Document Type : Original Article
Authors
1 Food Security Research Center
2 Department of Biostatistics and Epidemiology
3 Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Introduction: Metabolic syndrome is a collection of metabolic disorders, which can increase the
mortality rates from 20% to 80%. One of strategies to control the disease is the attention to the
dietary habits. Compliance with proper diet is one of the major challenges in the management
of this syndrome. Due to this fact, that the patient is responsible for the adjustment of the
daily diet, it is important to identify the factors affecting the adoption of nutritional self-care.
Besides, self-efficacy is considered as an important pre-requisite for this behavior because it
acts as an independent part of the basic skills. This study was carried out with the purpose of
determining the predictive role of perceived self-efficacy on macronutrients intake in women
with metabolic syndrome. Materials and Methods: In this descriptive study with correlational
nature in 2012, there were 329 patients with the metabolic syndrome. The patients were covered
by Isfahan oil industry medical centers and selected by a systematic method. In order to gather
information on perceived self-efficacy, the questionnaires constructed by the researchers were
used and the validity and reliability had been confirmed by the calculation of content validity
indexand content validity ratio values and the indices of internal consistency and stability of the
tool. The 24-h dietary recall questionnaire was also used for 3 days in order to investigate the
nutritional behavior. The obtained data from the dietary recall questionnaire were analyzed by
the N4 nutritional software. In this study, AMOS software version 16 was used for the structural
model fitting by using the generalized least squares method besides the SPSS statistical
software version 16. Results: These averages obtained from the results: 2512.37 kcal energy
intake, 70.95 g protein, 420 g carbohydrates and 61.61 g of fat per day. The mean of perceived
self-efficacy score was 47.89. The Pearson correlation coefficient was indicated a significant
inverse relationship between the perceived self-efficacy and intake of macronutrients in the
metabolic syndrome. The most direct effect of the coefficient of perceived self-efficacy was
observed on fat and carbohydrate intake (P < 0.05 and β = −0.592) and (P < 0.05 and β =
−0.395). Conclusions: The amount of energy,
carbohydrate, fat and protein were more than
the recommended dietary allowances levels
and the amount of self-efficacy was moderate.
The present study showed that perceived
self-efficacy provided a useful framework to
understand and predict adherence to dietary
self-care behaviors in patients with metabolic
syndrome.
Keywords
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Iranian men and women. Experimental and Clinical Endocrinology
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its relation to all-cause and cardiovascular mortality in nondiabetic
European men and women. Archives of Inter Med 2004;164:1066-76.
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Study. The metabolic syndrome in older individuals: prevalence
and prediction of cardiovascular events: The Cardiovascular Health
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Cardiovascular morbidity and mortality associated with the
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Female Employees of Tabriz University of Medical Sciences.
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Med Sci 2005;330:273-9
2. Day C. Metabolic syndrome or what you will: definitions and
epidemiology. Diabetes Vasc Dis Res 2007 69:2875-88.
3. Zabetian A, Hadaegh F, Azizi F. Relationship between metabolic
syndrome and its components with coronary heart disease in
Iranian men and women. Experimental and Clinical Endocrinology
and Diabetes 2008;116:525-31.
4. Ford ES, Schulze MB, Pischon T, Bergmann MM, Joost H-G,
Boeing H. Metabolic syndrome and risk of incident diabetes:
findings from the European Prospective Investigation into Cancer
and Nutrition- Potsdam Study. Cardiovasc Diabetol 2008;35:1-8.
5. Hu G, Qiao Q, Tuomilehto J, Balkau B, Borch-Johnsen K, Pyorala K;
DECODE Study Group. Prevalence of the metabolic syndrome and
its relation to all-cause and cardiovascular mortality in nondiabetic
European men and women. Archives of Inter Med 2004;164:1066-76.
6. Scuteri A, Najjar SS, Morrell CH, Lakatta EG; Cardiovascular Health
Study. The metabolic syndrome in older individuals: prevalence
and prediction of cardiovascular events: The Cardiovascular Health
Study. Diabetes Care 2005;28:882-7.7. Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, et al.
Cardiovascular morbidity and mortality associated with the
metabolic syndrome. Diabetes Care 2001;24:683-9.
8. Shaw DI, Hall WL, Williams CM. Metabolic syndrome: What is it
and what are the implications? Proceedings of the Nutrition Society
2005;64:349-57.
9. Sarrafzadegan N, Kelishadi R, Baghaei A, Hussein Sadri G,
Malekafzali H, Mohammadifard N, et al. Metabolic syndrome: An
emerging public health problem in Iranian Women: Isfahan Healthy
Heart Program. Int J Cardiol 2008;131:90-6.
10. GhariPour M, Baghei B, Boshtam M, Rabiei K. Prevalence of
metabolic syndrome among the adults of central of areas of Iran (as
part of “Isfahan Healthy Heart Study”). Journal of Birjand University
of Medical Sciences 2006;13:56-62.
11. Deen D. Metabolic syndrome: time for action. Am Fam Physician
2004:69:2875-82,87-8.
12. Feldeisen SE, Tucker KL. Nutritional strategies in the prevention
and treatment of metabolic syndrome. Appl Physiol Nutr Metab
2007;32:46-60.
13. Glal O. Nutrition-related health patterns in the Middle East. Asia Pac
J Clin Nutr 2003;12:337-343.
14. Ghassemi H, Harrison G, Mohammad K. An accelerated nutrition
transition in Iran. Public Health Nutr 2002;5:149-155.
15. Kris-Etherton P, Daniels SR, Eckel RH. AHA scientific statement:
summary of the scientific conference on dietary fatty acids and
cardiovascular health. J Nutr 2001;131:1322-6.
16. Cornell S, Briggs A. Newer Treatment Strategies for the Management
of Type 2 Diabetes Mellitus J Pharm Pract 2004;17:49-54.
17. Truswell AS. What nutrition knowledge and skills do primary care
physicians need to have and how should this be communicated?
Eur J Clin Nutr 1999;53:67-71.
18. Janice Clarke R.N. Evaluation of a comprehensive diabetes disease
management program: progress in the struggle for sustained
behavior change. Disease management 2002;5:77-86.
19. Chan YM. Molassiotis A. The relationship between diabetes
knowledge and compliance among Chinese with non-insulin
dependent diabetes mellitus in Hong Kong. Journal of Advanced
Nursing 1999;30:431-438.
20. Mosavi Jazayeri SM. Knowledge, attitude and practices (KAP) of
diet prescription among university students of Ahwaz, Iran. Asia
Pac J clin Nutr 2004;13 Suppl 1:130.
21. Pirouznia M. The Association between nutrition knowledge and
eating behavior in male and female adolescents in the US. Meta
Press Int J Food Sci Nutr. 2001;52:127-132.
22. Bashour HN. Survey of dietary habits of in-school adolescents in
Damascus, Syrian Arab Republic. East Mediterr Health J 2004;
10:853-862.
23. Sakamaki R, Toyama K, Amamoto R, Liu CJ, Shinfuku N. Nutritional
knowledge of Chinese university students: A cross sectional study.
Nutr J 2005;4:4.
24. Susan L.N. Recommendation for Healthcare system and
Self-Management Education interventions to reduce morbidity and
mortality from diabetes. American Journal of Preventive Medicine
2002;22:10-14.
25. Acuna K, Muniz P, Formiga C, Bastos G, Camilo M, Hashimoto R,
Ney-Oliveria F, Cruz T, Waitzburg DL. A proposal for clinical nutrition
education for health care university students and professionals in
the Amazon. Nutr Hosp 2004;19:353-361.
26. Avazeh A., Jafari N., Rabie siahkali S., Mazloomzadeh S. Knowledge
level Attitude and Performance of Women on Diet and Exercise
and Their Relation with Cardiovascular Diseases Risk Factors.
Journal of Zanjan University of Medical Sciences and Health
Services 2010;18:50-57.
27. Ostarahimi A, Safaiyan AR, Modarresi J, Parvin Pourabdollahi P,
Mahdavi R. Effect of Nutrition Education Intervention on
Nutritional Knowledge, Attitude and Practice (KAP) among
Female Employees of Tabriz University of Medical Sciences.
Medical Journal Tabriz University of Medical Sciences 2010;
31:12-17.
28. Mazloomy S, Mirzaei A, Afkhami Ardakani M, Baghiani Moghadam M,
Fallahzadeh H. The Role of Health Beliefs in Preventive Behaviors
of Individuals at High- Risk of Type 2 Diabetes Mellitus. Journal
of Shahid Sadoughi University of Medical Sciences And Health
Services 2010;18:24-31
29. Shahab Jahanlo AR., GHofrani Poor FA., Vafaie M., Kimiyagar M.,
Heidarnia AR., Sobhani AR. Structures measuring health belief model
with HbA1c in diabetic patients with good control and poor. Journal
of Hormozgan University of Medical Sciences 2008;12:37-42.
30. Shortridge-Baggett LM. Self-efficacy: Measurement and intervention
in nursing. Sch Inq Nurs Pract 2001;15:183-8.
31. Stuifbergen AK, Seraphine A, Roberts G. An explanatory model of
health promotion and quality of life in chronic disabling conditions.
Nursing Research 2000;49:122-9.
32. Sharfi Rad Gh, Azadbakht L, Feizi A, Mohebi S,-Kargar M. The Role
of Self-Efficacy in Self-Care among Diabetic Patients. Health System
Research 2012;7:1-12.
33. Robert C. MacCallum, Michael W. Browne, and Hazuki M. Sugawara.
Power analysis and determination of sample size for covariance
structure modeling. Psychological Methods 1996;1:130-149.
34. Lawshe, C. H. A quantitative approach to content validity. Personnel
Psychology 1975;28:563-575.
35. Esmaillzadeh A, Azadbakht L. Consumption of hydrogenated versus
nonhydrogenated vegetable oils and risk of insulin resistance and
the metabolic syndrome among Iranian adult women. Diabetes
Care 2008;31:223-6.
36. Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi T, Azizi F. Beneficial
effects of a Dietary Approaches to Stop Hypertension eating
plan on features of the metabolic syndrome. Diabetes Care
2005;28:2823-31.
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