title: Evaluating Barriers to Adherence to Dietary Recommendations in Iranian Adults with Metabolic Syndrome: A Qualitative Study Using the Theory of Reasoned Action.
abstract: BACKGROUND
  Metabolic syndrome (MS) is defined as a pattern of metabolic disorders including central obesity, insulin resistance or hyperglycemia, high blood pressure, and dyslipidemia. Many studies show a clear relationship between diet and components of MS. The aim of the current study was to identify barriers to adherence to dietary recommendations among Iranian MS patients.
  
  
  METHODS
  The theory of reasoned action (TRA) served as the framework for this qualitative study. Data collection was conducted through six semi-structured focus group discussions, from Apr to Jun 2013. Subjects included 36 married men and women with different levels of education between the ages of 20-50 with MS diagnosed based on IDF's (International Diabetes federation) criteria. All focus group discussions were audio recorded and transcribed. The thematic content analysis method was used to analyze the study data.
  
  
  RESULTS
  This study identified the most important barriers to adherence to dietary recommendations. MS patients have problems in their attitude toward MS components and their relationship to nutrition. They also had wrong attitudes toward fats and oils, salt, dairy products, cereals, and sugary drinks and sweets. Subjective norms that affects patient eating identifies too.
  
  
  CONCLUSIONS
  We identified barriers to adherence to dietary recommendations in MS patients that could be used to prevent MS consequences and provide patients with nutrition education.
authors: Dept. of Nutrition, School of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Naseh
authors: N
authors: Esmaeili
authors: Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Mohammad
authors: M
authors: Alizadeh
authors: Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Ali
authors: A
authors: Tarighat Esfanjani
authors: Dept. of Nutrition, School of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Sorayya
authors: S
authors: Kheirouri
keywords: Barriers; Dietary recommendations; Metabolic syndrome; Theory of reasoned action