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Hey , I m Hermoxita. I work as a meetup lankan. I m originally a Free oriental. Hence now I am only engaged in walking as a physical activity. They also did not discuss possible adverse effects of physical activity and precautions to be taken before physical activity for a patient with diabetes. Discussion To our knowledge the present study is the first qualitative study to evaluate the perception about diet and physical activity among Sri Lankan adults with diabetes mellitus.

In the present study most patients with diabetes were aware of the importance of diet and physical activity in relation to their disease. However, they emphasized many difficulties faced when implementing these practices, especially social circumstances. Their food choices were mainly determined by the choices of those in the family, including non-diabetic healthy individuals.

Lack of autonomy regarding food choices and the need to conform to family practices was a key issue identified by many participants. This has not been previously described in the literature, even in other South Asian countries. This emphasises the clear need for development of an effective and meaningful national dietary guidelines for patients with diabetes. It is important to have such locally developed and culturally sensitive guidelines, since some of the main food items are different from those found elsewhere in the world.

Such guidelines should also aim to tackle common dietary myths encountered in the local population, and qualitative studies are important to generate necessary evidence.

In the present study we also came across several such dietary myths, commonly prevalent amongst the population with diabetes. Other common misperceptions such as complete avoidance of sugar and fruits, also stems from the above concept. As mentioned earlier the total diet or overall pattern of food eaten is the most important focus of a healthful eating style.

Patients have derived such information commonly from media, native medicine and other patients. Furthermore, it may also benefit science if future studies are developed to scientifically evaluate such strongly advocated claims.

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Most study participants were aware about the importance of being physically active. Patients claimed to have only received vague and non-specific guidance about physical activity from health professionals and from other sources such as media. It is important that health care professionals understand the importance of physical activity, and have the ability convey the same to their patients. Development of local guidelines that are socially and culturally sensitive, with involvement of all stakeholders, including patients, might be the first step in bridging the knowledge gap.

Awareness regarding these barriers and appropriate interventions are important in maintaining motivation and commitment in physical activity interventional programs.

This study helped to fill a nationally recognised research gap. The qualitative methods used were rigorous and the study suggested some new findings regarding perceptions on diet and physical activity amongst Sri Lankan adults with diabetes. There is also need for further research to understand the non-specific guidance and the perceived lack of encouragement from health professionals identified in this study.

There are several limitations in the present study. However, there was a mixture of ethnicities and faith groups in each FGD and this could have affected the interactions within groups. Another weakness of the study may be the generalisability of the findings. The group of people interviewed were recruited from one clinical centre and may not be representative of the wider Sri Lankan population with diabetes.

The presence of complications also could have influenced their dietary preferences and knowledge. Contributor Information Pigera, Email: moc. Ishara, Email: moc. Jayasekara, Email: moc. Jayawardena, Email: moc. Katulanda, Email: moc. Diabetes Care.

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Department of census and statistics Sri Lanka, The diabetes epidemic in Sri Lanka - a growing problem. Ceylon Med. Office, Editor.

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Diabetes in South Asians. Diabet Med. Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-analysis. BMC Public Health. Hu FB. Globalization of diabetes: the role of diet, lifestyle, and genes. Nutrition therapy recommendations for the management of adults with diabetes. Freeland-Graves J, Nitzke Position of the American Dietetic Association: total diet approach to communicating food and nutrition information.