Promoting food literacy in type 2 diabetes: a systematic review

Background Diabetes is one of the major global health threats whose burden is sharply increasing. Food literacy is proved to be relevant to optimize self-management in diabetic patients. The present review aims to map the current literature on educational interventions to promote food literacy in type 2 diabetes, with a particular focus on the concept of patient engagement. Methods Five databases were queried using the Population-Intervention-Context-Outcome (PICO) model. Individual study quality was assessed using the Quality Criteria Checklist for primary research provided by the American Diabetes Association. Data were summarized using descriptive statistic and a comparison between intervention carried out by a multidisciplinary team versus a single professionist was performed adopting a Chi-square test (p < 0.05 was deemed as statistically significant). Results Of 1580 articles, 28 were finally included. Outcome categories were narratively labelled as “clinical”, “psychological”, “behavioural” and “literacy”. When the provider was a multidisciplinary team (25% of studies) improvement in self-management occurred in 86% of cases while in single-provider intervention the percentage was 71%, but the difference was not significant (p = 0.45). In the 10.7% of articles the use of technologies was reported, but generically descripted as the use of webpages, email or social media. Globally, an improvement in food literacy was reported in 75% of the interventions. Conclusions Nowadays, the use of a technology proxy is recognized as an efficient support in boosting patients' education, but the evidence in improving food literacy is scarce and difficult to compare. Public health programs improving food literacy are effective at different levels. These findings should encourage decision makers to allocate resources in this kind of programs.