ASSOCIATION BETWEEN KNOWLEDGE, ATTITUDE, AND PRACTICE ABOUT DIETARY FIBRE INTAKE AND TYPE 2 DIABETES AMONG RURAL PEOPLE IN TERENGGANU, MALAYSIA
DOI:
https://doi.org/10.37268/mjphm/vol.21/no.2/art.1039Keywords:
Dietary fibre intake, KAP, Family history, Awareness, Diabetes mellitusAbstract
Awareness of the dietary fibre intake (DF) and its importance in prevention and management of type 2 diabetes mellitus (T2DM) among rural people is seldom reported in Malaysia. This study aimed to determine the knowledge, attitude, and practice (KAP) of DF intake and their association with type 2 diabetes mellitus (T2DM) among rural people in Terengganu, Malaysia. A community-based cross-sectional study was carried out among the households in Kampung Jati, Kuala Nerus, Terengganu, Malaysia from 29th December 2019 until 20th February 2020. The village has 524 houses, the data was collected from all available and eligible subjects in each household by completed socio-demographic, validated KAP on DF intake questionnaire, as well as a 24-hour dietary recall using a self-administered questionnaire. In our study of 396 respondents, 208 (52.5%) were men. The mean age of participants was 37.85 (15.13). Most of the subjects were Malay 384 (97.0%), employed 207 (52.3%) and 274 (69.2%) attained high level of education (from tertiary school level). However, only 170 (42.9%) had a high family income which was of >RM 3860 per month. Out of 396 respondents, 157 (39.6%) of them had family history of diabetes mellitus. Respondents had moderate knowledge (39.1%), positive attitude (88.1%) and good practice (59.3%) scores towards DF intake. Among the respondents, only 39.1% of total respondents knew the nationally recommended amount of daily fibre intake which is of 20-30 grams per day. With multivariable analysis using multiple logistic regression, the analysis results revealed that age (adjusted OR: 1.11, 95% CI: 1.08, 1.15; p <0.001), having family history of T2DM (adjusted OR: 6.81, 95% CI: 2.75, 16.84; p <0.001) and having total attitude scores (adjusted OR: 0.84, 95% CI: 0.76, 0.93; p <0.001) were found to be adjusted significant associated factors of T2DM among the respondents after controlling confounders. Public health authorities should raise awareness on health benefit of consuming dietary fibre to promote an increase in consumption which can help in prevention and management of chronic diseases among rural population of Malaysia.
References
World Health Organization (WHO). Diabetes. 2010. http://www.who.int/dietphysicalactivity/ (accessed 23 May 2020).
Wild S, Roglic G, Green A, et al. Global Prevalence of Diabetes Estimates for the year 2000 and projections for 2030. Diabetes Care 2004. https://pubmed.ncbi.nlm.nih.gov/15111519/. (accessed 18 July 2020).
World Health Organization (WHO). Diabetes (Key facts), World Health Organization. 2020. https://www.who.int/news-room/fact-sheets/detail/diabetes (accessed 23 May 2020).
Letchuman GR, Nazaimoon WMW, Mohamad WBW, et al. prevalence of diabetes in the Malaysian National Health Morbidity Survey III 2006. Med J Malaysia 2010; 65(3):180-6.
Ministry of Health Malaysia. National Health and Morbidity Survey 2019: Technical Report- Volume 1: Non-Communicable Diseases: Risk Factors and other Health Problems. 2020. http://iku.moh.gov.my/images/IKU/Document/REPORT/NHMS2019/Report_NHMS2019-NCD_v2.pdf (accessed 19 December 2020).
Sazlina SG, Zailinawati AH, Zaiton A, Ong I. A clinical audit on diabetes care in two urban public primary care clinics in Malaysia. Malaysian Journal of Medicine and Health Sciences 2010;6(1):101–9.
Sherwani S, Khan H, Ekhzaimy A, Masood A, Sakharkar M. Significance of HbA1c Test in Diagnosis and Prognosis of Diabetic Patients. Biomark Insights 2016;11:95–104.
Chew BH, Mastura I, Lee PY, Wahyu TS, Cheong AT, Zaiton A. Ethnic Differences in Glycaemic Control and Complications: The Adult Diabetes Control and Management (ADCM), Malaysia. Med J Malaysia 2011; 66(3): 244–8.
McRae, MP. Dietary Fiber Intake and Type 2 Diabetes Mellitus: An Umbrella Review of Meta-analyses. J Chiropr Med 2018; 17(1):44–53.
Kuijsten A, Aune, D, Schulze M, et al. Dietary fibre and incidence of type 2 diabetes in eight European countries: the EPIC-InterAct Study and a meta-analysis of prospective studies. Diabetologia 2015;58(7):1394–408.
Schulze, MB, Schulz M, Heidemann C, et al. Fiber and magnesium intake and incidence of type 2 diabetes: A prospective study and meta-analysis. Arch Intern Med 2007; 167(9):956–65.
Dhingra D, Michael M, Rajput H, Patil RT. Dietary fibre in foods: A review. J Food Sci Technol 2012;49(3); 255–266.
Papathanasopoulos A, Camilleri M. Dietary Fiber Supplements: Effects in Obesity and Metabolic Syndrome and Relationship to Gastrointestinal Functions. Gastroenterology 2010; 1381(1):65-72, e1-2.
World Health Organization (WHO). Healthy diet. 2020. https://www.who.int/news-room/fact-sheets/detail/healthy-diet (accessed 12 August 2021).
Ministry of Health Malaysia (MOH). Malaysian Dietary Guidelines. 2010. https://nutrition.moh.gov.my/wp-content/uploads/penerbitan/buku/Malaysia Dietary Guidelines 2010.pdf (accessed 12 August 2021).
Ministry of Health Malaysia (MOH). Diabetes care performance report. 2016. https://www.researchgate.net/publication/277833167_A_Clinical_Audit_on_Diabetes_Care_in_Two_Urban_Public_Primary_Care_Clinics_in_Malaysia/link/55b772aa08aec0e5f4381d2b/download (accessed 24 July 2020).
Daud NM, Fadzil NI, Yan LK, Makbul IAA, Yahya NFS, Teh AH, et al. Knowledge, attitude and practice regarding dietary fibre intake among Malaysian rural and urban adolescents. Malays J Nutr 2018;24(1):77–88.
Dupont W, Plummer W. Power and Sample Size Calculations: A Review and Computer Program. Control Clin Trials 1990;11:116–28.
IBM Corp. IBM SPSS Statistics for WindowS. Armonk, NY: IBM Corp. 2013.
Hussein Z, Taher SW, Gilcharan Singh HK, Chee Siew Swee W. Diabetes Care in Malaysia: Problems, New Models, and Solutions. Ann Glob Heal 2015;81(6):851–62.
Harvard School of Public Health. Obesity Prevention Source. 2020. https://www.hsph.harvard.edu/obesity-prevention-source/obesity-and-urbanization/ (accessed 22 August 2021).
Michalski W, Miller R, Stevens B. Towards the creative society: 21st century social dynamics. Foresight 2000;2(1):85–94.
Ramawickrama J, Ratnayaka RM. The impact of employee benefits on job satisfaction. 2008. http://i-rep.emu.edu.tr:8080/xmlui/handle/11129/1658 (accessed 22 August 2021).
Borhanuddin B, Ahmad N, Shah SA, Murad NAA, Zakaria SZS, Kamaruddin MA, et al. Association of job sectors with type 2 diabetes mellitus, hypercholesterolemia and obesity: a cross-sectional study from the Malaysian Cohort (TMC) project. Int Health 2018;10(5):382.
Lee YY, Muda WAMW. Dietary intakes and obesity of malaysian adults. Nutr Res Pract 2019;13(2):159–68.
Ministry of Education Malaysia. Malaysia Education Blueprint 2015-2025 (Higher Education). 2015 https://www.um.edu.my/docs/um-magazine/4-executive-summary-pppm-2015-2025.pdf (accessed 22 August 2021).
Carraccio C, Englander R, Melle E, Cate O, Lockyer J, Chan M, et al. Advancing Competency-Based Medical Education: A Charter for Clinician-Educators. Acad Med 2016;91(5):645–9.
Rose T, Barker M, Jacob C, Morrison L, Lawrence W, Strömmer S, et al. A systematic review of digital interventions for improving the dietand physical activity behaviours of adolescents. J Adolesc Health 2017; 61(6):669.
Stogios N, Kaur B, Huszti E, Vasanthan J, Nolan R. Advancing Digital Health Interventions as a Clinically Applied Science for Blood Pressure Reduction: A Systematic Review and Meta-analysis. Can J Cardiol 2020;36(5):764–74.
Guldbrand H, Lindström T, Dizdar B, Bunjaku B, Östgren C, Nystrom F, et al. Randomization to a low-carbohydrate diet advice improves health related quality of life compared with a low-fat diet at similar weight-loss in Type 2 diabetes mellitus. Diabetes Res Clin Pract 2014;106(2):221–7.