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CONTEXT: Diet quality is directly related to glycemic control in individuals with type 2 diabetes mellitus (T2DM). The use of dietary indices can provide a comprehensive understanding of the relationship between diet quality and clinical outcomes. OBJECTIVE: The aim was to evaluate the relationship between diet quality, measured using dietary indices, and its impact on improving glycemic control in individuals with T2DM through health interventions. DATA SOURCE: This study was conducted using 6 databases, including Web of Science, MEDLINE (via PubMed), Embase, Bireme, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as the gray literature (Google Academic). DATA EXTRACTION: Randomized clinical trials that evaluated the effectiveness of health interventions in adult and older adult individuals with T2DM and presented data on diet quality evaluated using dietary indices and the percentage of glycated hemoglobin (%HbA1c) were included. DATA ANALYSIS: A total of 3735 articles were retrieved, 4 of which were included in the study selection stages. The quality indices assessed in the studies were the Alternate Healthy Eating Index (AHEI), Healthy Eating Index-2010 (HEI-2010), Diet Quality Index-International (DQI-I), and Diet Quality Index-Revised (DQI-R). A reduction in %HbA1c was observed in 2 studies, which correlated with the AHEI and DQI-I scores in the intervention groups. The approach of using food labels to improve diet quality reduced %HbA1c by 0.08% in the intervention group compared with the control group. Only 1 study found no significant association between the DQI-R index and %HbA1c. Additionally, negative correlations were observed between body weight and the AHEI and DQI-I scores. CONCLUSION: Health interventions improved diet quality, glycemic control, and weight loss in individuals with T2DM. SYSTEMATIC REVIEW REGISTRATION: PROSPERO no. CRD42023430036.
RESUMO
This study aimed to validate a food frequency questionnaire for foods high in sodium (FFQ-FHS) in a population aged ≥18 years and to test its reproducibility. This cross-sectional study included 50 individuals (≥18 years) of both sexes. In addition to the FFQ-FHS, four 24-h dietary recalls (24hRs) were conducted and a socioeconomic and lifestyle questionnaire was administered. Two 24-h urinary excretions were collected for sodium analysis, and anthropometry was performed. For validation, the triad method was applied using the validity coefficient (ρ). For reproducibility, the intraclass correlation coefficient (ICC), 95% confidence interval, kappa coefficient, and Bland-Altman plots were used to check for agreement. The Kolmogorov-Smirnov test was used to verify the data distribution. The validity coefficients for daily energy-adjusted sodium intake were high for the 24hR (ρRAI = 0.85) and weak for the FFQ-FHS (FFQAI = 0.26) and biomarker (ρBAI = 0.20). The ICC values were 0.68 for unadjusted sodium and 0.54 for energy-adjusted sodium intake. The weighed Kappa scores were 0.49 (p<0.01) and 0.260 (p = 0.02) for unadjusted and adjusted sodium intake, respectively. Although the FFQ-FHS is reproducible, it is not valid for the assessment of sodium intake and cannot be the sole instrument used for this purpose.