Dietary assessment of type-2 diabetes in Africa: A systematic scoping review

The prevalence of type 2 diabetes (t2dm) in Africa is increasing due to increase in associated risks factors such as unhealthy eating, obesity and physical inactivity. Diet monitoring is an important component in the management of t2dm to aid and prevent progression and complications. Research on dietary assessment in Africa is currently gaining interests and this paper aims to review the dietary assessment methods used with people living with t2dm. The Cochrane Library, MEDLINE, Global Health and Web of Science databases were searched using keywords to identify studies that assessed the diet of people living with type-2 diabetes in Africa. The keywords were those related to the concepts: t2dm, dietary assessment, Africa and nutrient intake. We excluded papers not written in English, studies without a quantitative dietary assessment and studying a specific food, studies done among Africans but in developed countries, studies done among children and studies that measured neither energy intake or body mass index. Search yielded 132 papers after duplicates were removed. This reduced to 41 after the title and abstract screening and further to 10 after the full text screening. The included papers were based in six African countries: Algeria, Morocco, Uganda, Ghana, Cameroon and South Africa. The 24-hour dietary recall was the most common dietary assessment method used in 8 studies and two studies used the estimated food diaries. Five studies did not use a country-specific food composition table. Eight used a researcher-entered online dietary analysis software for nutrient intake estimation, out of which 7 contained the food database of a different country. Two studies estimated nutrient intake using a statistical tool and paper-and-pen. None of the dietary assessment methods used in the studies was validated in this patient group. Limited evidence was available on the measurement of diet in patients with t2dm in Africa. There is need to improve the dietary assessment methods in Africa to prevent the progression and complication of t2dm.