Food for Thought: Do People Who Know They Have Diabetes Eat Healthier Than Those Who Do Not Know?
What to Know
Eating a healthy diet can be difficult, whether or not you have diabetes. But does having diabetes motivate people to follow a healthy eating plan? The authors of this study investigated whether people with diabetes or prediabetes eat differently from those who don’t know whether they have the disease. They also wanted to learn more about how well people with diabetes follow healthy-eating guidelines and whether those who have visited a diabetes educator or registered dietitian (RD) eat a healthier diet than those who have not.
A total of 3,725 adults with diabetes or prediabetes participated in the study. Each participant listed everything they had eaten in the past 24 hours and took a fasting blood glucose test. The researchers asked them whether they knew their diabetes status and whether they had consulted a diabetes educator or an RD regarding their diet. The researchers compared the eating habits of participants who knew their diabetes status with those who did not. They also looked at whether those who had seen an educator or an RD had better eating habits.
Men and women who knew they had diabetes ate less sugar and more protein than those who did not know. Such men also ate fewer carbohydrates. Knowing one’s prediabetes status did not impact eating habits. Overall, the participants ate less fiber and more saturated ("bad") fat than dietary guidelines recommend. Those who had seen a diabetes educator or RD within the past year ate fewer calories than those who had had such a visit more than a year ago or never. Those with recent diabetes education ate less protein, fat, and cholesterol than those who had had diabetes education in the more distant past.
When people know they have diabetes, they may be more likely to change at least some of their eating habits, like reducing sugar and carbohydrates. The same does not appear true for people who know they have prediabetes. Health care providers need to do more to help people with prediabetes understand the importance of healthy eating. Nutrition education helps people with diabetes improve their eating habits, especially when done right away after diagnosis and then annually. The participants shared their own information about what they ate and their visits with educators or RDs, which may not have been completely accurate and could have affected the results.
Does knowing one’s elevated glycemic status make a difference in macronutrient intake? By Bardenheier and colleagues. Diabetes Care 2014;37:3143–3149 https://doi.org/10.2337/dc14-1342