{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T18:06:38Z","timestamp":1781114798130,"version":"3.54.1"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Type 2 diabetes mellitus is a major public health problem worldwide. Nonadherence to lifestyle modifications in individuals with type 2 diabetes poses a great problem.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study assessed magnitude and factors associated with nonadherence to diet and exercise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An institution-based cross-sectional study was conducted on 302 type 2 diabetic patients at Asella Referral and Teaching Hospital of Arsi University. The data were collected via structured questionnaire. Multivariate logistic regression was used to determine the effects of independent variables on nonadherence to diet and exercise recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the individuals in the study, 247(81.8%) patients did not follow the exercise recommendations, and 157(52%) patients did not follow the diet recommendations for type 2 diabetes. Duration since diagnosis\u2009&gt;\u20095 years (AOR\u2009=\u20092.1, 95% CI [1.18\u20133.36]), doctors\u2019 advice (AOR\u2009=\u20092.3, 95% CI [1.24\u20134.47]) and family history of DM (AOR\u2009=\u20094.3, 95% CI [2.55\u20137.29]) were independent determinants of nonadherence to dietary recommendations. Similarly, female sex (AOR\u2009=\u20093.6, 95% CI [1.60\u20138.60]), duration\u2009&gt;\u20095 years since the diagnosis (AOR\u2009=\u20092.1, 95% CI [1.03\u20134.43]) and educational status attending only primary school (AOR\u2009=\u20093.33, 95% CI [1.33\u20138.34]) and only reading and writing or illiteracy (AOR\u2009=\u20096.7, 95% CI [1.86\u201324.29]) were independently associated with nonadherence to the exercise recommendation of type 2 diabetes patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overall, in our study, many patients were nonadherent to diet and exercise recommendations. Female patients and patients who attended primary school or less and &gt; 5 years since diagnosis were more likely to be nonadherent to exercise. The determinants of diet nonadherence were a lack of doctors\u2019 advice,\u2009&gt;\u20095 years since diagnosis and a lack of family history.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0330576","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T17:27:17Z","timestamp":1781112437000},"page":"e0330576","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Magnitude of nonadherence to diet and exercise recommendations and associated factors among type 2 diabetes patients on treatment follow-up at Asella Referral and Teaching Hospital, Arsi, Ethiopia: A cross sectional 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