Thissection describes various studies on T2D in order to provide insight forconducting the study at hand. Diverse literatures relevant to the study havebeen reviewed so as to gather related information with significance to thestudy. It therefore provides concrete information on the role of healthydietary practices, relationship between diet and T2D, dietary recommendationsin diabetes conditions, enablers for compliance to recommended feedingbehaviors in diabetes as well as barriers to comply with the recommendedfeeding regime in the context of T2D. The section further describes the theoretical framework whichguides the study.2.0 The role of healthy dietarypracticesPeopleliving with type II diabetes should consider making access to healthy food apriority. Foods choices should considerfood sources that are lower in calorie and which have no or do not requireadditional sugar while also limit as much as possible the intake of saturatedfats. They should increase their intake of fruits and vegetables as they aregood sources of dietary fibres.
Compliance to a well balanced diet adjusted to meet the needs of adiabetic patients contribute inmaintaining an ideal body weight which further reduce the risk of developing other complications that would arise asa result of poorly managed diabetes. Restricting dietary practices especiallyin this population group is therefore one way to the reduction of symptoms orto the reversal of hyperglycaemia typical of type II diabetes1.2.1 Relationships between diet andtype II diabetesInthe past years, type II diabetes was highly observed among rich people who alsowere reported to have a significant excessive consumption of oil, flour andsugar. In the contrary, mortality ratesattributed to diabetes were less documented in populations experiencing foodshortage and famine for considerable duration7.
Today, rapidincrease in urbanization has led to a number of lifestyle changes which hasalso influenced feeding patterns among various population groups. Distancescovered from home and workplace coupled with heavy traffic roads makes itdifficult to access the food prepared athome all the time, which in this case would have been carefully selected andprepared to meet the individual’s requirement. The mushrooming of various fastfood places has replaced to a large extent the previously common family platesharing. It’s also regrettable that most of considerably cheap foods in suchplaces are high in fats and sugars not recommended for patients with T2D. While the disproportionate quantity and qualityof food consumed tend to worsen the wellbeing of T2D patients, the intake ofred meat, sweets and fried foods contribute to a large extent the resistance ofinsulin leading to many other complications among T2D patients. However,consumption of high fibre diet from vegetables and fruits has shown the delay indevelopment stages of T2D8.Excessiveintake of soft drinks has also been associated with obesity which is apredisposing factor to diabetes. Some of the ingredients used in themanufacturing process of such products contain a considerable large amount ofsugars which on consumption tend to raise blood glucose at levels which cannotbe well tolerated by the body systems9.
Glycated chemicals used in the production ofsoft drinks tend to impair the normal functioning of insulin leading toabnormal high levels of blood glucose, a major sign of diabetes disease. 2.3 Dietary practices and theirimplications towards type II diabetesStudieshave revealed that healthy dietary pattern acts as a primary treatment to typeII diabetes.
Following a health feeding regime contribute significantly to themaintenance of blood glucose levels within normal range while also minimizingthe complications of type II diabetes. It is therefore important that the primaryfocus for a T2D patient diet be able to meet the patient’s recommended dailyallowance by providing all essential nutrients, energy sources, maintaining anideal body weight, maintaining acceptable ranges of blood lipids as well asregulating the blood glucose levels within a normal range2.Maintainingan ideal body weight provides both preventive and curative majors to type IIdiabetes. A consistent intake of a well diversified diet comprising of vegetablesand fruits has shown to be one way an individual can maintain an ideal weight2.
It is therefore important that patients with diabetes consider reducingexcessive weight and aim at keeping their ideal weight sustainable. Followingfeeding instructions and carefully selecting when and what they eat also helpthem to stay much healthier by keeping blood glucose levels within normal rangefor longer periods. 2.4 Factors identified to enhancehealthy feeding Supportfrom relatives and friends plays an important role in achieving a nutritionalstable diet. The emotional influence gained from interactions from family andfriends, improves access to healthy feeding patterns and even adherence toother medical recommendations7. The general understanding of specialrequirement of a family member under special feeding needs bridges the gap thatwould be created if the patient would miss such support.7.
Further, education,social support and accessibility of community-based recreational and socialgatherings are the key promoters of a good health10. 2.5 Barriers to healthy feedingpractices2.5.1 Strict dietary plansFollowingstrict dietary plans requires a lot of modifications and adjustment which mayalso take time to be accommodated by an individual.
Patients with diabetes findit challenging to follow special feeding patterns as a result of perceivedchanges in food palatability resulting from cooking methods (boiling againstfrying) and ingredients which are added on not added to the food. Perceived lowself efficacy among patients tend to subject them into reflections that feedingrestrictions are less important and hence may tend to ignore them especially insituations where there is no health practitioner to witness. As such, followingdiet high in sodium or sugar instead of sweeteners is a common practice among diabeticpatients9.Limitedfood choices during social gatherings may occasionally dictate what patientseat. In such circumstances T2D patients may suffer a social distance resultingfrom either the fear of being tempted to eat foods they are forbidden to orwhat may be perceived among rest of members. Also in trying to cope withanxiety and stress which is common among this population group, over eatingbecomes a habitual practice which also creates a threat towards achieving adesired feeding pattern recommended to keep blood sugar levels as normal aspossible11. 2.5.
2 Changes in the lifestyleRealizingthat one has been diagnosed with a lifetime condition signals a number oflifetime adjustments in order for a patient to accommodate such changes.However, a loss in control may lead to crisis, requiring great moral strengthto hold the personality together. That freedom they had been used to in theprevious including feeding patterns have to be limited in order to maintain ahealth state possible. Keeping an eye for each serving before consumption aswell as taking precautions not to fall into an abnormal blood glucose levelsleads to feelings of frustrations 6. Coping with new feeding patternmay be perceived as a punishment among patients.
Uncertainties of what willhappen in the future and how family members feel about them brings more tensionand a sense of frustration. Among married couples feelings of frustration mayrise as result of sexual dysfunction leading to sexual disatsifaction12. 2.6 Theoretical frameworkThisstudy will use the Health Belief Model (HBM) which was developed for explaininghealth related behavior and possible reasons for non-compliance14.The theory stresses that health practice is an outcome of personal beliefs andperceptions about a health event and the mechanisms available to suppress theoccurrence.
The theory builds on four main constructs essentially used toexplain health behavior either at an individual or a combination of individualand surrounding environment. The framework applies on perceived seriousness,perceived susceptibility, perceived benefits and perceived barriers for healthaction with recommended action. Cues to action, motivating factors and selfefficacy have also been incorporated to the theory to effect on otherinfluences towards a health behavior. Modifying variables; culture, level ofeducation, past experience, skill and motivation were included to complementthe first four theoretical constructs which basically address individualcharacteristics.