title: Sense of coherence, food selection and leisure time physical activity in type 1 diabetes.
abstract: BACKGROUND
  Successful management of type 1 diabetes depends on the self-care practices. Sense of coherence has been associated with various measures of lifestyle choices. We aimed to study the associations between sense of coherence and self-care practices in patients with type 1 diabetes. We hypothesized that patients with weak sense of coherence have less prudent food choices and lower physical activity.
  
  
  METHODS
  Cross-sectional data from 1104 patients (44% men, mean age 45±12 years) from the FinnDiane Study were available. Sense of coherence, dietary intake, and leisure time physical activity were evaluated using self-reported questionnaires. Diet score was calculated based on the degree to which food choices complied with dietary guidelines. Weekly metabolic equivalent hours were calculated by multiplying the activity duration by the activity- and intensity-specific metabolic equivalent.
  
  
  RESULTS
  The sense of coherence score correlated positively both with the diet score and the weekly metabolic equivalent hours. Those in the lowest sense of coherence tertile had both the lowest diet scores and the lowest weekly metabolic equivalent hours values. Among women, the sense of coherence score was associated with the diet score when adjusted for age, socioeconomic status, received dietary guidance, and nephropathy status. The sense of coherence score independently predicted the metabolic equivalent hours value in men.
  
  
  CONCLUSIONS
  A higher sense of coherence score predicted more prudent food choices in women and higher physical activity in men. In the future, the health consequences associated with a weak sense of coherence should be studied prospectively. Also, the possibility to use the sense of coherence questionnaire as a screening instrument to identify patients who could benefit from intensified counseling should be investigated.
authors.affiliation: Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, Finland.
authors.forename: Aila J
authors.initials: AJ
authors.lastname: Ahola
authors.forename: Vera
authors.initials: V
authors.lastname: Mikkilä
authors.forename: Markku
authors.initials: M
authors.lastname: Saraheimo
authors.forename: Johan
authors.initials: J
authors.lastname: Wadén
authors.forename: Sari
authors.initials: S
authors.lastname: Mäkimattila
authors.forename: Carol
authors.initials: C
authors.lastname: Forsblom
authors.forename: Riitta
authors.initials: R
authors.lastname: Freese
authors.forename: Per-Henrik
authors.initials: PH
authors.lastname: Groop
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology / Q000628:therapy*; D005260:Female; D005387:Finland; D005518:Food Preferences / Q000523:psychology*; D006801:Humans; D007899:Leisure Activities / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D012648:Self Care / Q000523:psychology*; D060685:Sense of Coherence