Assessing the dietary behaviours and food choices of type 2 diabetics in the Wa Municipality of Ghana

Early Abstract:

Introduction: Type 2 diabetes poses a growing global health challenge, with dietary behaviours and food choices playing a critical role in its management. This study assessed dietary practices, food preferences, and nutrition-related determinants among patients with type 2 diabetes in the Wa Municipality of Ghana, and further evaluated overall dietary behaviour using a dietary behaviour index derived from key dietary behavioural indicators. 
Methods: A cross-sectional survey was conducted among 208 adult respondents selected from diabetes clinics in the Municipality using structured interviewer-administered questionnaires and 24-hour dietary recalls. Descriptive statistics were used to summarize demographics, food-choice determinants, dietary practices, and 24-hour food-group consumption. A Total Dietary Behaviour Score was computed from ten dietary behaviour indicators, classified into a Dietary Behaviour Index. Independent samples t-tests and one-way ANOVA were used to examine differences in dietary behaviour scores across selected participant characteristics at a significance level of p < 0.05. 
Results: Most participants were female (69.2%), aged 45–64 years (49.0%), married (73.6%), had no family history of diabetes (48.1%), and had no formal education (39.4%). Major influences of food choices included food availability (79.8%), financial constraints (76.0%), appetite (71.6%), and nutrition advice from healthcare providers (72.1%). In the previous 24 hours, a high proportion of participants reported consuming meat, poultry, and fish (90.4%), whereas fewer reported consuming eggs (17.8%), other fruits (26.9%), and healthy fats (38.5%); 67.3% reported consuming trans-fat-containing foods. Participants had limited nutrition knowledge as 53.4% did not understand the glycemic index, 60.6% did not know which carbohydrates raise blood sugar levels, and 63.9% never read nutrition labels. Most participants indicated moderate dietary behaviour (65.4%), while 23.6% had good dietary behaviour and 11.1% had poor dietary behaviour. Total dietary behaviour scores were significantly associated with eating situation (p = .001), meal decision maker (p = .004), and nutrition labels use (p < .001), but not with gender (p = .070), religion (p = .254), or family history of diabetes (p = .112). Participants demonstrated predominantly moderate dietary behaviour, with important gaps in fruit intake, carbohydrate monitoring, application of glycemic knowledge, and nutrition label use.
Conclusions: Household food arrangements and nutrition literacy were found to be more strongly associated with healthier dietary behaviour than basic sociodemographic characteristics. Context-specific interventions that strengthen practical nutrition education, improve food label literacy, and support household-level dietary decision-making may improve diabetes dietary management in this setting.
Keywords: diabetes mellitus, glycemic control, insulin, obesity, Wa Municipality.