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Del Razo-Olvera FM, Martin-Vences AJ, Brito-Córdova GX, Elías-López D, Landa-Anell MV, Melgarejo-Hernández MA, Cruz-Bautista I, Manjarrez-Martínez I, Gómez-Velasco DV, Aguilar-Salinas CA. Primary Barriers of Adherence to a Structured Nutritional Intervention in Patients with Dyslipidemia. Nutrients 2021; 13:nu13061744. [PMID: 34063795 PMCID: PMC8223790 DOI: 10.3390/nu13061744] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 01/30/2023] Open
Abstract
PURPOSE To describe the primary barriers to adequately adhering to a structured nutritional intervention. PATIENTS AND METHODS A total of 106 participants diagnosed with dyslipidemia and without a medical nutrition therapeutic plan were included in this two-year study conducted at the INCMNSZ dyslipidemia clinic in Mexico City. All patients were treated with the same structured strategies, including three face-to-face visits and two telephone follow-up visits. Diet plan adherence was evaluated at each site visit through a 3-day or 24-h food recall. RESULTS Barriers to adhere to the nutritional intervention were: lack of time to prepare their meals (23%), eating outside the home (19%), unwillingness to change dietary patterns (14%), and lack of information about a correct diet for dyslipidemias (14%). All barriers decreased significantly at the end of the intervention. Female gender, current smoking, and following a plan of more than 1500 kcal (R2 = 0.18 and p-value = 0.004) were associated with good diet adherence. Participants showed good levels of adherence to total caloric intake at visit 2 and 3, reporting 104.7% and 95.4%, respectively. Adherence to macronutrient intake varied from 65.1% to 126%, with difficulties in adhering to recommended carbohydrate and fat consumption being more notable. CONCLUSION The study findings confirm that a structured nutritional intervention is effective in reducing barriers and improving dietary adherence and metabolic control in patients with dyslipidemias. Health providers must identify barriers to adherence early on to design interventions that reduce these barriers and improve adherence.
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Affiliation(s)
- Fabiola Mabel Del Razo-Olvera
- Research Unit of Metabolic Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (F.M.D.R.-O.); (D.E.-L.); (I.C.-B.); (D.V.G.-V.)
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
| | | | - Griselda X. Brito-Córdova
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
| | - Daniel Elías-López
- Research Unit of Metabolic Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (F.M.D.R.-O.); (D.E.-L.); (I.C.-B.); (D.V.G.-V.)
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
| | - María Victoria Landa-Anell
- Centro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico;
| | - Marco Antonio Melgarejo-Hernández
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
- Centro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico;
| | - Ivette Cruz-Bautista
- Research Unit of Metabolic Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (F.M.D.R.-O.); (D.E.-L.); (I.C.-B.); (D.V.G.-V.)
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
| | - Iliana Manjarrez-Martínez
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
| | - Donají Verónica Gómez-Velasco
- Research Unit of Metabolic Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (F.M.D.R.-O.); (D.E.-L.); (I.C.-B.); (D.V.G.-V.)
| | - Carlos Alberto Aguilar-Salinas
- Research Unit of Metabolic Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (F.M.D.R.-O.); (D.E.-L.); (I.C.-B.); (D.V.G.-V.)
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
- Division of Nutrition, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán (INCMNSZ), Vasco de Quiroga #15, Tlalpan, Mexico City 14080, Mexico
- Correspondence: ; Tel.: +52-55-54-87-09-00 (ext. 1501); Fax: +52-55-55-13-45-07
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