Intention and Perceptions of Healthy Eating versus Actual Intake Among Patients with Type 1 and Type 2 Diabetes and the General Population

Figures & data

Table 1 Background Characteristics

Characteristics	Patients with T1D (n = 426)	Patients with T2D (n = 348)	General Population (n = 2899)
Gender (F/M), % (n)	49/51 (209/217)	29/71 (101/247)	52/48 (1507/1392)
Age, years	53 (41–64)	66 (58–71)	48 (35–60)
BMI, kg/m^2	25.0 (22.7–27.6)	29.2 (26.5–33.3)	25.6 (23.1–28.6)
Diabetes duration, years	26 (14–39)	15 (9–21)	–
Smokers, % (n)	13.6 (58)	11.2 (39)	20.8 (603)
Physical activity
Low activity, % (n)	18.3 (77)	39.4 (136)	32.9 (895)
Moderate activity, % (n)	42.9 (180)	36.5 (126)	25.2 (684)
High activity, % (n)	38.8 (163)	24.1 (83)	41.9 (1141)
Education
No further education, % (n)	13.1 (56)	11.2 (39)	22.5 (652)
Vocational education, % (n)^a	20.0 (85)	26.4 (92)	38.0 (1101)
Short further education, % (n)	12.3 (52)	7.2 (25)	7.4 (213)
Medium further education, % (n)	26.7 (114)	26.2 (91)	20.3 (589)
Long further education, % (n)	23.9 (102)	15.2 (53)	11.8 (342)
Unspecified education, % (n)	4.0 (17)	13.8 (48)	0 (0)
Occupation
Employed, n (%)	57.0 (243)	34.7 (121)	61.4 (1776)
Unemployed, n (%)	4.0 (17)	1.7 (6)	3.8 (111)
Pensioner, n (%)^b	27.3 (116)	56.4 (196)	21.2 (613)
Other, n (%)^c	11.7 (50)	7.2 (25)	13.6 (395)
Cohabitation
Living with partner/spouse	71.3 (304)	66.4 (231)	72.4 (2096)

Notes: Adapted from Nutrition, 61, Ewers B, Trolle E, Jacobsen SS. et al. Dietary habits and adherence to dietary recommendations in patients with type 1 and type 2 diabetes compared with the general population in Denmark. 49–55, Copyright (2019), with permission from Elsevier⁸ and data on occupation and cohabitation have been added in this version. ^aSkilled worker, office worker, crafts education; ^bDisability and old age pensioner; ^cSeeking education, student, housewife/-husband, on long-term sick leave or unspecified. Data are presented as medians and interquartile range (25th to 75th percentiles) or percentages and numbers.

Abbreviations: T1D, type 1 diabetes; T2D, type 2 diabetes; BMI, body mass index.

Table 2 Self-Assessment of Dietary Habits in Patients with T1D and T2D

	“How Do You Consider Your Dietary Habits?”
	T1D n = 426	T2D n = 348	All n = 774
Answers	% (n)	% (n)	% (n)
Very unhealthy	0 (0)	0 (0)	0 (0)
Unhealthy	2 (9)	3 (11)	3 (20)
Neither healthy nor unhealthy	23 (98)	40 (138)	30 (236)
Healthy	67 (286)	51 (178)	60 (464)
Very healthy	8 (33)	6 (21)	7 (54)
Variables	OR	95% CI	P
Groups
T1D (reference)	1	–	–
T2D	0.41	0.29–0.57	<0.0001
Gender
Men (reference)	1	–	–
Women	1.49	1.10–2.03	0.011
Age	1.02	1.01–1.03	0.001
Education^a
No further education (reference)	1	–	–
Vocational education	1.22	0.72–2.08	0.463
Short further education	0.92	0.50–1.72	0.798
Medium further education	1.34	0.79–2.25	0.273
Long further education	2.01	1.16–3.48	0.012
Unspecified education	1.75	0.90–3.42	0.098

Notes: Frequencies of answers are presented together with odds ratios (OR) and p-values for an ordinal logistic regression model adjusted for age, gender and education. ^ap = 0.037 for education examined with an ANOVA likelihood ratio tests of the ordinal regression models with and without adjustment for education.

Abbreviations: OR, odds ratio;T1D, type 1 diabetes; T2D, type 2 diabetes.

Table 3 Distribution of Macronutrients and Healthy Food Groups in Patients with T1D and T2D Who Assess Their Dietary Habits to Be “Neither Healthy nor Unhealthy” or “Healthy and Very Healthy”

Variables	“How Do You Consider Your Dietary Habits?”
	T1D (n = 417)			T2D (n = 337)
	Less Healthy Eaters “Neither Healthy nor Unhealthy” (n = 98)	Healthy Eaters “Healthy” and “Very Healthy” (n = 319)	P^a	Less Healthy Eaters “Neither Healthy nor Unhealthy” (n = 138)	Healthy Eaters “Healthy” and “Very Healthy” (n = 199)	P^a
Age, year	48 (34–58)	56 (45–65)	0.0001	67 (61–70)	66 (58–71)	0.603
Gender (F/M), %	48/52	49/51	0.908	19/81	36/64	0.001
Education (high/low)^b, %	32/68	57/43	0.0001	41/59	40/60	0.822
Carbohydrates, E%	45.0 (40.9–49.3)	45.2 (41.3–49.3)	0.865	46.5 (42.0–50.8)	45.7 (40.5–49.0)	0.056
Added sugar, E%	3.8 (2.4–5.4)	3.1 (1.8–4.7)	0.005	3.3 (2.2–5.2)	3.1 (1.7–5.0)	0.293
Dietary fibre, g/d	19.9 (15.0–27.5)	24.7 (17.6–33.8)	0.001	20.1 (14.7–26.6)	22.0 (16.9–31.7)	0.021
Dietary fibre, g/10MJ	27.7 (21.9–35.3)	31.5 (26.1–37.6)	0.001	28.0 (22.5–33.7)	31.1 (25.3–37.7)	0.001
Fat, E%	38.7 (34.7–42.6)	37.4 (33.9–41.5)	0.135	36.0 (32.4–40.6)	36.9 (33.1–41.2)	0.185
SFA, E%	13.5 (11.7–15.4)	13.0 (11.3–14.8)	0.137	13.4 (11.1–15.0)	13.3 (11.3–15.3)	0.798
MUFA, E%	14.7 (12.9–17.1)	14.7 (12.8–16.9)	0.710	13.6 (11.7–15.8)	14.2 (12.2–16.2)	0.114
PUFA, E%	6.7 (5.8–7.8)	6.8 (5.8–8.0)	0.552	6.3 (5.6–7.4)	6.6 (5.5–7.5)	0.434
Proteins, E%	16.5 (15.6–18.0)	17.0 (15.8–19.1)	0.026	17.1 (15.7–18.6)	17.6 (16.0–19.8)	0.036
Alcohol, g/d	4.8 (1.3–11.6)	8.0 (2.6–15.8)	0.014	3.7 (1.0–11.8)	4.5 (1.1–13.0)	0.418
Vegetables, g/d	192 (120–290)	298 (187–444)	0.0001	185 (109–268)	276 (168–432)	0.0001
Vegetables, g/10MJ	264 (167–403)	382 (247–566)	0.0001	227 (157–337)	369 (235–553)	0.0001
Fruit, g/d	76 (39–126)	116 (64–231)	0.001	92 (148–178)	108 (68–217)	0.035
Fruit, g/10MJ	101 (57–176)	145 (78–252)	0.0001	122 (69–243)	157 (82–257)	0.054
Fish, g/week	141 (78–244)	216 (119–316)	0.0001	173 (106–293)	228 (127–336)	0.006

Notes: Energy percentages for carbohydrates, added sugar, fat, SFA, MUFA, PUFA and proteins are calculated without alcohol. Data are medians and interquartile range (25th to 75th percentiles) or percentages. ^aNonparametric Mann Whitney U-test used to test for differences between two independent groups less healthy eaters versus healthy eaters in T1D and T2D respectively. ^bEducation presented as a binary variable in percentages. High education defined as medium- or long-cycle further education. Low education defined as short/vocational/other or no education.

Abbreviations: E%, percentage of energy; MUFA, monounsaturated fatty acid; PUFA, polyunsaturated fatty acid; SFA, saturated fatty acid;T1D, type 1 diabetes; T2D, type 2 diabetes.

Table 4 Perceived Healthy Diet Characteristics in Patients with Diabetes and General Population

	”What Do You Consider a Healthy Diet?”
	T2D n = 426	T2D n = 348	General Population n = 2897	P
Response categories^a	% (n)	% (n)	% (n)	–
Dietary variety	15.4 (185)	13.8 (135)	12.7 (951)	<0.0001
Home cooked	4.8 (58)	7.1 (69)	3.9 (289)	0.0018
Fresh foods/ingredients	9.8 (118)	8.8 (86)	8.0 (601)	0.1331
Organic	2.1 (25)	2.7 (26)	3.7 (280)	0.0020
Sustainable	0.2 (3)	0.4 (4)	0.3 (23)	0.9004
Low in fat	14.5 (175)	16.6 (162)	17.1 (1280)	0.3287
High in dietary fibre	13.0 (157)	11.6 (113)	6.1 (457)	<0.0001
High in wholegrain foods	5.7 (69)	5.9 (58)	2.5 (188)	<0.0001
Includes whole meal bread eg ryebread	3.2 (38)	2.6 (25)	2.0 (148)	0.0041
High in vegetables	16.8 (202)	14.9 (145)	26.0 (1944)	<0.0001
High in fruit	0.4 (5)	0.6 (6)	4.4 (333)	<0.0001
Includes proteins, vitamins and minerals	3.5 (42)	1.6 (16)	6.0 (449)	0.0001
Includes lean meat	3.7 (44)	4.2 (41)	2.6 (194)	0.0124
High in fish	3.7 (44)	3.8 (37)	3.3 (248)	0.5149
Low in added sugar	3.3 (40)	5.3 (52)	1.3 (101)	<0.0001
Total number of responses, % (n)	100 (1205)	100 (975)	100 (7486)	–

Notes: Binary logistic regression model adjusted for age, gender, education and group for each response category separately. Percentages have been calculated using numbers of responses for each group and each response category divided with total number of responses for each group separately. ^aUp to three responses were allowed.

Abbreviations: T1D, type 1 diabetes; T2D, type 2 diabetes.

Table 5 Effort to Eat Healthily in Patients with Diabetes and the General Population

	”Do You Aim to Eat Healthily Every Day?”
	T1D N = 426	T2D n = 348	General Population n = 2897
Answers	% (n)	% (n)	% (n)
Yes, very often	23 (96)	15 (52)	35 (1020)
Yes, often	58 (247)	54 (189)	44 (1279)
Occasionally	16 (70)	28 (97)	16 (471)
No never	2 (10)	2 (6)	4 (124)
Do not know^a	1 (3)	1 (4)	0 (3)
Variables	OR	95% CI	P
Groups
T1D (reference)	1	–	–
T2D	1.66	1.26–2.17	0.0003
General population	0.62	0.51–0.75	<0.0001
Gender
Men (reference)	1	–	–
Women	0.40	0.35–0.45	<0.0001
Age	0.98	0.98–0.99	<0.0001
Education^b
No further education (reference)	1	–	–
Vocational education	0.79	0.66–0.95	0.018
Short further education	0.71	0.55–0.92	0.009
Medium further education	0.54	0.44–0.65	<0.0001
Long further education	0.44	0.35–0.55	0.000
Unspecified education	0.56	0.34–0.91	0.020

Notes: Frequencies of answers are presented together with OR and p-values for an ordinal logistic regression model adjusted for age, gender and education. OR and p presented. ^aNot included in the ordinal regression analyses. ^bp<0.0001 for education examined with an ANOVA likelihood ratio tests of the ordinal regression models with and without adjustment for education.

Abbreviations: OR, odds ratio; T1D, type 1 diabetes; T2D, type 2 diabetes.

Ewers B, Trolle E, Jacobsen SS, et al. Dietary habits and adherence to dietary recommendations in patients with type 1 and type 2 diabetes compared with the general population in Denmark. Nutrition. 2019;61:49–55. doi:10.1016/j.nut.2018.10.021

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