Food Choice Decision-Making Profiles and Health Outcomes in Adults With Type 2 Diabetes and Overweight/Obesity: A Cluster Analysis

Purpose To identify food decision-making profiles for adults with T2DM and overweight/obesity based on nutritional health and decision process, and to explore differences in health outcomes among profiles. Design Cross-sectional. Setting Primary healthcare settings. Subject 105 adults with T2DM and overweight/obesity (90.52% retention). Measures Nutritional health and decision process were assessed through the Food Choice Task, indicated by healthy decision rate and reaction time respectively. Health outcomes included clinical (HbA1C, fasting blood glucose, BMI) and psychological (diabetes management self-efficacy, food choice motives) measures. Analysis Hierarchical cluster analysis was used to identify profiles according to nutritional health and decision process. Welch’s ANOVA were used to test their differences in health outcomes. Results Five profiles were identified: Cautious (healthy choice + slow reaction, 42.86%), Moderate (moderate healthy choice/reaction time, 28.57%), Well-Habit (healthy choice + fast reaction, 11.43%), Strained (unhealthy choice + slow reaction, 7.62%) and Impulsive (unhealthy choice + fast reaction, 9.52%). The Well-Habit Profile exhibited the best outcomes, including lower BMI, higher self-efficacy and healthier food choice motives. The Cautious Profile showed healthy choices but suboptimal self-efficacy. The Impulsive Profile presented a good self-efficacy, but the highest BMI and inadequate healthy choice motives. Conclusion This study identified five food decision-making profiles for adults with T2DM and overweight/obesity, providing insights of considering both nutritional health and decision process as food choice features when conducting dietary interventions. Limitation included the small sample size and limited settings.