Mindful eating questionnaire: Validation and reliability in Brazilian adults with type 2 diabetes mellitus.

OBJECTIVE: The objective was to evaluate the psychometric properties of the Mindful Eating Questionnaire (MEQ) in Brazilian subjects with type 2 diabetes mellitus (T2DM) and validate a Brazilian version of the MEQ for adults with T2DM (MEQ-DM). METHODOLOGY: Baseline data from the multicentre Nutritional Strategy for Glycaemic Control in Patients with Type 2 Diabetes Mellitus (NUGLIC) trial were used. Construct validity was assessed using exploratory factor analysis (EFA). The root mean square error of approximation (RMSEA), comparative fit index (CFI) and Tucker‒Lewis index (TLI) fit indices indicated the adequacy of the model. The reliability of the questionnaire was evaluated considering the different factor loadings. Criterion validity was tested by correlating the MEQ-DM with sociodemographic variables, body mass index (BMI) and physical activity levels. RESULTS: A total of 370 participants were included, who were mostly female (60.8 %) and had a median age of 61 (54-67) years. The EFA results supported the two-factor structure of the 25-item MEQ-DM: disinhibition and awareness. The results of the fit indices (RMSEA = 0.04; CFI = 0.95 and TLI = 0.94) and composite reliability (disinhibition = 0.84 and awareness = 0.81) were consistent. The criterion validity analysis indicated a significant association between MEQ-DM scores and age, sex, civil status, education level, BMI and physical activity (p < 0.05). CONCLUSION: When explored with Brazilian adults with T2DM, the MEQ-DM presented a factorial model with two dimensions: disinhibition and awareness. This model must be confirmed in future studies with Brazilians with T2DM.

Training adolescents with type 1 diabetes to carbohydrate counting without parents' help / Capacitação de adolescentes com diabetes tipo 1 para a contagem de carboidratos sem a ajuda dos pais

ABSTRACT Objective: To develop and evaluate the effectiveness of a nutrition education program to enable adolescents with type 1 diabetes to count carbohydrates without the parents' help. Methods: Nineteen adolescents with type 1 diabetes from a diabetes center participated in four fortnightly meetings of one hour, with lectures and discussions about healthy nutrition, importance of nutrients for blood glucose, portion sizes, food replacements, and carbohydrate counting therapy. All meetings ended with exercises to check the learning. Adolescents were followed for one year after the intervention. Results: All participants were 100% successful in all the steps of the program and started carbohydrate counting in the main meals. Nutritional status and total daily insulin doses before and after the study did not differ. After 12 months, 68% of the adolescents counted carbohydrates at all times, 16% did so in extra snacks, and 16% were suspended from the new therapy. Eighty percent of the parents were satisfied with the program, believing teenagers were trained in the new therapy. Conclusion: A short nutrition education program successfully trained adolescents to count carbohydrates without the parents' help.

RESUMO Objetivo: Desenvolver e avaliar a eficácia de um programa de educação nutricional para capacitar adolescentes com diabetes tipo 1 na contagem de carboidratos sem ajuda dos pais. Métodos: Dezenove adolescentes com diabetes tipo 1 de um centro de diabetes participaram de quatro encontros quinzenais de uma hora, com palestras e discussões sobre alimentação saudável, importância dos nutrientes na glicemia, tamanho das porções, substituições de alimentos e contagem de carboidratos. Todos os encontros foram finalizados com exercícios para verificar o aprendizado. Os adolescentes foram acompanhados por um ano após a intervenção. Resultados: Todos os pacientes tiveram 100% de sucesso em todas as etapas do programa e começaram a contagem de carboidratos nas refeições principais. Não houve diferença no estado nutricional e doses totais diárias de insulina antes e depois do estudo. Após 12 meses, 68% dos adolescentes contavam carboidratos em todas as refeições, 16% nos lanches extras, e 16% tinham interrompido a nova terapia. Oitenta por cento dos pais estavam satisfeitos com o programa e acreditavam que os adolescentes estavam capacitados para nova terapia. Conclusão: Após um programa de educação nutricional, de curta duração, foi possível capacitar adolescentes na contagem de carboidratos sem a presença constante dos pais.