Diabetes and Metabolism Journal

Korean Diabetes Association (대한당뇨병학회)
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Bowl-Based Meal Plan versus Food Exchange-Based Meal Plan for Dietary Intake Control in Korean Type 2 Diabetic Patients

제2형 당뇨병환자에서 식기를 활용한 식사계획법과 식품교환표를 활용한 식사계획법이 섭취량 조절에 미치는 효과

Ahn, Hee-Jung;Koo, Boo-Kyung;Jung, Ji-Yeon;Kwon, Hwi-Ryun;Kim, Hyun-Jin;Park, Kang-Seo;Han, Kyung-Ah;Min, Kyung-Wan
안희정;구보경;정지연;권휘련;김현진;박강서;한경아;민경완

  • Published : 20090400
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Abstract

Background: The food exchange-based meal plan is effective in controlling dietary energy intake with a macronutrient balance. However, it is difficult to practice for relatively low-literacy patients. As an alternative, we developed a system employing a standardized–.sized bowl and investigated its effectiveness on achieving proper energy intake and macronutrient composition and patient compliance, compared to the conventional food exchange system in Korean type 2 diabetes patients. Methods: Eighty subjects with type 2 diabetes were assigned to both the novel bowl-based meal plan group(BG) and the food exchange-based meal plan group (ExG). BG received limited simple instructions for the plan. Time spent for plan instruction was 10 min for BG and 40 min for ExG. Dietary energy and macronutrient intake were estimated with 3-day dietary records and patient comprehension of the plan was estimated with a 5-point Likert scale. Results: After 12 weeks, dietary energy compliance showed no difference between the groups (BG: 103 ${\pm}$ｯ10%, ExG: 101 ${\pm}$ 17%). Both groups showed significant reduction in carbohydrate and protein intake and there was no difference in the proportion of carbohydrate, protein and fat in energy intake between the groups despite the shorter instruction time for BG. Following the instruction period, there was no difference in the understanding score between the groups. Conclusion: This bowl-based plan was equally effective as the food exchange-based plan in controlling dietary energy intake and macronutrient composition, as well as patient comprehension and compliance. Our novel plan may allow for more cost-effective methods in terms of time needed for plan instruction.

연구배경: 식품교 환표를 활용한 식사계획은 제2형 당뇨병환자들에게 섭취량과 영양소 구성을 교정하는데 유용한방법이다. 그러나 인지능력이 낮은 환자들은 이러한 교육 내용을 이해하는데 어려움을 느낀다. 이에 본 연구는 한국인 제2형 당뇨병환자에서 정량화된 식기와 식품 교환표를 활용하여 영양소 섭취량, 영양소 구성, 교육의 이해도에 미치는 효과를 조사해 보고자 하였다. 방법: 80명의 제2형 당뇨병환자는 정량화된 식기를 활용한 식사계획 군(BG)과 식품 교환표를 활용한 식사계획 군(ExG)으로 분류하였다. BG는 식기 활용방법에 대해 간단히 교육하였다. 교육 시간은 BG에서 10분, ExG에서 40분정도 소요하였다. 총 섭취량과 열량 영양소 섭취량은 3일 식사 기록지로, 교육의 이해도는 5점 척도로 조사하였다. 결과: 섭취 열량에 대한 순응도는 12주 교육 후 BG에서 103 ${\pm}$ 10%, ExG에서 101 ${\pm}$ 17%로 두 군 간 차이가 없었다. 두 군 모두에서 탄수화물과 단백질 섭취량이 유의하게 감소하였고, 그룹 간 총 섭취 열량에 대한 탄수화물, 단백질, 지방 섭취비의 차이는 없었다. 교육 후 이해도에서도 그룹간 차이는 없었다. 결론: 제2형 당뇨병환자에서 식기를 활용한 식사 계획법은 짧은 교육 시간에도 식품 교환표를 활용한 식사계획법에 비해 섭취량과 열량 영양소 구성비 조절, 교육의 이해도에서 동등한 효과를 보였다.

Keywords

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