{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T12:47:38Z","timestamp":1782564458808,"version":"3.54.5"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Diabetic foot ulcers (DFUs) are a serious complication of type 2 diabetes mellitus (T2DM). Diet quality may influence DFU risk; however, evidence remains limited. This study investigated the association between overall diet quality and DFU prevalence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this case\u2013control study, 390 adults with T2DM were enrolled, including 130 patients with clinically confirmed DFUs and 260 controls without DFU. Habitual dietary intake was evaluated using a validated 147-item Food Frequency Questionnaire supplemented with a recall interview. Multivariable logistic regression model was applied to examine the association between overall diet quality and DFU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean total overall diet quality scores were significantly lower in participants with DFUs than in controls (56.3\u2009\u00b1\u20098.2 vs 61.2\u2009\u00b1\u20098.5; P\u2009&lt;\u20090.001). All diet quality components, variety, adequacy, moderation, and overall balance, were also lower among DFU cases (P\u2009&lt;\u2009.01). In fully adjusted model, the association between diet quality score and DFU was no statistically significant when analyzed as a continuous variable (OR = 0.90; 95% CI: 0.78-1.03). However, participants in the highest diet quality tertile had significantly lower odds of DFU compared with those in the lowest tertile (OR = 0.71; 95% CI: 0.49-0.99), with a significant dose\u2013response trend observed across tertiles (P for trend = 0.031).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Diet quality score was not significantly associated with DFU when modeled as a continuous variable; however, higher diet quality tertiles were associated with lower odds of diabetic foot ulcer, suggesting a potential protective relationship of overall dietary patterns after accounting for major sociodemographic and clinical risk factors.<\/jats:p>\n                  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