Fat- and fiber-related diet behavior among type 2 diabetes patients from distinct regions

Figures & data

Table 1 Cronbach’s α values of particular language versions of the questionnaire

Language version	Part of the questionnaire	Cronbach’s α value
Czech	Dietary fat intake (24 items)	0.772
	Dietary fiber intake (13 items)	0.484
English	Dietary fat intake (24 items)	0.749
	Dietary fiber intake (13 items)	0.466
Spanish	Dietary fat intake (24 items)	0.635
	Dietary fiber intake (13 items)	0.509
Arabic	Dietary fat intake (24 items)	0.662
	Dietary fiber intake (13 items)	0.461

Table 2 Basic characteristics of the study cohort

Characteristic	Full cohort (n=607; 49.1% men)	Czech Republic (n=200; 54.5% men)	US (n=207; 38.2% men)a	Yemen (n=200; 55% men)	P-value (Kruskal–Wallis test)
Age (years)	57.6±13.2	66.2±10.1	56.8±12.6	50.0±11.3	<0.001
Age at diabetes diagnosis (years)	48.2±12.6	54.4±10.9	45.3±12.7	45.1±11.7	<0.001
BMI (kg/m^2)	30.6±6.4	31.1±5.0	33.3±7.8	27.4±4.1	<0.001
Waist circumference (cm)	105.0±16.5	104.6±11.2	110.6±18.2	99.6±16.9	<0.001
DCCT A1C (%)	7.7±1.9	7.6±1.7	8.0±1.9	7.6±2.0	0.006

Notes: Data are mean ± SD.

a Multi-ethnic population was involved: 18.4% of Caucasian, 24.6% of Native Americans, 52.2% of Hispanics, and 4.8% of Asians.

Abbreviations: SD, standard deviation; BMI, body mass index; DCCT, Diabetes Control and Complications Trial; A1C, glycated hemoglobin.

Table 3 Characteristics of diabetes treatment in the study cohort

Type of diabetes treatment*	Full cohort (n=607; 49.1% men)	Czech Republic (n=200; 54.5% men)	US (n=207, 38.2% men)	Yemen (n=200; 55% men)	P-value (Kruskal–Wallis test)
Diet alone	8.4	5.1	9.7	10.5	<0.001
Oral antidiabetic drugs	62.0	63.6	48.8	74.0	<0.001
Insulin therapy	15.0	16.2	14.0	15.0	<0.001
Oral antidiabetic drugs + insulin therapy	14.5	15.2	27.5	0.5	<0.001
Mean number of antidiabetic drugsa	1.54	1.7	1.83	1.14	<0.001

Notes: Data are percentage.

* Statistically significant difference between countries (P<0.0001 according to the Kruskal–Wallis test).

a For combination drugs, each active ingredient is taken into account separately, as is each type of insulin used.

Table 4 Items and scales of the Fat- and Fiber-related Diet Behavior Questionnaire

How often did you…	Mean ± SD			Percentage of subjects reporting scores 1 and 2			P-value
Item/scale	Czech Republic	US	Yemen	Czech Republic	US	Yemen	Pearson χ^2	Other tests
Eat broiled, baked, or poached fish?	2.41±1.00	2.3±1.02	2.45±1.18	50.6	55.2	47.0	0.078
Eat broiled or baked chicken?	1.97±0.77	1.99±0.86	1.1±0.40	74.1	69.3	97.5	<0.0001r
Take the skin off chicken?	2.81±1.30	1.83±1.15	1.88±1.28	37.5	71.3	69.8	<0.0001
Eat pasta or noodles without meat?	2.57±0.80	2.8±1.00	2.79±1.25	46.6	33.5	33.0	<0.0001
Eat whole-wheat pasta or noodles?	3.51±0.73	3.41±0.93	4.00±0.00	10.9	14.9	0.0	<0.0001
Trim visible fat from red meat?	2.00±1.18	2.04±1.13	1.86±1.16	64.8	62.9	74.6	0.035
Eat extra lean ground meat?	2.59±1.14	2.12±1.08	3.94±0.41	49.4	59.8	1.9	<0.0001
Eat bread, rolls, or crackers without butter or margarine?	2.58±0.96	2.37±1.08	2.82±1.24	43.1	51.4	37.4	<0.0001
Eat whole grain types of bread, rolls, or crackers?	2.47±1.01	2.11±1.14	3.98±0.22	47.5	61.1	0.5	<0.0001
Eat high-fiber cereal or add dried fruit?	2.87±1.04	2.36±0.96	4.00±0.00	34.2	55.0	0.0	0.016	0.014e
Add bran or some type of fiber to cereal?	3.22±1.02	3.27±0.94	4.00±0.00	25.0	19.2	0.0	0.91	0.84e
Use low-fat or nonfat milk?	2.55±1.26	2.63±1.34	3.55±0.98	48.9	44.0	13.6	<0.0001
Eat specially made low-fat cheese?	2.43±1.04	3.24±1.10	4.0±0.00	50.3	21.9	0.0	<0.0001
Eat low-fat or nonfat frozen dessert?	3.10±0.96	2.94±1.00	3.68±0.70	23.1	28.6	7.9	0.001
Add butter, margarine, or other fat to cooked vegetables?a	2.30±1.08	2.27±1.16	2.69±1.26	34.8	40.0	57.5	<0.0001
Eat fried vegetables?a	1.53±0.66	1.38±0.76	1.02±0.22	5.7	8.1	0.5	<0.0001r
Eat fried potatoes?a	1.56±0.58	2.21±0.94	1.63±1.03	3.6	33.9	17.6	<0.0001
Add butter, margarine, or sour cream to potatoes?	2.47±1.08	2.93±1.04	1.00±0.00	51.5	27.7	100.0	<0.0001
Eat brown rice?	3.54±0.68	3.32±0.97	4±0	7.4	17.3	0.0	<0.0001
Eat salads without dressing?	2.40±1.19	2.95±1.12	2.46±1.46	51.9	29.5	50.8	<0.0001
Eat salads with low-fat or nonfat dressing?	2.57±1.20	2.69±1.25	4.00±0.00	48.4	39.3	0.0	<0.0001
Eat no meat, fish, eggs, or cheese at dinner?	2.99±0.85	3.23±0.80	2.95±1.16	24.7	15.5	33.0	<0.0001
Eat two or more vegetables at dinner?	2.77±0.77	2.60±0.92	1.70±1.04	39.1	42.0	79.0	<0.0001
Eat one or more vegetables at lunch?	2.49±0.77	2.54±0.96	2.99±0.84	45.8	45.9	19.7	<0.0001
Eat fresh fruit at breakfast?	3.57±0.65	2.75±0.99	3.9±0.40	7.9	36.3	2.6	<0.0001
Eat cereal or oats at breakfast?	3.79±0.52	2.51±1.06	3.97±0.30	4.2	48.0	1.0	<0.0001
Add cream or whipped cream to dessert?a	1.45±0.82	1.63±0.82	1.32±0.80	9.9	12.9	8.5	3.00E–4r
Eat only fruit for dessert?	2.70±0.89	2.61±0.93	3.45±0.90	38.5	40.2	13.3	<0.0001
Eat raw vegetables as a snack?	2.85±0.85	2.93±0.83	3.58±0.67	36.4	25.9	9.9	<0.0001
Eat fresh fruit as a snack?	2.49±0.81	2.44±0.9	3.46±0.67	48.7	47.1	9.9	<0.0001
Use olive oil when fry?	2.58±1.13	2.78±1.17	3.58±0.82	48.7	33.6	12.5	<0.0001
Trim visible fat from red meat before cooking?	2.02±1.19	2.06±1.17	1.83±1.13	65.3	62.1	76.0	0.083
Eat low-fat or nonfat mayonnaise?	2.90±1.09	3.09±1.08	3.63±0.74	32.7	25.0	12.5	0.315	0.355e
Use less fat when bake cookies or cakes?	2.75±1.16	3.18±0.9	3.61±0.86	35.4	20.3	13.2	<0.0001
Subscales*
Modify meat	2.30±0.69	2.05±0.67	1.82±0.67				<0.0001r	<0.0001K
Avoid fat as flavoring	2.09±0.49	2.24±0.56	1.91±0.54				<0.0001r	<0.0001K
Replace, meat	2.79±0.58	3.07±0.74	2.97±1.01				<0.0001r	<0.0001K
Substitute low fat	2.61±0.73	2.89±0.76	3.85±0.34				<0.0001r	<0.0001K
Replace, fruits and vegetables	2.71±0.67	2.66±0.72	3.47±0.71				<0.0001r	<0.0001K
Fruits and vegetables	2.86±0.49	2.64±0.60	2.98±0.47				<0.0001r	<0.0001K
Substitute high fiber	3.34±0.48	3.32±0.63	3.56±0.56				0.004r	<0.0001K
Cereals and grains	3.16±0.61	2.59±0.74	3.98±0.18				<0.0001r	<0.0001K
Main scales*
Fat-related diet habits summary scale	2.39±0.42	2.46±0.41	2.44±0.35				0.014r	0.115K
Fiber-related diet habits summary scale	3.06±0.39	2.79±0.44	3.39±0.29				<0.0001r	<0.0001K

Notes:

a Reverse scoring (always – never =4–1).

r P-value after rebinning, the answers “always” and “usually” are associated with the same outcome.

e P-value of Fisher’s exact test.

K P-value of Kruskal–Wallis test.

* The percentage of subjects reporting scores 1 and 2 was not counted for the subscales and main scales.

Abbreviation: SD, standard deviation.