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Noh, Nam, Kang, Lee, and Lee: Nutrition Knowledge, Dietary Attitude, and Dietary Behavior among Children and Adolescents with Type 1 Diabetes
Original Article
Korean Journal of Community Nutrition

Korean Journal of Community Nutrition 2013; 18(2): 101-111.

Published online: 30 April 2013

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

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

Na-Yeon Noh, So-Young Nam, Hee-Suk Kang1, Ji-Eun Lee2, Soo-Kyung Lee

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 3 January 2013       Revised 15 March 2013       Accepted 1 April 2013

Copyright © 2013 The Korean Society of Community Nutrition

(open-access):

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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

Figures and Tables

Table 1
General characteristics of the subjects
kjcn-18-101-i001

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
kjcn-18-101-i002

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
kjcn-18-101-i003

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
kjcn-18-101-i004

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
kjcn-18-101-i005

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
kjcn-18-101-i006

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
kjcn-18-101-i007

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
kjcn-18-101-i008

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
kjcn-18-101-i009

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

Notes

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

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