People with multiple chronic conditions more likely to stick to healthier diets

People suffering from at least two chronic conditions seem to keep better diets, according to a recent Singapore study. The same is true for older individuals, women, and those of Indian descent.

“Given that individuals who are younger and healthy at present tended to have lower Dietary Approaches to Stop Hypertension (DASH) scores, it is critical that efforts are directed towards monitoring less-than-ideal dietary practices given its significance towards the development of chronic conditions,” the researchers said.

Drawing from the 2019–2020 Knowledge, Attitudes, and Practices study on diabetes in Singapore, data from 2,895 residents (aged ≥18 years, 51.55 percent women) were included in the present analysis. Diet quality was measured using the DASH screener, while the World Mental Health Composite International Diagnostic Interview version 3.0 was used for the assessment of chronic conditions.

Linear regression analysis showed that compared with participants aged 18–34 years, those aged 35–49 years had significantly better DASH scores (B, 1.78, 95 percent confidence interval [CI], 1.23–2.33; p<0.001). A similar effect was reported for participants aged 50–64 years (B, 2.86, 95 percent CI, 2.24–3.47; p<0.001) and ≥65 years (B, 3.45, 95 percent CI, 2.73–4.17; p<0.001), underlining the direct correlation between age and diet quality. [Arch Public Health 2022;80:62]

Moreover, Indians showed significantly higher DASH scores than Chinese counterparts (B, 2.54, 95 percent CI, 2.09–2.98; p<0.001), while men kept worse diets than women (B, –1.50, 95 percent CI, –1.87 to –1.14; p<0.001). Education likewise correlated with diet quality, with DASH scores being significantly lower among less vs more educated participants.

Nearly half (46.2 percent) of the participants had no chronic condition, while 26.3 percent and 27.2 percent reported 1 and ≥2 chronic conditions, respectively. Diet quality was worst among participants without chronic conditions, with the mean DASH score increasing progressively with the number of conditions (18.54 to 19.19 and 19.75, respectively).

Further dividing patient subgroups according to the number of chronic conditions did not meaningfully alter the principal findings. For example, men without, with 1, and with ≥2 chronic conditions continued to show significantly lower mean DASH scores than women. Similarly, Indians without, with 1, and with ≥2 such conditions kept better diets than Chinese counterparts.

“Overall, people with multiple chronic conditions had demonstrated better dietary practices in terms of number of servings taken per day for the DASH components. In the Singapore [context], this could be attributed to various initiatives and support received from primary care providers,” the researchers said, pointing to initiatives such as the Healthier Dining and Chronic Disease Management Programmes.

“Information obtained from the present study may provide certain insights to international counterparts pertaining to the effectiveness of diet related policies and initiatives in Singapore. Such information may be useful in aiding policymakers with modifying or forming new polices to better suit their respective population,” they added.