Validation of dietary intake data in black women with type 2 diabetes.

The validity of baseline dietary intake data in women participating in a culturally competent intervention study for black women with type 2 diabetes was assessed. The relationship of sociodemographic and physiologic factors with underreporting of dietary intake was determined. Criterion validity of dietary intake, which had been assessed using the Nutritionist Five Collection Form, a combination of a standard 2-day dietary recall and a modified, culturally appropriate food frequency questionnaire, was determined. Data were analyzed using First Data Bank Nutritionist Five (version 2.3, 2000, First Data Bank, San Bruno, CA) software. Validation of baseline dietary data in 109 women was performed by calculating the ratio of energy intake to resting metabolic rate. Chi(2) and t tests were used to assess relationships between underreporting and sociodemographic and physiologic factors. Mean ratio of energy intake to resting metabolic rate was 1.46 (+/-0.4). Using a lower limit of 1.35, the prevalence of underreporting was 46.8%. Underreporting was significantly associated with body mass index (P< or =0.001) and waist circumference (P<0.001). Use of this combined dietary recall and modified food frequency questionnaire might, therefore, provide more accurate dietary assessment in this population. Additional modification and validity testing is warranted in this and other populations.

Barriers to medical nutrition therapy in black women with type 2 diabetes mellitus.

PURPOSE: The purpose of this study was to explore food purchasing, preparation, and consumption among black women with type 2 diabetes mellitus (T2DM) in an urban setting to assess barriers to medical nutrition therapy recommendations. METHODS: A telephone survey was developed to assess shopping habits, the use of community resources for food supplementation, use of restaurant/fast-food establishments, dining habits, food purchasing and consumption, and food preparation methods. This 38-item questionnaire provided both frequencies and trends regarding participants' dietary habits. RESULTS: Black women identified ways in which their participation in a culturally competent intervention of diabetes care and education helped them to change dietary behaviors. The most common areas of change included purchasing, preparation, and portion size. Barriers to medical nutrition therapy identified included low income, time constraints, competing demands, and knowledge deficits. CONCLUSIONS: Culturally sensitive diabetes interventions are an effective way to overcome some of the barriers to medical nutrition therapy. Feedback provided by this survey suggests that identification of more affordable healthy food resources in the community is necessary. In addition, access issues such as transportation to grocery stores should be on the agenda for public policy issues. Finally, alternate sites for nutrition education, such as a supermarket forum, warrant further investigation.

Coronary heart disease prevention and lifestyle interventions: cultural influences.

Unless action is directed to address the multiple influences on coronary heart disease (CHD) risk reduction behaviors, across all population groups, the aims of Healthy People 2010 with regard to CHD will not be realized. Health-promotion and disease-prevention models, including a framework for primordial, primary, and secondary prevention provided by an American Heart Association task force, and a model for interventions to eliminate health disparities are reviewed. The role of culture, ethnicity, race, and socioeconomic status and how these concepts have been studied in recent lifestyle interventions aimed at CHD risk reduction is explored. Finally, these findings are synthesized to provide suggestions for nursing care delivery in primary and tertiary care settings.