(P28-047-23) Acceptance of Alternative Staple Foods by Diabetics in Singapore: A Mixed Methods Study

Objectives: To explore the expectations and perceptions of diabetics towards alternative forms of staple foods and their feasibility in a mixed methods approach. These staples are modified to improve glycemic responses to offer healthier alternatives to diabetics without majorly affecting dietary preferences.

Methods: We conducted a 5-week, randomised within-subject crossover study among 16 diabetics, with 2-week interventions of a control and treatment each and 1-week of washout. For treatment, 3 types of modified carbohydrate-rich staple foods were consumed in mixed meals: (i) bread fortified with anthocyanins for carbohydrase inhibition, (ii) white rice fortified with fibre, and (iii) reduction of available carbohydrates in noodles for breakfast, lunch, and dinner respectively. These staples were replaced with conventional white bread, rice, and noodles in the control. Participants were interviewed before and after each arm on their experiences with the foods and continuous glucose monitoring (CGM) was used to measure post-prandial glycemic responses of each meal. Thematic analysis was used to analyse interviews. Glycemic responses were presented as 2h incremental area under the curve (iAUC). A paired t-test was conducted to analyse differences in iAUC mean values relative to control.

Results: Thematic analysis indicated that perceived health benefits were a major influence in acceptance of the alternative staples, and were more accepted if comparable in taste and texture to controls, though compromised sensory properties were expected for health benefits. Despite higher anticipated pricing, participants were still inclined to purchase them for health reasons. However, CGM analysis indicated a significant reduction (p value < 0.05) in 2h iAUC only in alternative noodles.

Conclusions: In this study, qualitative data highlighted the importance of palatable sensory properties, reasonable pricing, and health benefits to diabetics in alternative staple foods. However, quantitative data reflected improvements in glycemic responses for only specific foods. This study revealed feasibility aspects for consideration in future designs of alternative staple foods for their potential incorporation into the diet of diabetics.

Funding Sources: Health Innovation Programme: Future Foods For Health and Singapore Ministry of Education Academic Research Grant