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Influence of Diabetes Prevention Education on Healthy Dietary Practices among Adults in Nigeria

Abstract

Diabetes mellitus is an increasing public health concern in Nigeria and is associated with significant morbidity, mortality, and healthcare costs. Unhealthy dietary practices, including excessive consumption of refined carbohydrates, sugar-sweetened foods and beverages, energy-dense foods, and inadequate intake of fruits, vegetables, and other nutrient-rich foods, may contribute to the development and progression of type 2 diabetes. Diabetes prevention education provides adults with information about diabetes risk factors, healthy dietary choices, appropriate portion sizes, balanced diets, food preparation methods, the importance of regular physical activity, weight management, and other lifestyle practices that can reduce the risk of diabetes. Healthy dietary practices involve regular consumption of balanced and nutrient-dense meals, appropriate portion control, adequate intake of fruits and vegetables, moderation of added sugars and unhealthy fats, and reduced consumption of highly processed and energy-dense foods. In Nigeria, dietary practices may be influenced by food availability, income, cultural preferences, nutritional knowledge, urbanization, food marketing, and changing lifestyles. Effective diabetes prevention education may improve adults' knowledge and encourage the adoption of healthier dietary practices. Against this background, this study investigates the influence of diabetes prevention education on healthy dietary practices among adults in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding adults' decisions to adopt healthier dietary behaviours. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, behavioural capabilities, social influences, and environmental conditions in shaping dietary behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from diabetes prevention education may influence healthy dietary practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how diabetes prevention education may influence dietary behaviour among adults in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from adults in selected communities, workplaces, primary healthcare facilities, and other appropriate community settings in Nigeria using a structured interviewer-administered questionnaire and, where feasible, a dietary assessment tool. A multistage sampling technique will be employed to select states, local government areas, communities, institutions, and eligible participants. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Participants in the intervention group will receive structured diabetes prevention education covering diabetes risk factors, healthy dietary choices, balanced meals, portion control, consumption of fruits and vegetables, reduction of added sugars and unhealthy fats, healthier food preparation methods, food label awareness, physical activity, weight management, and other diabetes prevention practices. Healthy dietary practices will be assessed using indicators such as frequency of fruit and vegetable consumption, intake of whole or minimally processed foods, portion control, consumption of sugar-sweetened foods and beverages, consumption of highly processed foods, dietary diversity, and other appropriate measures of healthy eating. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, diabetes prevention knowledge, exposure to education, and dietary practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be used to determine the influence of diabetes prevention education on healthy dietary practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that diabetes prevention education has a significant positive influence on healthy dietary practices among adults in Nigeria. Adults exposed to structured diabetes prevention education are expected to demonstrate improved knowledge of diabetes risk factors and greater adoption of healthier dietary behaviours. Education may encourage increased consumption of fruits and vegetables, improved portion control, reduced intake of sugar-sweetened foods and beverages, reduced consumption of highly processed foods, and greater attention to balanced meal choices. However, education alone may not guarantee sustained dietary changes because adults may continue to face barriers such as food prices, household income, availability of healthy foods, cultural dietary preferences, limited access to nutrition information, food marketing, and competing lifestyle demands. Consequently, diabetes prevention education is expected to be most effective when supported by affordable access to healthy foods, community-based nutrition programmes, supportive food environments, and broader non-communicable disease prevention initiatives. The study is expected to contribute to the literature on diabetes prevention, nutrition education, dietary behaviour, non-communicable disease prevention, health promotion, and public health in Nigeria by providing empirical evidence on the influence of diabetes prevention education on healthy dietary practices among adults. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), state ministries of health, primary healthcare facilities, hospitals, nutrition programmes, public health professionals, dietitians, community health workers, development partners, and policymakers regarding strategies for preventing type 2 diabetes through improved dietary behaviour. The study will also provide evidence-based recommendations for strengthening diabetes prevention education, integrating nutrition education into primary healthcare services, promoting affordable healthy food choices, improving community-based dietary interventions, and encouraging sustainable healthy eating practices among adults across Nigeria.

Keywords: Diabetes prevention education, healthy dietary practices, diabetes prevention, adults, nutrition education, healthy eating, dietary behaviour, type 2 diabetes, non-communicable diseases, health promotion, public health, Nigeria.