects

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD

3) Mann-Whitney U test

4) N (%)

5) Fisher's exact test

HAZ: Height for Age z-score

WAZ: Weight for Age z-score

BAZ: Body Mass Index for Age z-score

Table 3

Average intake of energy and nutrients

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, 3) Mann-Whitney U test

Table 4

Nutrition knowledge related to diabetes

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) N (%), 3) Fisher's exact test, 4) Mean ± SD, 5) Mann-Whitney U test

Table 5

Attitude toward diabetes-related dietary behaviors

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, Response categories used a 5-point Likert scale (High scores indicate strong agreement.).

3) Mann-Whitney U test

Table 6

Subjective norms toward diabetes-related dietary behaviors

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, Response categories used a 5-point Likert scale (High scores indicate strong agreement.).

3) Mann-Whitney U test, 4) Data multiplied Normative Belief by Motivation to Comply

Table 7

Perceived behavioral control toward diabetes-related dietary behaviors

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, Response categories used a 5-point Likert scale (High scores indicate strong agreement.).

3) Mann-Whitney U test

Table 8

Behavioral intention and dietary behaviors related to blood glucose control

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, Response categories used a 5-point Likert scale (High scores indicate strong agreement.).

3) Mann-Whitney U test

Table 9

Multiple regressions on the Theory of Planned Behavior

1) Multiple logistic regression analysis adjusted for age and sex.

2) Standardized parameter estimate R² = 0.311, model F = 2.350, p = 0.069

3) Standardized parameter estimate R² = 0.553, model F = 8.356, p = 0.000

Figure & Data

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Spatial Distribution of Diabetes Prevalence Rates and Its Relationship with the Regional Characteristics
Eun-Kyung Jo, Eun-Won Seo, Kwang-Soo Lee
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Nutrition Knowledge, Dietary Attitude, and Dietary Behavior among Children and Adolescents with Type 1 Diabetes

Korean J Community Nutr. 2013;18(2):101-111. Published online April 30, 2013

DOI: https://doi.org/10.5720/kjcn.2013.18.2.101

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Nutrition Knowledge, Dietary Attitude, and Dietary Behavior among Children and Adolescents with Type 1 Diabetes

Table 1

General characteristics of the subjects

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) N (%)

3) Fisher's exact test

4) Mean ± SD

5) Mann-Whitney U test

6) Single-parent family

Table 2

Anthropometric and clinical characteristics of the subjects

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD

3) Mann-Whitney U test

4) N (%)

5) Fisher's exact test

HAZ: Height for Age z-score

WAZ: Weight for Age z-score

BAZ: Body Mass Index for Age z-score

Table 3

Average intake of energy and nutrients

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, 3) Mann-Whitney U test

Table 4

Nutrition knowledge related to diabetes

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) N (%), 3) Fisher's exact test, 4) Mean ± SD, 5) Mann-Whitney U test

Table 5

Attitude toward diabetes-related dietary behaviors

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, Response categories used a 5-point Likert scale (High scores indicate strong agreement.).

3) Mann-Whitney U test

Table 6

Subjective norms toward diabetes-related dietary behaviors

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, Response categories used a 5-point Likert scale (High scores indicate strong agreement.).

3) Mann-Whitney U test, 4) Data multiplied Normative Belief by Motivation to Comply

Table 7

Perceived behavioral control toward diabetes-related dietary behaviors

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, Response categories used a 5-point Likert scale (High scores indicate strong agreement.).

3) Mann-Whitney U test

Table 8

Behavioral intention and dietary behaviors related to blood glucose control

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, Response categories used a 5-point Likert scale (High scores indicate strong agreement.).

3) Mann-Whitney U test

Table 9

Multiple regressions on the Theory of Planned Behavior

1) Multiple logistic regression analysis adjusted for age and sex.

2) Standardized parameter estimate R² = 0.311, model F = 2.350, p = 0.069

3) Standardized parameter estimate R² = 0.553, model F = 8.356, p = 0.000

Table 1 General characteristics of the subjects

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) N (%)

3) Fisher's exact test

4) Mean ± SD

5) Mann-Whitney U test

6) Single-parent family

Table 2 Anthropometric and clinical characteristics of the subjects

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD

3) Mann-Whitney U test

4) N (%)

5) Fisher's exact test

HAZ: Height for Age z-score

WAZ: Weight for Age z-score

BAZ: Body Mass Index for Age z-score

Table 3 Average intake of energy and nutrients

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, 3) Mann-Whitney U test

Table 4 Nutrition knowledge related to diabetes

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) N (%), 3) Fisher's exact test, 4) Mean ± SD, 5) Mann-Whitney U test

Table 5 Attitude toward diabetes-related dietary behaviors

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, Response categories used a 5-point Likert scale (High scores indicate strong agreement.).

3) Mann-Whitney U test

Table 6 Subjective norms toward diabetes-related dietary behaviors

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, Response categories used a 5-point Likert scale (High scores indicate strong agreement.).

3) Mann-Whitney U test, 4) Data multiplied Normative Belief by Motivation to Comply

Table 7 Perceived behavioral control toward diabetes-related dietary behaviors

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, Response categories used a 5-point Likert scale (High scores indicate strong agreement.).

3) Mann-Whitney U test

Table 8 Behavioral intention and dietary behaviors related to blood glucose control

1) Normal HbAlc level was defined as: 6 - 12 y < 8.0%, 13 - 19 y < 7.5% and > 19 y < 7.0%.

2) Mean ± SD, Response categories used a 5-point Likert scale (High scores indicate strong agreement.).