Recent decades have seen dramatic changes in nutritional and eating patterns worldwide. Combined with increasing sedentary behaviour, a worldwide epidemic of ‘diabesity’ has arisen, where obesity and type 2 diabetes mellitus (T2DM) occur in the same individual.

In Oman, there are about 98,000 T2DM cases, rising by about 7,000 a year. Defining adherence and understanding its barriers may help evolve more effective strategies and tools that improve diet adherence in adults with T2DM.

Therefore, a group of researchers, led by Dr. Nasser Al-Salmi of the College of Nursing, have looked into the concept of diet adherence and its components in the management of T2DM. They used the Walker and Avant method of concept analysis.

The findings suggest that the concept of diet adherence implies the process of following a diet plan by means of self-monitoring, maintaining and preventing relapses. Diet adherence is facilitated by antecedents which comprise motivation, understanding dietary recommendations, developing appropriate health beliefs, self-efficacy, setting achievable goals and receiving social support.

Successful diet adherence brings consequences in health as reflected in improved T2DM-specific clinical parameters and enhanced health-related quality of life.

The team concluded that patients with T2DM often have poor diet adherence due to failure to understand, implement, and maintain the required antecedents, such as motivation, understanding, health beliefs, self-efficacy, practical goals and social support. Adults with T2DM are required to adhere to a self-care regimen comprising dietary restrictions, physical exercises, medications and self-monitoring of glucose levels, which is vital for sustained glycemic control and long-term health outcomes.

Diet adherence is affected by social pressure, cultural and psychological factors and self-efficacy specific to diet. Antecedents can be distinguished in terms of social factors, such as watching others consume forbidden foods, and individual factors, including adhering to diet recommendations and resisting the offer to eat unhealthy foods at social events. Fatalism or beliefs about the causes of diabetes outside the self are associated with low socioeconomic status.

Furthermore, the findings contribute to the body of knowledge regarding the education of nurses and adults about the importance of diet adherence and better nutritional choices in reducing complications. The study recommended that healthcare providers need to ensure that patients understand the concept of diet adherence and implement it in their daily lives.

Further research is needed into diet adherence and its components to evolve more effective measures and strategies to be communicated to T2DM patients. Additionally, researchers should study the concept of diet adherence as part of a comprehensive and multifactorial approach to providing better control of T2DM.