Estimating the Impact of Medication on Diabetics' Diet and Lifestyle Choices



lactating women since their dietary needs differ from the rest of the population. In total, our
sample includes observations on 7,319 individuals.

For this study, we question if and how individuals alter behaviors with the knowledge that they
have diabetes and take medication to control the disease. As such, we look at how well
individuals conform to dietary recommendations set forth by the American Diabetes Association
and defined in the Diabetes Food Pyramid (DFP) and their chosen level of physical activity. In
general, diabetics are instructed to choose a diet that is rich in vegetables, fruits, whole grains,
beans, lean meats and fiber while limiting consumption of fats and sugars. We therefore created
several dependent variables (Table 1). For five of the six food groups2 defined in the DFP—
grains and starches; vegetables; fruit; milk; meat and meat substitutes—the dependent variable
for each individual is the number of servings consumed during his or her 24-hour dietary recall
divided by the number of servings recommended for their caloric intake3. For fat, the dependent
variable is the percent of daily calories derived from fat. For fiber and sugar the dependent
variable is the total grams or teaspoons divided by the number of calories consumed that day. For
physical activity, we create a score using both the amount and intensity of time an individual
spent being physically active in leisure time.

The explanatory variables used in our econometric estimation are also described in Table 1. To
gauge income effects, we include a household’s poverty income ratio. We also control for an

2 The Diabetes Food Pyramid (DFP) provides no specific quantity recommendation for the sixth group, fats, sweets
and alcohol. It is simply advised that these foods be saved for special occasions.

3

The DFP is not completely congruent with either the previous Food Guide Pyramid (FGP) or more recent
MyPyramid. Specifically, starches in the DFP include the categories grains, potatoes, starchy vegetables and
legumes as counted in the FGP; The DFP vegetables only include dark green vegetables, deep yellow vegetables and
tomatoes; and under the FGP, cheeses are counted as a serving of meat instead of a serving of dairy.

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