Dietary adherence and associated glycemic control in families of young children with type 1 diabetes.
ABSTRACT This study examined the dietary intake, dietary adherence, and associated daily glycemic control of young children (mean age 5.6+/-1.6 years) with type 1 diabetes in 33 families.
This was a one-sample cross-sectional study. Children's nutrient and energy intakes were measured using 3-day diet diaries. Children's mean daily blood glucose levels were assessed prospectively for 2 weeks using the FreeStyle (TheraSense, Inc, Alameda, CA) home blood glucose meter.
Means, standard deviations, and frequencies described the sample. Associations between dietary adherence and glycemic control were examined by one-tailed Pearson correlations.
Mean nutrient intakes were less than the Dietary Reference Intake for children's intake of vitamin B-12 and calcium. Children's dietary deviations revealed better-than-predicted adherence to the number and timing of feedings per day and number of carbohydrate units consumed per meal. In contrast, children's daily carbohydrate intake was approximately 80%+/-21% of the recommended levels based on their weight and age. In addition, children's energy intake was only 78%+/-18% of the recommended levels based on age. Correlations revealed a positive association between poor dietary adherence and higher blood glucose levels.
Young children with type 1 diabetes are likely to have adequate dietary intake of most micronutrients. However, their adherence to specific carbohydrate and energy intake recommendations may be lower. Because the preschool years represent a period of rapid growth, diet plans for preschoolers with diabetes need to be revised often for optimal management of type 1 diabetes. Close adherence to dietary recommendations is one behavior that may improve blood glucose control in young children with diabetes.
- SourceAvailable from: Renata Maria de Noronha[Show abstract] [Hide abstract]
ABSTRACT: To determine the relationship between adherence to the diet reported by patients with type 1 diabetes under routine clinical care in Brazil, and demographic, socioeconomic status, glycemic control and cardiovascular risk factors. This was a cross-sectional, multicenter study conducted between December 2008 and December 2010 in 28 public clinics in 20 Brazilian cities. The data was obtained from 3,180 patients, aged 22 +/- 11.8 years (56.3% females, 57.4% Caucasians and 43.6% non-Caucasians). The mean time since diabetes diagnosis was 11.7 +/- 8.1 years. Overall, 1,722 (54.2%) of the patients reported to be adherent to the diet without difference in gender, duration of diabetes and socioeconomic status. Patients who reported adherence to the diet had lower BMI, HbA1c, triglycerides, LDL-cholesterol, non HDL-cholesterol and diastolic blood pressure and had more HbA1c at goal, performed more frequently self-monitoring of blood glucose (p < 0.001), and reported less difficulties to follow specific schedules of diet plans (p < 0.001). Less patients who reported to be adherent were obese or overweight (p = 0.005). The quantity of food and time schedule of the meals were the most frequent complaints. Logistic regression analysis showed that ethnicity, (Caucasians, (OR 1.26 [1.09-1.47]), number of medical clinical visits in the last year (OR 1.10 [1.06-1.15]), carbohydrate counting, (OR 2.22 [1.49-3.30]) and diets recommended by diabetes societies', (OR 1.57 [1.02-2.41]) were related to greater patients' adherence (p < 0.05) and age, [adolescents (OR 0.60 [0.50-0.72]), high BMI (OR 0.58 [0.94-0.98]) and smoking (OR 0.58 [0.41-0.84]) with poor patients' adherence (p < 0.01). Our results suggest that it is necessary to rethink medical nutrition therapy in order to help patients to overcome barriers that impair an optimized adherence to the diet.Nutrition Journal 03/2014; 13(1):19. · 2.65 Impact Factor
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ABSTRACT: Early onset diabetes increases the risk of cardiovascular disease. This study examined the eating habits of children under seven-years-of-age with diabets to see whether their diet increased that risk even further. A total of 24 children with type 1 diabetes (mean age 4.5 years) and 27 healthy controls (mean age 4.6 years) participated in this cross-sectional study. Food intake was assessed by two, four-day food records. Children with type 1 diabetes had a higher energy intake from protein (18 vs 15%, p <0.05) and fat (35 vs 31%, p <0.05) but lower intake from carbohydrates (47 vs 54%, p <0.05), than the healthy control group. Intake of saturated fat was higher than recommended in both groups and consumption of fruit and vegetables was lower than recommended, but similar, in both the diabetes and contol groups (191 versus 207g per day). Total intake of fat was negatively correlated with intake of fruit and vegetables (r= -0.74 p<0.05) in children with type 1 diabetes. Children under seven-years-of-age with type 1 diabetes eat too much saturated fat and not enough fruit and vegetables. Their diet should be improved to reduce their cardiovascular risk. This article is protected by copyright. All rights reserved.Acta Paediatrica 12/2013; · 1.97 Impact Factor
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ABSTRACT: To present results for a parent-based educational intervention targeting mealtime behaviors plus nutrition among families of young children (mean age, 5.0 ± 1.2 years) with type 1 diabetes mellitus (T1DM). The researchers recruited 9 caregivers who participated in the 6-session intervention and completed baseline and posttreatment assessments, which included dietary intake, acceptability of diet changes, mealtime behavior, and mean blood glucose values. Children's mean daily blood glucose levels decreased from 185 ± 46 mg/dL to 159 ± 40 mg/dL (P < .001). There were also decreases in problematic parent and child mealtime behaviors. There was no change in children's dietary intake indicators that could be detected. It appears promising that this targeted behavior plus nutrition intervention can improve glycemic control and behavior for young children with type 1 diabetes mellitus. Larger, randomized controlled trials will clarify significant results, limitations, and sustainability. Techniques within the program may have application to current practice.Journal of nutrition education and behavior. 01/2014;