Dietary Beliefs and Management of Older American Indians With Type 2 Diabetes

J Nutr Educ Behav. Jul-Aug 2019;51(7):826-833. doi: 10.1016/j.jneb.2018.11.007. Epub 2018 Dec 20.


Objectives: This qualitative study examined dietary-related beliefs and self-management among older American Indians with type 2 diabetes mellitus (T2DM).

Design: Semistructured in-person interviews were conducted and digitally recorded.

Setting: Southeastern American Indian tribal community.

Participants: A total of 28 noninstitutionalized older tribal members aged >60 years.

Phenomenon of interest: Study participants' beliefs and experiences with dietary practices and management related to T2DM.

Analysis: Transcribed qualitative interviews were coded using an inductive content analysis approach.

Results: Four themes regarding T2DM dietary beliefs and T2DM dietary management emerged from the analyses: diet changes, portion control, health care professional and family influence, and barriers to healthy eating. Study participants described how their beliefs, practices, and experiences in these 4 areas related to T2DM.

Conclusions and implications: American Indian older adults face a variety of challenges to dietary management of T2DM. Future research efforts can focus on assessing how social support can be leveraged to facilitate healthy diets for American Indians with T2DM. Clinicians and diabetes educators and Native communities have an instrumental role in identifying culturally appropriate messages and programs to help persons effectively manage T2DM.

Keywords: American Indians; dietary beliefs and management; type 2 diabetes mellitus.

Publication types

  • Evaluation Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / therapy*
  • Diet / methods*
  • Diet / psychology
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Indians, North American / psychology*
  • Indians, North American / statistics & numerical data
  • Interviews as Topic
  • Male
  • Middle Aged
  • Qualitative Research
  • Self Care / methods*
  • Self Care / psychology