ArticlePublic health nutrition2019
The importance of the cultural dimension of food in understanding the lack of adherence to diet regimens among Mayan people with diabetes.
Article in Public health nutrition, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers and facilitators to successful management of type 2 diabetes mellitus in Latin America and the Caribbean: A systematic review.PloS one · 2020Pooled it
- Exploring Meaning-Making and Identity Transformation Among Adults Living with Type 2 Diabetes in Saudi Arabia: A Hermeneutic Phenomenological Study.Healthcare (Basel, Switzerland) · 2026Article
- Factors associated with sugar-sweetened beverage and water consumption among adults in rural Baja California.Global health promotion · 2026Article
- Practice-based observations of barriers to dietary adherence among patients hospitalized with congestive heart failure in a safety-net hospital.Frontiers in nutrition · 2026Article
- Overcoming dietary complexity in type 2 diabetes: influencing factors and coping strategies.European journal of medical research · 2025Article
- Association of Social Support and Self-Care Beverage Consumption in Adults With Type 2 Diabetes From the Southwest of Mexico.Nursing research and practice · 2025Article
- Social Determinants Influencing Nutrition Behaviors and Cardiometabolic Health in Indigenous Populations: A Scoping Review of the Literature.Nutrients · 2024Article
- Impact on Glycemic Variation Caused by a Change in the Dietary Intake Sequence.Foods (Basel, Switzerland) · 2023Article
- "Food Doesn't Have Power Over Me Anymore!" Self-Efficacy as a Driver for Dietary Adherence Among African American Adults Participating in Plant-Based and Meat-Reduced Dietary Interventions: A Qualitative Study.Journal of the Academy of Nutrition and Dietetics · 2022Article
- Intuitive eating is associated with glycemic control in type 2 diabetes.Eating and weight disorders : EWD · 2021Observational
- Review
- Association between Dietary Habits and Physical Function in Brazilian and Italian Older Women.Nutrients · 2020Article
- State Regulations to Support Children's Cultural and Religious Food Preferences in Early Care and Education.Maternal and child health journal · 2020Article
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Authors and funding
7 authors.
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Abstract
objectiveTo understand non-adherence to medically recommended diets among Mayans with diabetes.
designUsing partially sequential mixed methods, questionnaires, semi-structured brief and in-depth interviews were applied. Questionnaire data were analysed with Pearson's χ2 and Student's t tests and qualitative interviews with grounded theory microanalysis.
settingRural, predominantly Mayan communities in Chiapas, Quintana Roo and Yucatan, Mexico, 2008-2012.
participantsPurposive sample of Mayans with type 2 diabetes; using public health care; 168 women and twenty-seven men; age 21-50+ years.
resultsParticipants understood diabetes as caused by negative emotions, divine punishment, revenge via spells, chemicals in food and high sugar/fat consumption. Eliminating corn, pork, sugary beverages and inexpensive industrialized foods was perceived as difficult or impossible. More Mayans reporting not understanding physician instructions (30 v. 18 %) reported difficulty reducing red meat consumption (P = 0·051). Non-adherence was influenced by lack of patient-provider shared knowledge and medical recommendations misaligned with local culture. Men whose wives prepared their meals, women who liked vegetables and young adults whose mothers prepared their meals reported greater adherence to dietary recommendations. Partial adherents said it made life tolerable and those making no physician-recommended dietary changes considered them too restrictive (they meant 'starving to death'). Over half (57 %) of participants reported non-adherence; the two principal reasons were dislike of recommended foods (52·5 %) and high cost (26·2 %).
conclusionsAdherence to dietary regimens in diabetes treatment is largely related to social and cultural issues. Taking cultural diversity, food preferences, local food availability and poverty into consideration is essential when developing health-promotion activities related to diabetes.
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