Numeracy and Dietary Intake in Patients With Type 2 Diabetes

Diabetes Educ. Mar-Apr 2013;39(2):240-7. doi: 10.1177/0145721713475841. Epub 2013 Feb 11.


Purpose: The purpose of this study is to describe the association between numeracy and self-reported dietary intake in patients with type 2 diabetes.

Methods: Numeracy and dietary intake were assessed with the validated Diabetes Numeracy Test and a validated food frequency questionnaire in a cross-sectional study of 150 primary care patients enrolled in a randomized clinical trial at an academic medical center between April 2008 and October 2009. Associations between numeracy and caloric and macronutrient intakes were examined with linear regression models.

Results: Patients with lower numeracy consumed a higher percentage of calories from carbohydrates and lower percentages from protein and fat. However, no differences in energy consumption or the percentage of energy intake owing to carbohydrates, fat, or protein were observed in adjusted analyses. Patients with lower numeracy were significantly more likely to report extremely high or low energy intake inconsistent with standard dietary intake.

Conclusions: Numeracy was not associated with dietary intake in adjusted analyses. Low numeracy was associated with inaccurate dietary reporting. Providers who take dietary histories in patients with diabetes may need to consider numeracy in their assessment of dietary intake.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diet*
  • Dietary Carbohydrates / metabolism*
  • Educational Measurement
  • Educational Status
  • Energy Intake*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Literacy* / statistics & numerical data
  • Humans
  • Male
  • Mathematics
  • Middle Aged
  • Nutrition Assessment
  • Patient Education as Topic
  • Primary Health Care
  • Reading
  • Surveys and Questionnaires
  • Tennessee / epidemiology
  • Texas / epidemiology


  • Dietary Carbohydrates