Changes in Eating Competence and Its Association with Dietary and Clinical Outcomes in Brazilian Older Adults with Type 2 Diabetes or Prediabetes Attending a Public Health Service
4 affiliations
- 1Department of Nutrition, Faculty of Health Sciences, University of Brasília, Campus Universitario Darcy Ribeiro, Brasilia 70910-900, Brazil
- 2Graduate Program in Health Sciences and Technologies, University of Brasília, Campus Universitario Ceilândia, Brasilia 72220-275, Brazil
- 3Department of Statistics, University of Brasília, Campus Universitario Darcy Ribeiro, Brasilia 70910-900, Brazil
- 4School of Health (ESSV), Polytechnic University of Viseu, 3504-510 Viseu, Portugal
Abstract
Background/Objectives: This prospective, longitudinal, quasi-experimental study evaluated changes in eating competence (EatC) and its association with nutritional risk, dietary markers, and clinical outcomes, including body mass index (BMI), body fat percentage, and glycated hemoglobin (HbA1c), in Brazilian older adults with type 2 diabetes (T2DM) or prediabetes. Methods: Thirty-three older adults (87.9% female, predominantly inactive, regarding occupational status, and with low educational level) participated in a 12-month food and nutrition education (FNE) program at a public Primary Health Care unit in Ceilândia, Distrito Federal, Brazil. EatC was assessed using the validated ecSI2.0™BR; nutritional risk was measured by the Determine Your Nutritional Health (DNH) Checklist; and dietary intake was characterized using VIGITEL markers. Body composition was measured by bioelectrical impedance and HbA1c using standardized methods. Results: At baseline, regarding occupational status, active participants had significantly higher total EatC scores than inactive participants (p = 0.021). After 12 months, body fat percentage decreased significantly (p = 0.011), whereas BMI and HbA1c remained stable. Total EatC scores and its domains did not change significantly and most participants were already competent eaters at baseline (84.8%). However, variation in specific EatC domains was associated with important outcomes. Variation in food acceptance was negatively correlated with DNH variation (r = −0.417, p = 0.016), indicating an association between increased food acceptance and reduced nutritional risk. Variation in internal regulation was positively correlated with DNH variation (r = 0.492, p = 0.004). Variation in contextual skills was negatively associated with variation in body fat percentage (r = −0.412, p = 0.019). Additionally, variation in soda or artificial juice consumption was positively associated with variation in nutritional risk (r = 0.503, p = 0.003). Conclusions: Improvements in contextual skills and food acceptance were associated with better clinical and nutritional outcomes in older adults with T2DM or prediabetes. Public health interventions should prioritize meal planning, food preparation, and contextual skills as factors potentially associated with nutritional risk.
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BibTeX
@article{dusi2026changes,
title = {{Changes in Eating Competence and Its Association with Dietary and Clinical Outcomes in Brazilian Older Adults with Type 2 Diabetes or Prediabetes Attending a Public Health Service}},
author = {Rafaella Dusi and Raíza Rana de Souza Lima Trombini and Silvana Schwerz Funghetto and Marina Morato Stival and Eduardo Yoshio Nakano and Cláudia Chaves and Renata Puppin Zandonadi},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18213605},
url = {https://www.mdpi.com/2072-6643/18/21/3605},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Changes in Eating Competence and Its Association with Dietary and Clinical Outcomes in Brazilian Older Adults with Type 2 Diabetes or Prediabetes Attending a Public Health Service
AU - Rafaella Dusi
AU - Raíza Rana de Souza Lima Trombini
AU - Silvana Schwerz Funghetto
AU - Marina Morato Stival
AU - Eduardo Yoshio Nakano
AU - Cláudia Chaves
AU - Renata Puppin Zandonadi
PY - 2026
DA - 2026/10/30
JO - Nutrients
DO - 10.3390/nu18213605
UR - https://www.mdpi.com/2072-6643/18/21/3605
AB - Background/Objectives: This prospective, longitudinal, quasi-experimental study evaluated changes in eating competence (EatC) and its association with nutritional risk, dietary markers, and clinical outcomes, including body mass index (BMI), body fat percentage, and glycated hemoglobin (HbA1c), in Brazilian older adults with type 2 diabetes (T2DM) or prediabetes. Methods: Thirty-three older adults (87.9% female, predominantly inactive, regarding occupational status, and with low educational level) participated in a 12-month food and nutrition education (FNE) program at a public Primary Health Care unit in Ceilândia, Distrito Federal, Brazil. EatC was assessed using the validated ecSI2.0™BR; nutritional risk was measured by the Determine Your Nutritional Health (DNH) Checklist; and dietary intake was characterized using VIGITEL markers. Body composition was measured by bioelectrical impedance and HbA1c using standardized methods. Results: At baseline, regarding occupational status, active participants had significantly higher total EatC scores than inactive participants (p = 0.021). After 12 months, body fat percentage decreased significantly (p = 0.011), whereas BMI and HbA1c remained stable. Total EatC scores and its domains did not change significantly and most participants were already competent eaters at baseline (84.8%). However, variation in specific EatC domains was associated with important outcomes. Variation in food acceptance was negatively correlated with DNH variation (r = −0.417, p = 0.016), indicating an association between increased food acceptance and reduced nutritional risk. Variation in internal regulation was positively correlated with DNH variation (r = 0.492, p = 0.004). Variation in contextual skills was negatively associated with variation in body fat percentage (r = −0.412, p = 0.019). Additionally, variation in soda or artificial juice consumption was positively associated with variation in nutritional risk (r = 0.503, p = 0.003). Conclusions: Improvements in contextual skills and food acceptance were associated with better clinical and nutritional outcomes in older adults with T2DM or prediabetes. Public health interventions should prioritize meal planning, food preparation, and contextual skills as factors potentially associated with nutritional risk.
SN - 2072-6643
ER -