{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:34:11Z","timestamp":1782488051903,"version":"3.54.5"},"reference-count":68,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000061","name":"Fogarty International Center","doi-asserted-by":"publisher","award":["K01TW012422"],"award-info":[{"award-number":["K01TW012422"]}],"id":[{"id":"10.13039\/100000061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Dietitian-led medical nutrition therapy (MNT) is an effective and cost-efficient strategy for improving dietary adherence and glycemic control in adults with type 2 diabetes (T2D). However, culturally adapted MNT interventions that account for local food systems, food security, and sociocultural eating practices remain scarce in African contexts. This paper describes the development of\n                      <jats:italic>Objectif Sant\u00e9 Diab\u00e8te B\u00e9nin<\/jats:italic>\n                      (OSanDiaB\u00e9), a culturally tailored, dietitian-led MNT intervention designed to improve dietary adherence and glycemic control among adults with T2D in Benin, West Africa, using the Obesity-Related Behavioral Intervention Trials (ORBIT) model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To design OSanDiaB\u00e9, we use a hybrid framework integrating the ORBIT model with ecological validity and cultural adaptation approaches. In Phase Ia (Define), we developed a theory-driven model to identify key behavioral targets and hypothesized pathways linking a culturally tailored MNT intervention to dietary adherence and glycemic control. Phase Ib (Refine) involved adapting and refining an MNT intervention that combines evidence-based menu plans grounded in the 4A food security framework with individual nutrition counseling and group diabetes education. Intervention refinement was informed by mixed-methods data collected from 512 adults with T2D, including quantitative assessments, focus group discussions, sensory evaluations, and a stakeholder workshop, to enhance feasibility, acceptability, and cultural relevance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Expected outcomes<\/jats:title>\n                    <jats:p>Phase II will evaluate feasibility, acceptability, and preliminary signals of effectiveness, including dietary adherence and glycemic control (HbA1c), prior to planned Phase III efficacy and Phase IV effectiveness trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>OSanDiaB\u00e9 offers a replicable framework for culturally tailoring MNT interventions in low-resource settings. By integrating food security, culturally relevant dietary guidance, and family-centered nutrition support, this approach has the potential to strengthen diabetes nutrition care and reduce inequities in access to effective MNT across African contexts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1688980","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T05:30:54Z","timestamp":1772775054000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Development of a culturally tailored medical nutrition therapy to improve dietary adherence in type 2 diabetes in Benin: an ORBIT model-based protocol"],"prefix":"10.3389","volume":"13","author":[{"given":"Halimatou","family":"Alaof\u00e8","sequence":"first","affiliation":[{"name":"Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona","place":["Tucson, AZ, United 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