CHSU Discovery

Abstract

Through the increased consumption of fruits and vegetables with low caloric value and rich in nutrients, the Mediterranean diet allows for greater consumption quantities promoting long term adherence to a healthy dietary pattern and adequate nutrition without vitamin supplementation.(1) The Mediterranean diet provides guidelines aligning with the dietary needs of Type 1 diabetes patients, making it an easily referenced standard for healthy nutrition.(2) Furthermore, in a study of Diabetic and prediabetic patients following the Mediterranean diet, it was found to not only have a greater degree of glycemic control, but improved control over cardiovascular risk factors, although adherence to the diet was a limitation. (3) In a recent study from 2015, researchers used an intervention based style to study adherence, finding that after three months, the patients in the intervention group had better scores in their diet quality and exhibited greater adherence to the Mediterranean diet. (4) Additionally, specifically in the Fresno area, a study found that 45% of participants were food insecure, with 34% experiencing food insecurity without hunger while the remaining 11% were food insecure with hunger. Income was the most significant predictor of food insecurity in these groups.(5) Overall, it can be inferred that even with the availability of fresh produce meeting the Mediterranean diet standards, income is a primary determinant in obtaining access to these foods. Access, secondary to income, ultimately limits adherence to a diet. Other factors include social determinants of health, which have been found to have impacts on nonadherence to recommended routine examinations as well as medication costs in diabetic patients. Given this information, it is important to include questions related to social determinants of health in the survey with Mediterranean diet adherence, as they have been shown to correlate with other aspects of care related to diabetic patients.(6, 7)

SMART AIM

If the barriers preventing prediabetic/diabetic patients from beginning and maintaining a Mediterranean diet can be identified and addressed, then those patients can effectively lower their A1c levels and thus better control their diabetes by May 2023.