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408 Asekenye et al. | Journal of Clinical and Translational Research 2023; 9(6): 398-413
like it was reported by Kabwama et al., 2019 in their national physical exercise is a risk factor of non-communicable diseases in
survey [54]. This is due to the availability of a higher number and general due to imbalance energy homeostasis [2,65,66].
diversity of vegetable species, eaten interchangeably for several Participants who prepared vegetables by steaming showed the
days of a week in households in Teso sub-region [22]. Ankole sub- highest prevalence of hyperglycemia compared to those who boiled
region residents are mostly cattle farmers and meat consumption is and added peanut/simsim butter. This result contradicts other study
rather more common [56] and generally categorizing their dietary results which showed that steaming vegetables is probably the
pattern as traditional, high-fat, medium environmental impact as most appropriate preparation method since it retains water soluble
opposed to plant-based, and low environmental impact dietary nutrients and phytochemicals (polyphenolics) beneficial for blood
pattern in Teso sub-region [57]. In both sub-regions, the dietary glucose control [67-70]. However, these authors cautioned the
patterns are transitioning real fast, and there is need to equally fast duration of steaming vegetables to prevent thermal degradation of
track intervention. components therein, a probable explanation for their loss [71], and
hence, higher prevalence of hyperglycemia even when consuming
5.4. Prevalence of hyperglycemia in Ankole and Teso sub-regions vegetables in the diet. Preparation of vegetables by boiling is
of Uganda preferred for vegetables having phytocompounds that are water-
The overall prevalence of hyperglycemia was 29.1% in this soluble and thermostable as long as the they are cooked in hot
study. Participants residing in Ankole sub-region had higher adequate water. In addition, the boiling method also inactivates
prevalence at 35.5% than those in Teso sub-region which was the anti-nutritive compounds (oxalates and tannins) in them
at 19.5%. Although these estimates are much higher than those (Putriani et al., 2020) [70]. Furthermore, boiling of more than
from the previous national baseline survey (3.3% and 0.8%, one vegetable species with local salt and addition of sour milk,
respectively) carried out by Bahendeka et al., in 2016, they agree simsim, and groundnut paste does not only improve on the taste
with the trend. These differences could be due to the different of the vegetable sauce but also compounds the phytochemicals
responsible for reducing high blood sugar [72]; meanwhile, the
definitions and measurements of hyperglycemia or the different tenderizing local salt is rich in plant based minerals which are
health determinants across the population [58,59]. The elderly beneficial for general health. Since most participants from Teso
participants (60 and above years) had the highest prevalence sub-region preferred this method most, it could explain the lower
compared to the youth participants (24.4%). This result concurs prevalence of hyperglycemia in the sub-region.
with that of Van Sande et al., in 1997, who long reported a strong Stir-frying of vegetables even though used by few participants
association of hyperglycemia with an advanced age [60], and in the study, used to be a preparation method for town and city
similarly later by the International Diabetes Federation (IDF) dwellers. However, due to the fast changing habits of Ugandans in
in their global estimates for diabetes prevalence in 2017 [61]. general, it is becoming a traditional preparation method for some
The BMI of participants in our study did not show a statistical vegetables. Residents in Teso sub-region added that the adoption
significant impact on the prevalence of hyperglycemia, whereas of frying vegetables is increasing with the decreasing availability
the nationwide baseline survey (2016) reported unclear association of groundnut/simsim butter for mixing with the vegetables.
between the BMI and hyperglycemia status [8]. This discrepancy This preparation method was reported to cause the greatest loss
could be due to the fact that BMI is an indirect measure of of vegetable phytochemicals (phenols) which were repeatedly
obesity (body fat), a predisposing factor of hyperglycemia, reported to be responsible for the hypoglycemic benefit [68,71].
and furthermore, BMI has a non-linear relationship with body Participants in Teso sub-region consumed more than five
fat [62] and hence making BMI an erroneous method of body fat servings of vegetables per meal which concurs with Kabwama
measurement [63], and consequently an erroneous prediction of et al., (2019) findings. This could be due to the tasty vegetable
hyperglycemia. sauce resulting from addition of other ingredients (mentioned
Participants who were married had the least prevalence of above) during preparation. In addition, only the vegetable sauce
hyperglycemia at 27.2%, this is probably because the married without another was often eaten in a meal for even up to 5 days/
consumed more than five servings of vegetables daily and week. This frequency provides a clue on the importance of
regularly as shown by Dias et al., 2017 and Kabwama et al., 2019 these vegetables for household food security as opposed to just
in their studies [54,64]. These authors explained that marriage for nutrition purposes. Each geographical region has a cultural
and companionship involve social interactions which set stage for identity that includes traditional staples, and our report regarding
food consumption in which regular meals including vegetables vegetables consumption is not surprising.
are a pattern. Most of the Ankole participants are cattle keepers therefore,
Respondents involved in moderate intensity of physical they ate vegetables as a secondary/side sauce (alongside meat or
exercise had the least prevalence of hyperglycemia whereas those fresh groundnut paste sauce), whenever the other relishes are in
who did none at all had the highest prevalence, at 20% and 34%, short supply or when famine strikes, thereby being an alternative in
respectively. This finding supports the conclusion made by Manders times of need. This could explain the higher prevalence in the sub-
et al. (2010), who reported that low and moderate intensities of region since the participants consumed less than recommended
physical exercise, as opposed to high intensities, substantially amount of vegetables as stated in the American Heart Association
reduce the prevalence of hyperglycemia. Likewise lack of regular Dietary guidelines [73] and miss out on the benefits from their
DOI: http://dx.doi.org/10.18053/jctres.09.202306.23-00096