Changes in dietary intake improve glycemic control following a structured nutrition therapy during Ramadan in individuals with type 2 diabetes

Barakatun-Nisak Mohd Yusof; Farah Yasmin Hasbullah; Aainaa Syarfa Mohd Shahar; Noraida Omar; Zalina Abu Zaid; Firdaus Mukhtar; Rachel Xin Yi Liu; Agnieszka Marczewska; Osama Hamdy

doi:10.1016/j.clnesp.2021.09.738

Changes in dietary intake improve glycemic control following a structured nutrition therapy during Ramadan in individuals with type 2 diabetes

Clin Nutr ESPEN. 2021 Dec:46:314-324. doi: 10.1016/j.clnesp.2021.09.738. Epub 2021 Sep 30.

Authors

Barakatun-Nisak Mohd Yusof¹, Farah Yasmin Hasbullah², Aainaa Syarfa Mohd Shahar³, Noraida Omar², Zalina Abu Zaid², Firdaus Mukhtar⁴, Rachel Xin Yi Liu⁵, Agnieszka Marczewska⁶, Osama Hamdy⁷

Affiliations

¹ Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; Research Centre of Excellence, Nutrition and Non-Communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; Institute for Social Science Studies, Universiti Putra Malaysia, Serdang, Selangor, Malaysia. Electronic address: bnisak@upm.edu.my.
² Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
³ Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
⁴ Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
⁵ Nestlé Health Science, Petaling Jaya, Malaysia.
⁶ Nestlé Health Science, Vevey, Switzerland.
⁷ Joslin Diabetes Centre, Harvard Medical School, Massachusetts, USA.

PMID: 34857213
DOI: 10.1016/j.clnesp.2021.09.738

Abstract

Background and aims: It is unknown whether dietary modifications during Ramadan could influence glycemic control in diabetes. This study assessed dietary intake following structured Ramadan nutrition therapy and determined the association between changes in dietary intake and glycemic control parameters in patients with type 2 diabetes.

Methods: This was an 8-week, parallel-group, non-randomised study of 60 type 2 diabetes patients who opted for structured Ramadan Nutrition Therapy (sRNT; n = 38) or standard care (SC; n = 22) group. The sRNT group received a structured Ramadan Nutrition Plan incorporated with diabetes-specific formula throughout the study, while SC received standard nutrition care. The 3-day food records assessed dietary intake at three-time points.

Results: At baseline, dietary characteristics were comparable; both groups had macronutrient intakes within the recommended range, but inadequate intakes of fiber and 11 essential micronutrients. After 8 weeks, the sRNT group significantly reduced intakes of carbohydrate, dietary glycemic index, glycemic load, and increased percentage of total energy intake from protein, fiber, pyridoxine, vitamin C, vitamin D, calcium, and chromium compared with the SC group. In the sRNT group, compliance to diabetes-specific formula predicted changes in HbA1c (p = 0.024), while fiber intake predicted fasting plasma glucose (p = 0.035), after adjusting for age, sex, weight changes and other dietary variables.

Conclusion: Intakes of certain nutrients improved significantly in sRNT group after 8 weeks of receiving a structured Ramadan Nutrition Plan compared to the standard care. The structured Ramadan Nutrition Plan with the incorporation of diabetes-specific formula significantly improved glycemic control and dietary adequacy during Ramadan fasting.

Keywords: Dietary intake; Glycemic index; Ramadan fasting; Ramadan nutrition plan; Type 2 diabetes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Blood Glucose
Diabetes Mellitus, Type 2* / therapy
Eating
Glycemic Control
Humans
Nutrition Therapy*

Substances

Blood Glucose