Confirmatory Factor Analysis Derived Dietary Patterns and Its Relationship with Glycemic Control in Type 2 Diabetic Patients in Semnan, 2023

1Clinical Research Development Unit, Kowsar Educational, Research and Therapeutic Hospital, Department of Internal Medicine, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran

2Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran

3Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran

4Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran

Koomesh:Vol. 26, issue 2; e149334

Published online:Nov 05, 2024

Article type:Research Article

How to Cite:Doustmohamadian S, Babazadeh Z, Ghorbani R, Amini M, Rasekhi H, et al. Confirmatory Factor Analysis Derived Dietary Patterns and Its Relationship with Glycemic Control in Type 2 Diabetic Patients in Semnan, 2023.koomesh.2024;26(2):e149334.https://doi.org/10.69107/koomesh-149334.

Abstract

Background: Dietary modifications remain the mainstay in managing type 2 diabetes mellitus (T2DM).

Objectives: The present study aims to extract the dietary patterns and investigate their association with abnormal glycemic control determined by elevated glycated hemoglobin (HbA1c) levels.

Methods: In this cross-sectional study, data from 180 adult patients (≥ 18 years) with T2DM who were referred to the endocrinology clinic of Kowsar Hospital of Semnan (68.9% males) in 2023 were analyzed. Usual dietary intake was assessed by a validated dish-based semi-quantitative food frequency questionnaire (FFQ). We classified major dietary patterns by explanatory factor analysis (EFA) and confirmatory factor analysis (CFA). The adjusted OR and 95% CI for abnormal glycemic control (based on the HBA1c levels ≥ 7%) were estimated using multiple logistic regression.

Results: Three major dietary patterns, including unhealthy characterized by high consumption of fast foods, processed meats, salty snacks, high-fat dairy products, and grains-vegetables dietary pattern comprised of nuts, coffee, pickles/lemon juices, and vegetables/vegetable juices, and mixed dietary patterns, characterized by high frequent consumption of salt, oils, legumes, red and organ meats, potatoes, white meats, and refined grains. The result of CFA indicated acceptable good data fit of the dietary patterns) χ2/df = 3.11, GFI = 0.901, AGFI = 0.890, CFI = 0.921, IFI = 0.910, SRMR = 0.080, RMSEA = 0.090. In the multiple-adjusted model, adult patients who adhere to the unhealthy dietary pattern were more affected by abnormal glycemic control risk (3rd vs. 1st tertile: OR = 9.36; 95% CI = 2.70 - 32.41, Ptrend = 0.002). Patients who adhere to the mixed dietary pattern were also more affected by abnormal glycemic control risk (3rd vs. 1st tertile: OR = 14.69; 95% CI = 1.46 - 147.32, Ptrend = 0.003). However, the odds ratio trend was insignificant in the grains-vegetables dietary pattern.

Conclusions: Our findings suggest that unhealthy and mixed dietary patterns are associated with an increased prevalence of elevated HbA1c levels among T2DM patients. However, future longitudinal studies are required to confirm the integrity of our findings.

Keywords

Type 2 Diabetes Mellitus

Factor Analysis

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Author(s):

Soraya Doustmohamadian:[PubMed][Scholar]
Zohreh Babazadeh:[PubMed][Scholar]
Raheb Ghorbani:[PubMed][Scholar]
Maryam Amini:[PubMed][Scholar]
Hamid Rasekhi:[PubMed][Scholar]
Azam Doustmohammadian:[PubMed][Scholar]