Development and Validation of a Malian Food Exchange System based on Local Foods and Dishes for the Assessment of Nutrient and Food Intake in Type 2 Diabetic Subjects

Abstract

Objective: To develop and validate exchange lists for the assessment of food and nutrient intakes in people with diabetes in Mali. Design: Malian food exchange system was elaborated using food composition tables for Mali. Dietary intakes were assessed by two 48-hour dietary recalls. Daily numbers of exchanges in each food group were determined for the whole sample and for each gender. Energy and macronutrient intakes obtained by nutritional analysis of the dietary recalls were compared with those calculated with two versions of nutrient values from the exchange lists. Setting: Centre National de Lutte contre le Diabète Subjects: 17 male and 40 female adults with type 2 diabetes. Results: The analysis of food recalls using the Malian exchange system showed that subjects consumed the following numbers of exchanges per day: 2.6 ± 1.5 meat and substitutes, 0.5 ± 0.8 legumes, 0.7 ± 1.2 milk, 8.0 ± 4.0 fat, 8.3 ± 3.0 starch, 1.5 ± 0.9 vegetables, 0.2 ± 0.5 fruit, and 0.0 ± 0.2 sugar-added foods, totalling 1854 ± 648 kcal, 260 ± 92 g carbohydrate, 56 ± 23 g protein and 63 ± 31 g fat. These results for energy and macronutrients did not differ significantly from those obtained by nutritional analysis of the food recalls with a software using data from the Mali Food Composition Table. Compared to women, men consumed significantly larger numbers of exchanges of meat and substitutes, fat, starch, and fruit. No significant differences were found for intake of legumes, milk, vegetables and sugar-added foods. Conclusion: This study allowed the development and validation of Malian food exchange lists useful for a description of the dietary pattern and energy and macronutrient intakes of male and female Malian type 2 diabetic patients.