Associations of dietary fiber knowledge and intake with glycemic control among Jordanian patients with type two diabetes mellitus: a cross-sectional study.

BACKGROUND: Dietary fiber plays an important role in glycemic control, as reflected by glycated hemoglobin (HbA1c), among individuals with type 2 diabetes mellitus. However, evidence from Jordan regarding patients' knowledge of dietary fiber, consumption patterns, and perceived barriers to adequate intake remains limited. OBJECTIVE: This study aimed to assess dietary fiber knowledge and consumption frequency among patients with type 2 diabetes mellitus, and to examine their associations with glycemic control and perceived barriers to adequate intake. METHODS: A cross-sectional study was conducted among 722 adults with type 2 diabetes mellitus attending the National Center for Diabetes, Endocrinology, and Genetics in Amman, Jordan. Data were collected using a validated questionnaire that assessed dietary fiber knowledge related to food sources and health benefits (15 items), frequency of consumption of fiber-rich foods, and perceived barriers to intake. Glycemic control was evaluated using HbA1c levels. RESULTS: Most fiber-rich food items showed no statistically significant association with glycated hemoglobin levels (P > 0.05); however, oat consumption was significantly associated with better glycemic control. Higher dietary fiber knowledge was significantly associated with improved glycemic control, both in relation to knowledge of health benefits (P = 0.049) and food sources (P = 0.017). Despite this, 61.9% of participants had suboptimal glycemic control, with HbA1c levels of 7-8% or > 8%. Gastrointestinal discomfort and lack of awareness were the most commonly reported barriers to adequate dietary fiber intake. CONCLUSION: Better glycemic control among patients with type 2 diabetes mellitus is associated with higher dietary fiber knowledge; however, existing barriers may hinder the translation of knowledge into actual dietary practices. Educational interventions should emphasize practical and culturally appropriate strategies to support the incorporation of dietary fiber into daily diets. Future research should focus on closing the gap between dietary fiber knowledge and its effective application in diabetes management.