Contextual Factors Are Associated with Diet Quality in Youth with Type 1 Diabetes Mellitus (original) (raw)
2012
The objective of this study was to examine associations of food preferences and availability with dietary intake in youth with type 1 diabetes, for whom dietary intake and quality are essential to disease management. Youth (n = 252, age 13.2 ± 2.8 y, diabetes duration 6.3 ± 3.4 y) reported preferences and parents reported household availability for 61 food items categorized as fruit, vegetables, whole grains, refined grains and fats/sweets. Youth energy-adjusted daily servings of food groups, Healthy Eating Index-2005 and Nutrient Rich Foods 9.3 scores were calculated from 3-day diet records. Associations of dietary intake and quality variables with preference and availability of all food groups were evaluated by linear regressions adjusted for sociodemographic characteristics. Fruit and whole grain intake were positively related to corresponding preference and availability; whole grain intake and refined grain availability were inversely related. Vegetable, refined grain and fats/sweets intake were unrelated to preference and availability. Diet quality measures were related positively to fruit preference and whole grain availability and inversely to refined grains availability. Findings indicate associations of dietary intake with food preference and availability vary by food group in youth with type 1 diabetes. Measures of overall dietary quality were more consistently associated with food group availability than preferences.
A Cross-Sectional Study on Factors Affecting Dietary Quality of Adolescents with Type 1 Diabetes
İstanbul tıp fakültesi dergisi, 2021
Objective: The diet quality of adolescents with type 1 diabetes is shaped by some individual factors. These include age, gender, sociodemographic characteristics, lifestyle habits, and adaptation to diabetes treatment. This study aims to investigate the factors affecting the diet quality of adolescents with type 1 diabetes. Material and Methods: The sample in this study consisted of adolescents with type 1 diabetes who were followed in the Department of Pediatric Endocrinology of the Faculty of Medicine at the University of Ankara between July 2017-January 2018. The research data was collected using the face-to-face interview technique with a questionnaire. The physical activity levels of the individuals were determined using a '24-hour physical activity level detection form (short)'. Three-day food consumption records were taken and evaluated via BeBiS. The Healthy Eating Index-2010 was used to determine diet quality. Results: The study was conducted with a total of 110 adolescents (M:51.8%; F:48.2%) with type 1 diabetes in the 10-19 age range (mean age:14.0±2.40 years). Only 15.5% of all individuals have good diet quality. In a linear regression model formed by the variables of exercise status, physical activity type, and PAL value of individuals, a positive significant relationship was found between exercise status and diet quality (χ 2 (1,n=110)=1.392, p<0.05). Conclusion: As a result, it was found that the majority of individuals needed to improve their diet quality and that exercise affected the diet quality of type 1 diabetic adolescents. In addition, exercise levels, which have an important role in both diabetes management and improvement of diet quality, should be increased.
Analysis of the diet quality and dietary habits of children and adolescents with type 1 diabetes
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
Introduction: The dietary habits of patients with type 1 diabetes are key elements of treatment as they facilitate the normalization of glycemia and maintenance of normal body weight (BW), lipid concentration, and the level of blood pressure. Therefore, the aim of this study was to analyze dietary habits and to verify the influence of the quality of diet on insulin dosage and selected clinical variables. Materials and methods: The study included 194 subjects (8-18 years old) suffering from type 1 diabetes and treated with the use of insulin pump. A modified KomPAN questionnaire was used to assess dietary habits and the frequency of the consumption of selected products. Two groups of patients were distinguished: G1 (poorer quality of diet) and G2 (better quality of diet). Clinical data were also collected. Results: Very low scores were noted in the whole study group as regards the index of healthy diet (27.6±11.1, 3.8-61.0). After dividing the participants into groups, it was observed that G1 included more boys (63.8%), and more girls were found in G2 (66.9%). G2 patients chose sweet and salty snacks and fried meals less frequently, and they consumed boiled dishes and avoided sweetening with sugar or honey more frequently. The following characteristics were observed in G1 patients: longer duration of the disease (6.5 vs 5.2 years), higher doses of insulin (0.86 vs 0.76 U/kg of BW/day), and being overweight (31.0% vs 17.6%) and underweight (19.0% vs 8.8%) noted twice more frequently. We did not observe differences concerning the concentration of glycated hemoglobin and lipids in the serum and the values of blood pressure. Conclusion: The findings revealed unsatisfactory dietary habits in children and adolescents with type 1 diabetes and indicated the necessity to analyze additional factors that might influence the quality of diet of the patients.
Evaluating a dietary pattern in adolescents with type 1 diabetes mellitus: The dash-d approach
Diabetes management, 2019
Objective: Adolescents with type 1 diabetes (T1DM) must consider multiple factors in diet planning, including glycemic control and cardiovascular disease prevention, while ensuring adequate nutrition for growth. We examined diet composition, quality, and compliance for two dietary patterns-the traditional Dietary Approaches to Stop Hypertension (DASH) and a modified version of DASH in this population. Methods and Findings: Two feeding studies were conducted. First, adolescents with T1DM consumed their usual diet for 3 days followed by traditional DASH for 6 days. Next, DASH menus were adjusted to align with T1DM nutrition guidelines, and this modified DASH for Diabetes (DASH-D) was tested on a new group of adolescents with T1DM for 6 days, following 3 days of usual diet. Usual diet was measured via 24-hr dietary recalls. Dietary composition of DASH-D was compared to DASH and usual diet. Eighteen adolescents (9/group) participated. Compared to usual diet, intake of protein, fiber, fruit, vegetables, lean meats, and low-fat dairy were higher, while saturated fat and added sugar were lower, in DASH-D. Percent energy from fat was higher, and from carbohydrate lower, in DASH-D versus traditional DASH, with food group intake reflecting these patterns. Participants consumed 87% of foods provided for DASH, and 98% of foods provided for DASH-D. In both DASH iterations, participants met national guidelines for fat, saturated fat, fiber, and fruit/vegetable intake, while usual diet fell short *
DergiPark (Istanbul University), 2024
Aim: Eating behaviors affect young children with type 1 diabetes mellitus (T1DM). The aim is to identify eating behaviors, and nutritional status in young children with T1DM and healthy peers and evaluate the effect of eating behaviors on glycemic control in children with T1DM. The study was a single-center controlled cross-sectional study of young children with T1DM (n=33) (age<7 years) and healthy peers (n=31).The eating behaviors of the young children were examined through the Behavioral Pediatric Feeding Assessment Scale and the food consumption status was evaluated using a 3-day food record. Glycosilated hemoglobin (Hemoglobin A1c) values of the young children with T1DM were obtained from hospital records, and analyzed. Results: Young children with T1DM have higher energy, fiber, and cholesterol intake than their healthy peers. (p<0.05). The young children with T1DM eat more healthily and have fewer behavioral eating disorders than their healthy peers. Parents of children with T1DM reported feeling worse about the child's nutrition. No relationship was found between eating behaviors and glycemic control. Because parents of preschool children with type 1 diabetes feel more anxiety about their child's disease, behavioral observation techniques should be used to examine their eating behavior, glycemic control, and other factors that may affect nutritional management.
Teens with Type 1 Diabetes: How Does Their Nutrition Measure Up?
Journal of diabetes research, 2018
To characterize the intake of macronutrient and fiber in adolescents with type 1 diabetes (T1D) and examine their association with health indicators. Baseline data from an RCT were examined. Adolescent-parent dyads ( = 257, mean age 12 ± 1.2 years, 49.4% girls) reported dietary intake via two separate 24-hour recall interviews during a two-week period. Demographic and medical variables were abstracted from questionnaires and medical charts. Controlling for demographic and diet variables, a higher percentage of daily energy intake from fats was associated with poorer HbA1c. In contrast, an association between higher percent of energy intake from proteins and carbohydrates was found with higher systolic and diastolic BP, respectively. Many early adolescents with T1D did not meet diabetes nutritional guidelines. Lower adherence to nutritional guidelines, specifically more than recommended energy intake from fats, was associated with poorer HbA1c. Addressing nutritional guidelines and i...
Journal of the Academy of Nutrition and Dietetics, 2013
Despite the widely recognized importance of diet in managing diabetes, few studies have documented usual dietary intake in youth with type 2 diabetes (T2D). The objectives of this study were to assess dietary intake among a large, ethnically diverse cohort of youth with T2D and compare intake to current recommendations. Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) is a multi-center randomized clinical trial of 699 youth aged 10-17. At baseline, following a run-in period that included standard diabetes education, diet was assessed using a food frequency questionnaire between 2004 and 2009. Analysis of variance and non-parametric tests were used to compare mean and median nutrient intakes; logistic regression was used to compare the odds of meeting pre-defined dietary intake recommendation cut points between subgroups of age, sex and race-ethnicity. Percent of energy from saturated fat was consistently 13-14% across all subgroups-substantially exceeding national recommendations. Overall, only 12% of youth met Healthy People (HP) 2010 guidelines of < 10% saturated fat and only 1% of youth met American Diabetes Association recommendations of <7% saturated fat. Dietary intake fell substantially below other HP 2010 targets; only 3% met calcium intake goals, 11% met fruit consumption goals, 5% met vegetable consumption goals, and 67% met grain intake goals. Overall, dietary intake in this large cohort of youth with T2D fell substantially short of recommendations, in ways that were consistent by sex, age, and race-ethnicity. The data suggest a critical need for better approaches to improve dietary intake of these youth.
Dietary Education and Outcomes for Young People With Type 1 Diabetes
2005
Diet is integral to successful diabetes care, yet dietary educa- tion methods remain controversial and poorly evaluated. There is limited evidence regarding the effect of diet on glycemic control, serum lipids, cardiovascular (CV) out- comes, the incidence of hypoglycemia, weight management and adherence to medical recommendations in children with type 1 diabetes. Dietary education is concerned primarily with glycemic control,
Journal of the Academy of Nutrition and Dietetics, 2015
We examined the association of diet quality with diet cost in a sample of youth with type 1 diabetes, for whom diet is an important component of medical management. Differences in food group spending by diet quality were also examined to identify potential budgetary reallocation to improve overall diet quality. Families of 252 youth with type 1 diabetes aged 8 to 18 years completed 3-day youth diet records. Cost of each food reported was calculated based on the average price obtained from two online grocery stores. Diet cost was estimated as average daily cost of foods consumed. The Healthy Eating Index 2005 (HEI2005), Nutrient Rich Foods Index version 9.3, and Whole Plant Food Density scores were evaluated. Differences in mean daily diet cost across tertiles of HEI2005, Nutrient Rich Foods Index version 9.3, and Whole Plant Food Density were modest, with none reaching statistical significance. Those in the upper tertile of HEI2005 spent more on whole fruit, whole grains, lean meat, and low-fat dairy, and less on high-fat meat and high-fat dairy compared with those in the lower tertiles. Higher-quality diets can be obtained at comparable costs to lesser-quality diets, suggesting that cost need not be an insurmountable barrier to more healthful eating. Reallocation of spending may increase overall quality without substantially increasing overall spending. Findings suggest potential strategies for assisting families of youth with type 1 diabetes in identifying cost-effective ways to achieve a more healthful diet.