{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:07:02Z","timestamp":1787584022044,"version":"build-2736575974"},"reference-count":39,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T00:00:00Z","timestamp":1682640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Research Department of the Federal University of Par\u00e1 (Pr\u00f3-Reitoria de Pesquisa e P\u00f3s-Gradua\u00e7\u00e3o\u2014PROPESP\/UFPA)","award":["02\/2023"],"award-info":[{"award-number":["02\/2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Until this moment, no research has been found that has assessed adherence to online nutritional monitoring by adults with Diabetes Mellitus Type 1 (T1DM) during the pandemic. This article aims to analyze the association between eating habits and adherence to nutritional online care by adults with T1DM during social distancing because of the COVID-19 pandemic in Brazil. A cross-sectional study was carried out in July 2020. An online form was used to collect sociodemographic data, financial status, eating habits, carrying out online nutritional monitoring, and adherence to social distancing. Pearson\u2019s chi-squared test was performed with adjusted residual analysis and binomial logistic regression analysis (p &lt; 0.05). Out of the 472 adults, only 8.9% had consulted with a nutritionist. Doing nutritional monitoring online during social distancing was associated with a reduction in the consumption of ultra-processed foods (p = 0.021), eating more servings of fruit (p = 0.036), and doing carbohydrate counting (CC) more frequently (p = 0.000). Doing nutritional monitoring online increased adherence to carbohydrate counting by 2.57 times and increased the consumption of fruits by 0.423 times. Therefore, nutritional monitoring, even if performed remotely, can influence the acquisition and maintenance of healthier eating habits, in addition to assisting adherence to the practice of CC.<\/jats:p>","DOI":"10.3390\/nu15092121","type":"journal-article","created":{"date-parts":[[2023,4,28]],"date-time":"2023-04-28T06:12:55Z","timestamp":1682662375000},"page":"2121","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Adherence to Online Nutritional Monitoring Was Associated with Better Food Habits in People with T1DM during the COVID-19 Pandemic in Brazil"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0092-3396","authenticated-orcid":false,"given":"Daniela Lopes","family":"Gomes","sequence":"first","affiliation":[{"name":"Postgraduate Program in Neuroscience and Behavior, Behavior Theory and Research Nucleus, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Brazil"},{"name":"Faculty of Nutrition, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4426-3470","authenticated-orcid":false,"given":"Emily Cristina Barbosa","family":"da Silva","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline Le\u00e3o","family":"Reis","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Neuroscience and Behavior, Behavior Theory and Research Nucleus, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Brazil"},{"name":"Faculty of Nutrition, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1397-0471","authenticated-orcid":false,"given":"Manuela Maria de Lima","family":"Carvalhal","sequence":"additional","affiliation":[{"name":"Faculty of Nutrition, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeane Lorena Dias","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Neuroscience and Behavior, Behavior Theory and Research Nucleus, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela Correia","family":"Uliana","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Neuroscience and Behavior, Behavior Theory and Research Nucleus, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2603-9387","authenticated-orcid":false,"given":"Talita Nogueira","family":"Berino","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Neuroscience and Behavior, Behavior Theory and Research Nucleus, Federal University of Par\u00e1, Bel\u00e9m 66075-110, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,28]]},"reference":[{"key":"ref_1","unstructured":"Ministry of Health of Brazil (2021, July 20). What is COVID-19?, Available online: https:\/\/www.gov.br\/saude\/pt-br\/coronavirus\/o-que-e-o-coronavirus."},{"key":"ref_2","unstructured":"Ministry of Health of Brazil (2023, February 20). Secretaria de Vigil\u00e2ncia em Sa\u00fade. Guia de Vigil\u00e2ncia Epidemiol\u00f3gica: Emerg\u00eancia de Sa\u00fade P\u00fablica de Import\u00e2ncia Nacional pela Doen\u00e7a pelo Coronav\u00edrus 2019\u2014COVID-19, Available online: https:\/\/www.gov.br\/saude\/pt-br\/centrais-de-conteudo\/publicacoes\/publicacoes-svs\/coronavirus\/guia-de-vigilancia-epidemiologica-covid-19_2021.pdf\/view."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.dsx.2020.04.004","article-title":"Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations","volume":"14","author":"Singh","year":"2020","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_4","unstructured":"Wamsley, L. (2020, September 04). Life during Coronavirus: What Different Countries Are Doing to Stop the Spread. The Coronavirus Crisis. Available online: https:\/\/www.npr.org\/sections\/goatsandsoda\/2020\/03\/10\/813794446\/life-during-coronavirus-what-different-countries-are-doing-to-stop-the-spread."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/S2213-8587(20)30271-0","article-title":"Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: A population-based cohort study","volume":"8","author":"Holman","year":"2020","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_6","unstructured":"Brazilian Society of Diabetes (2019). Brazilian Diabetes Society Guidelines 2019\u20132020, Clanad S\u00e3o Paulo."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2589","DOI":"10.2337\/dci21-0043","article-title":"The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)","volume":"44","author":"Holt","year":"2021","journal-title":"Diabetes Care"},{"key":"ref_8","unstructured":"Brazilian Society of Diabetes (2023, February 20). Diretriz Oficial da Sociedade Brasileira de Diabetes. Available online: https:\/\/diretriz.diabetes.org.br\/."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"108343","DOI":"10.1016\/j.diabres.2020.108343","article-title":"The COVID19 pandemic\u2013Perspectives from people living with diabetes","volume":"173","author":"Rose","year":"2021","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"108547","DOI":"10.1016\/j.diabres.2020.108547","article-title":"People living with type 1 diabetes point of view in COVID-19 times (COVIDT1 study): Disease impact, health system pitfalls and lessons for the future","volume":"171","author":"Rios","year":"2021","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"108304","DOI":"10.1016\/j.diabres.2020.108304","article-title":"The impact of COVID-19 on people with diabetes in Brazil","volume":"166","author":"Barone","year":"2020","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"108301","DOI":"10.1016\/j.diabres.2020.108301","article-title":"COVID-19 impact on people with diabetes in South and Central America (SACA region)","volume":"166","author":"Barone","year":"2020","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_13","unstructured":"Conselho Federal de Nutricionistas (CFN)\u2014Federal Council of Nutritionists of Brazil (2021). Resolution CFN n\u00b0 684, February 11, 2021, CFN. Suspends the provisions of article 36 of Resolution No. 599, CFN, of 25 February 2018, which approves the Code of Ethics and Conduct for Nutritionists."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1159\/000519959","article-title":"Telehealth and nutrition support during the COVID-19 pandemic","volume":"1","author":"Mehta","year":"2021","journal-title":"Kompass Nutr. Diet."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1089\/tmj.2014.9983","article-title":"Telemedicine and e-health in disaster response","volume":"20","author":"Doarn","year":"2014","journal-title":"Telemed. E-Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1089\/dia.2020.0042","article-title":"Top 10 tips for successfully implementing a diabetes telehealth program","volume":"22","author":"Crossen","year":"2020","journal-title":"Diabetes Technol. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1002\/hpm.3536","article-title":"COVID-19\u2019s impact on type 1 diabetes management: A mixed-methods study exploring the Peruvian experience","volume":"37","author":"Najarro","year":"2022","journal-title":"Int. J. Heal. Plan. Manag."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"108682","DOI":"10.1016\/j.diabres.2021.108682","article-title":"The impact of a prolonged lockdown and use of telemedicine on glycemic control in people with type 1 diabetes during the COVID-19 outbreak in Saudi Arabia","volume":"173","author":"Alharthi","year":"2021","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2524","DOI":"10.1016\/j.jand.2021.01.009","article-title":"Telehealth during the COVID-19 pandemic: A cross-sectional survey of registered dietitian nutritionists","volume":"121","author":"Rozga","year":"2021","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_20","first-page":"486","article-title":"Internet access in recessive periods: The case from Brazil","volume":"E28","author":"Silva","year":"2020","journal-title":"Iber. J. Inf. Syst. Technol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Olmastroni, E., Galimberti, F., Tragni, E., Catapano, A.L., and Casula, M. (2023). Impact of COVID-19 Pandemic on Adherence to Chronic Therapies: A Systematic Review. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20053825"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/s13098-021-00706-8","article-title":"Diabetes self-care practices and resilience in the Brazilian COVID-19 pandemic: Results of a web survey: DIABETESvid","volume":"13","author":"Binhardi","year":"2021","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_23","unstructured":"Ministry of Health of Brazil, Department of Primary Care, Department of Health Care (2014). Food Guide for the Brazilian Population."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"823","DOI":"10.2337\/dc10-1490","article-title":"Effects of Carbohydrate Counting on Glucose Control and Quality of Life Over 24 Weeks in Adult Patients with Type 1 Diabetes on Continuous Subcutaneous Insulin Infusion: A randomized, prospective clinical trial (GIOCAR)","volume":"34","author":"Laurenzi","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"37067","DOI":"10.1038\/srep37067","article-title":"Effectiveness of advanced carbohydrate counting in type 1 diabetes mellitus: A systematic review and meta-analysis","volume":"6","author":"Fu","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"110158","DOI":"10.1016\/j.diabres.2022.110158","article-title":"Role of telemedicine during COVID-19 pandemic in type 2 diabetes outpatients: The AMD annals initiative","volume":"194","author":"Russo","year":"2022","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e00180","DOI":"10.1002\/edm2.180","article-title":"Use and perception of telemedicine in people with type 1 diabetes during the COVID-19 pandemic\u2014Results of a global survey","volume":"4","author":"Scott","year":"2021","journal-title":"Endocrinol. Diabetes Metab."},{"key":"ref_28","unstructured":"Ministry of Health of Brazil, National Health Council (2021, July 20). Resolution n\u00b0 510, April 7, 2016, Available online: https:\/\/conselho.saude.gov.br\/resolucoes\/2016\/Reso510.pdf."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Costa-J\u00fanior, F.M., Couto, M.T., and Maia, A.C.B. (2016). Gender and health care: The point of view of professionals working in hospital and outpatient settings. Sex. Salud Y Soc. (Rio De Jan.), 97\u2013117.","DOI":"10.1590\/1984-6487.sess.2016.23.04.a"},{"key":"ref_30","unstructured":"Conselho Federal de Nutricionistas (CFN)\u2014Federal Council of Nutritionists of Brazil (2020). Resolution CFN n\u00b0 646, March 18, 2020, CFN. Suspends until August 31, 2020 the provisions of article 36 of Resolution No. 599, CFN, of February 25, 2018, which approves the Code of Ethics and Conduct for Nutritionists."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1007\/s00592-017-1084-9","article-title":"Teleconsultation in type 1 diabetes mellitus (TELEDIABE)","volume":"55","author":"Bertuzzi","year":"2018","journal-title":"Acta Diabetol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"S393","DOI":"10.1016\/j.mjafi.2021.04.001","article-title":"Management of type 1 diabetes mellitus during the COVID-19 pandemic","volume":"77","author":"Muthukrishnan","year":"2021","journal-title":"Med. J. Armed Forces India"},{"key":"ref_33","unstructured":"Intituto Brasileiro de Geografia e Estat\u00edsticas (IBGE)\u2014Brazilian Institute of Geography and Statistics (2021, July 20). Work and Income Coordination. Pesquisa Nacional por Amostra de Domic\u00edlios (PNAD) cont\u00ednua: Acesso \u00e0 internet e \u00e0 televis\u00e3o e posse de telefone m\u00f3vel celular para uso pessoal 2017 [Continuous National Household Sample Survey (PNAD): Access to the Internet and Television and Possession of a Cell Phone for Personal Use], PNAD Cont\u00ednua, Available online: https:\/\/biblioteca.ibge.gov.br\/visualizacao\/livros\/liv101705_informativo.pdf."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e2020407","DOI":"10.1590\/s1679-49742020000400026","article-title":"The COVID-19 Pandemic and changes in adult Brazilian lifestyles: A cross-sectional study, 2020","volume":"29","author":"Malta","year":"2020","journal-title":"Epidemiol. E Servi\u00e7os De Sa\u00fade"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Grabia, M., Markiewicz-\u017bukowska, R., Pu\u015bcion-Jakubik, A., Bielecka, J., Nowakowski, P., Gromkowska-K\u0119pka, K., Mielcarek, K., and Socha, K. (2020). The nutritional and health effects of the COVID-19 pandemic on patients with diabetes mellitus. Nutrients, 12.","DOI":"10.3390\/nu12103013"},{"key":"ref_36","unstructured":"Sociedade Brasileira de Diabetes (SBD) [Brazilian Society of Diabetes] (2016). Carbohydrate Counting Manual for People with Diabetes, SBD."},{"key":"ref_37","unstructured":"Moreira, M.B., and Medeiros, C.A. (2001). Basic Principles of Behavior Analysis, Artmed. [2nd ed.]."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Vasconcelos, P.H.C., Gomes, D.L., Uliana, G.C., and Silva, A.A.C.E. (2021). Social distancing, physical activity, and COVID-19: Implications for type 1 Diabetes Mellitus in Brazil. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182312819"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2042018819839298","DOI":"10.1177\/2042018819839298","article-title":"Use of apps for physical activity in type 1 diabetes: Current status and requirements for future development","volume":"10","author":"Kordonouri","year":"2019","journal-title":"Ther. Adv. Endocrinol. Metab."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/9\/2121\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:25:40Z","timestamp":1760124340000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/9\/2121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,28]]},"references-count":39,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["nu15092121"],"URL":"https:\/\/doi.org\/10.3390\/nu15092121","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,28]]}}}