Effect of dietary fiber intake on blood pressure control in type 2 diabetic patients in selected hospitals of Ethiopia

Dietary fiber contributes to cardio metabolic health, yet contextual evidence in Ethiopia is scarce. This study examined the effect of dietary fiber intake on blood pressure (BP) control among patients with type 2 diabetes. An institutional-based cross-sectional study was conducted from March to April 2024 among 287 type 2 DM patients. Dietary intake was assessed using a repeated multiple-pass 24-hour recall, which involved collecting detailed recipes and estimating portion sizes in grams using dietary scales, proxy indicators, and standardized conversion and yield factors. Nutrient analysis, including dietary fiber (g/day), was performed using NutriSurvey 2007 based on the Ethiopian Food Composition Table and complementary regional and USDA sources. Blood pressure was measured using a calibrated digital sphygmomanometer, and HbA1c values were extracted from recent laboratory records. A significant proportion (79.4%) of respondents exhibited poor blood pressure control, while over half (56.7%) demonstrated poor glycemic control. Additionally, 10.3% of participants were classified as obese and 39% had stage 2 hypertension. The mean dietary fiber intake was 32.5 ± 20 g/day. Fiber intake showed significant inverse correlations with BP ( r = -0.551), BMI ( r = -0.605), and HbA1c ( r = -0.341), all p  < 0.001. In multivariable logistic regression, adjusted for age, duration of diabetes, diet, and physical exercise, showed that higher dietary fiber intake remained an independent predictor of good blood pressure control. Each 1 g/day increase in dietary fiber was associated with a 6% reduction in the odds of poor BP control (AOR = 0.936; 95% CI: 0.913–0.959; p  < 0.001). Regular physical activity also significantly reduced the odds of poor BP control (AOR = 3.35 for non-exercisers). Higher dietary fiber intake and regular exercise were strongly associated with improved BP and glycemic control in type 2 diabetes patients. These findings support not only public health initiatives to promote fiber-rich diets but also integration of dietary counseling and lifestyle modification into routine clinical diabetes and hypertension management.