Assessment of dietary quality and demographic and behavioral factors affecting it in patients with chronic diseases in Southeast Iran

Abstract

Dietary quality is a key determinant in managing chronic diseases, shaped by demographic, behavioral, and socioeconomic factors. This study aimed to investigate the influence of these variables on dietary quality among patients with chronic conditions in Southeast Iran. This cross-sectional study was conducted over six months (April–October 2023) in Saravan, Iran, enrolling 400 patients with hypertension, diabetes, or overweight/obesity through stratified random sampling with equal allocation across the three disease groups. Data were collected using a demographic questionnaire, the validated Persian Mini-EAT tool for dietary quality, and a Nutritional Self-Care Questionnaire (NSCQ). Multiple linear regression analysis was applied to identify predictors of dietary quality. Nutritional self-care emerged as the strongest predictor of dietary quality. Regression analysis revealed that nutritional self-care (β = 0.721, p < 0.001), income level (β = 0.345, p < 0.001), and age (β = 0.110, p = 0.012) were significant determinants, in order of predictive strength. Conversely, marital status, gender, education, and employment showed no significant impact. The model accounted for a substantial proportion of variance in dietary quality (R²=0.64). Nutritional self-care and economic status are strongly associated with dietary quality in this population. Given the cross-sectional design, causal inferences cannot be drawn; however, these findings suggest that interventions targeting these areas could be promising. Priority should be given to scalable, culturally adapted self-management education programs and economic support policies, such as food subsidies, to improve nutritional health in this vulnerable population.