title: Perceived barriers to recommended dietary adherence in patients with type 2 diabetes in Iran.
abstract: To identify barriers to recommended dietary adherence in patients with type 2 diabetes.
  
  
  
  Observational cross-sectional study.
  
  
  
  One hundred-forty six overweight/obese volunteers with type 2 diabetes, who had previously received dietary advice for at least one year, were recruited from two diabetes clinics in Tabriz, north-west of Iran.
  
  
  
  A 24-item questionnaire was designed to assess dietary barriers. The validity and reliability of the questionnaire were assessed by Content Validity Index, Content Validity Ratio and Cronbach's alpha, respectively. An exploratory factor analysis with principal component analysis extraction and varimax rotation was utilized in order to extract the underlying factors of dietary nonadherence.
  
  
  
  Factor analysis yielded seven barrier factors including: situational barriers/difficulty resisting temptation [percent variance=11.64%], stress-related eating disorder/cost [percent variance=9.11%], difficulty with meal and snack plans [percent variance=8.76%], confusion [percent variance=8.45%], work-related issues [percent variance=7.72%], small portion size [percent variance=6.87%] and lack of palatability/family support [percent variance=6.78%]. These factors explained about 59.4% of the total variance.
  
  
  
  Overall, patients with type 2 diabetes perceived some barriers to recommended dietary adherence. In dietary counseling, considering and addressing these barriers will likely be effective in increasing the dietary adherence for patients with type 2 diabetes in Iran.
authors.affiliation: Student Research Committee, Faculty of Nutrition, Tabriz University of Medical Sciences, Iran. Electronic address: Faranakhalali@gmail.com.
authors.forename: Faranak
authors.initials: F
authors.lastname: Halali
authors.affiliation: Nutrition Research Center, Faculty of Nutrition, Tabriz University of Medical Sciences, Iran. Electronic address: Mahdavirez@hotmail.com.
authors.forename: Reza
authors.initials: R
authors.lastname: Mahdavi
authors.affiliation: Bone Research Center, Tabriz University of Medical Sciences, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Mobasseri
authors.affiliation: Traffic Injury Prevention Research Center, Faculty of Health, Tabriz University of Medical Sciences, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Asghari Jafarabadi
authors.affiliation: Department of Endocrine and Metabolism, Imam Reza Medical Research and Training Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Sanaz
authors.initials: S
authors.lastname: Karimi Avval
mesh_terms: D001290:Attitude; D003376:Counseling; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy* / Q000523:psychology*; D004032:Diet / Q000379:methods*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data*; D025341:Principal Component Analysis; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards
keywords: Dietary adherence; Factor analysis; Perceived barriers; Self-management; Type 2 diabetes