title: Cultural factors and patients' adherence to lifestyle measures.
abstract: BACKGROUND
  Non-adherence to preventive and therapeutic lifestyle recommendations among patients at high risk of cardiovascular disease is more prevalent and varied than previously thought. The problem needs to be addressed by those who are involved in the care of these patients.
  
  
  OBJECTIVE
  To measure adherence and barriers of complying with lifestyle recommendations among patients with high cardiovascular risk factors.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Six family-practice health centres in Kuwait.
  
  
  METHODS
  Data are from 334 Kuwaiti adult males and females with hypertension, type 2 diabetes, or both, who completed a routine clinic visit in one of six family practice centres. Trained staff used a structured questionnaire to obtain a detailed medical history regarding exercise habits and barriers to compliance with diet and exercise programmes. Clinical criteria assessed were height, weight, and the control of blood pressure and blood sugar.
  
  
  RESULTS
  From the study sample, 63.5% of patients reported that they were not adhering to any diet regimen, 64.4% were not participating in regular exercise, and 90.4% were overweight and obese. The main barriers to adherence to diet were unwillingness (48.6%), difficulty adhering to a diet different from that of the rest of the family (30.2%), and social gatherings (13.7%). The main barriers to adherence to exercise were lack of time (39.0%), coexisting diseases (35.6%), and adverse weather conditions (27.8%). Factors interfering with adherence to lifestyle measures among the total sample were traditional Kuwaiti food, which is high in fat and calories (79.9%), stress (70.7%), a high consumption of fast food (54.5%), high frequency of social gatherings (59.6%), abundance of maids (54.1%), and excessive use of cars (83.8%).
  
  
  CONCLUSIONS
  The majority of individuals in the sample were overweight, did not engage in recommended levels of physical activity, and did not follow dietary recommendations. Additional cultural and demographic variables need to be considered to improve adherence to lifestyle measures.
authors: Family Practice Specialty Training Program (FPSTP), Capital Health Region, Hawalli 32056, Kuwait. drserour@hotmail.com
authors: Maleka
authors: M
authors: Serour
authors: Hanadi
authors: H
authors: Alqhenaei
authors: Sawsan
authors: S
authors: Al-Saqabi
authors: Abdel-Rahman
authors: AR
authors: Mustafa
authors: Abdulla
authors: A
authors: Ben-Nakhi
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003469:Culture; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy*; D015444:Exercise / Q000523:psychology; D005194:Family Practice; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000178:diet therapy*; D007730:Kuwait; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy; D050177:Overweight; D010349:Patient Compliance / Q000523:psychology; D011446:Prospective Studies; D012307:Risk Factors