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Awareness, motivations and beliefs underlying low-carbohydrate dietary behaviours

Carbohydrate knowledge, dietary guideline awareness, motivations and beliefs underlying low-carbohydrate dietary behaviours

https://www.nature.com/articles/s41598-020-70905-2

Quote:

Abstract

To explore the factors (including knowledge and attitude) influencing the decision to follow a low-carbohydrate diet (LCD) or not in a sample of the UK population. An online questionnaire was distributed electronically to adults who had either followed LCD or not (February–December 2019). Demographics and self-reported “LCD-status” (current, past and non-follower) were collected. Multivariable linear regression was used with carbohydrate knowledge, dietary guideline agreement and theory of planned behaviour (TPB) constructs (all as predictors) to explain the intention to follow a LCD (outcome). Respondents (n = 723, 71% women, median age 34; 85% white-ethnicity) were either following (n = 170, 24%) or had tried a LCD in the preceding 3 months (n = 184, 25%). Current followers had lower carbohydrate knowledge scores (1–2 point difference, scale − 11 to 11) than past and non-followers. A majority of current LCD followers disagreed with the EatWell guide recommendations “Base meals on potatoes, bread, rice and pasta, or other starchy carbohydrates. Choose whole grains where possible” (84%) and “Choose unsaturated oils and spreads and eat in small amounts such as vegetable, rapeseed, olive and sunflower oils” (68%) compared to past (37%, 10%, respectively) and non-followers (16%, 8%, respectively). Weight-loss ranked first as a motivation, and the internet was the most influencial source of information about LCDs. Among LCD-followers, 71% reported ≥ 5% weight loss, and over 80% did not inform their doctor, nurse, or dietitian about following a diet. Approximately half of LCD followers incorporated supplements to their diets (10% used multivitamin/mineral supplements), despite the restrictive nature of the diet. TPB constructs, carbohydrate knowledge, and guideline agreement explained 60% of the variance for the intention to follow a LCD. Attitude (std-β = 0.60), perceived behavioural control (std-β = 0.24) and subjective norm (std-β = 0.14) were positively associated with the intention to follow a LCD, while higher knowledge of carbohydrate, and agreeing with national dietary guidelines were both inversely associated (std-β = − 0.09 and − 0.13). The strongest primary reason behind UK adults’ following a LCD is to lose weight, facilitated by attitude, perceived behavioural control and subjective norm. Higher knowledge about carbohydrate and agreement with dietary guidelines are found among people who do not follow LCDs.

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Knowledge about carbohydrate-rich food was derived from 11 items designed around type and source of carbohydrate, food processing, and nutrition. Each item was scored 1 point for correct answer, − 1 for incorrect, and zero point if participants selected ‘do not know’. The score was summed, giving a range from − 11 to 11.

Dietary guideline awareness and agreement
To assess awareness of the current dietary guidelines, participants were asked whether they had heard of the UK Eatwell plate/guide (or MyPlate, USA) and whether they were following one of these guidelines. They were also asked whether they agreed with these guidelines, including agreement on each of the four statements in the UK Eatwell guide (i.e. carbohydrate foods, fruits and vegetables, oils, and foods high in fat, salt and sugar). To assess the level of agreement on UK Eatwell guide, each of four statements scored 1 point if respondents answered ‘agree’, − 1 for ‘disagree’, and no point for ‘not sure’. The score was summed, giving a range from − 4 to 4.

The above two items, a "high carbohydrate knowledge" plus agreeing with the UK Eatwell that one should eat lots of carbs, consume industrial seed oils and avoid saturated fats, were negatively correlated with use of low carb diets. The eleven question test of "carbohydrate knowledge" wasn't included in the article so no way to check my suspicion that questions were biased such that disagreeing with purported health benefits of carbohydrate scored as a wrong answer, therefore those who believe high carbohydrate intake isn't healthy would generate a low "carbohydrate knowledge" score. Labeling the test "carbohydrate knowledge" reveals more bias IMO. If you agree lots of carbohydrates are good (like the authors?) you have knowledge. But if not...?

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Originally Posted by Zei

Labeling the test "carbohydrate knowledge" reveals more bias IMO. If you agree lots of carbohydrates are good (like the authors?) you have knowledge. But if not...?

If not, you have fallen for an unhealthy fad diet, of course! It's not sustainable!

This is simply testing to determine how much the dietary propaganda has penetrated the population. That people pay attention and try to eat healthy according to the guidelines is known. Now, if we can only get guidelines that are fact-based and promote good health. :cool:

Quote:

Originally Posted by Zei

The questions are in the supplementary file...

Number one is

Do you understand what the term carbohydrate means?

To which possible multiple choice answers start with "Yes, very good idea."

Which as an answer, wouldn't convince me that somebody understood the term, if they'd come up with it themselves.

In the true/false one of the questions is

Carbohydrate is Not the body's main source of energy

...which is both true and false, depending on what you've eaten over the last two or three days.

Questions about whole grains being a good source of minerals.. if you've ever heard of phytic acid, you'll probably lose some points there.

I couldn't find the questions part of the supplementary file, but I'm not surprised if they've scored any LC leaning answers as wrong, counting it as false information about carbohydrates.