Assessments of energy, macro and micronutrient intakes in children and adolescents with type 1 diabetes mellitus

Year 2023, Volume: 36 Issue: 2, 235 - 241, 31.05.2023

Volkan Ozkaya , Sebnem Ozgen Ozkaya

https://doi.org/10.5472/marumj.1307977

Abstract

Objective: This study aims at examining dietary intake in children and adolescents with type 1 diabetes mellitus (DM) and comparing
the results with national dietary intake recommendations.
Patients and Methods: One hundred fifty children and adolescents (52.7% female) with an average age of 12.2±3.1 years and with
type 1 DM who were followed by the Pediatric Endocrinology Polyclinic participated in the study. Three-day food intake records and
clinical information regarding the type 1 DM condition of the participants were obtained.
Results: No gender-related significant difference was found among the participants regarding food intake. The percentage of energy
derived from fat (average 39.6%) and saturated fat (16.1%) were higher than the recommended levels in both gender groups. The
percentage of energy derived from carbohydrates (female 44.1±5.7%, male 43.0±6.8%) was below the recommended levels. The dietary
fiber intake in children aged 6-10 years with type 1 DM met recommendations, whereas, it was below the recommended levels in other
age groups. Micronutrient inadequacy was common in children and adolescents with type 1 DM.
Conclusions: The authors believe that guidelines and programs are needed for children and adolescents with type 1 DM to reduce
total fat and saturated fat intake, increase carbohydrate and dietary fiber intake up to the recommended levels, and prevent multiple
micronutrient inadequacies.

Keywords

Type 1 Diabetes, Children, Adolescents, Nutritional Status, Dietary Intake, Macronutrient Distribution

References

• DiMeglio LA, Evans-Molina C, Oram RA. Type 1 diabetes. The Lancet 16;391(10138):2449-62. doi: 10.1016/S0140- 6736(18)31320-5.
• Merger SR, Kerner W, Stadler M, et al. Prevalence and comorbidities of double diabetes. Diabetes Res Clin Pract 2016;119:48-56. doi: 10.1016/j.diabres.2016.06.003
• Minges KE, Whittemore R, Grey M. Overweight and obesity in youth with Type 1 diabetes. Annu Rev Nurs Res 2013;31:47- 69. doi: 10.1891/0739-6686.31.47.
• Bae JP, Lage MJ, Mo D, et al. Obesity and glycemic control in patients with diabetes mellitus: Analysis of physician electronic health records in the US from 2009-2011. J Diabetes Complications 2016;30:212-20. doi: 10.1016/j. jdiacomp.2015.11.016.
• Smart CE, Annan F, Higgins LA, et al. ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2018;19 Suppl 27:136-154. doi: 10.1111/pedi.12738.
• Kalra S, Das AK, Raghupathy P, et al. Current ındicators of nutritional care in children with type 1 diabetes in India: Do we need a national nutritional guideline? Indian J Endocrinol Metab 2017; 21: 6707-8. doi: 10.4103/ijem.IJEM_183_17
• Dłużniak-Gołaska K, Panczyk M, Szostak-Węgierek D, et al. Analysis of the diet quality and dietary habits of children and adolescents with Type 1 diabetes. Diabetes Metab Syndr Obes 2019;12: 161-70. doi: 10.2147/DMSO.S186237
• Spinks J, Guest S. Dietary management of children with Type 1 diabetes. Paediatrics and Child Health 2017; 27: 176-80 doi:https://doi.org/10.1016/j.paed.2017.01.001
• Meissner T, Wolf J, Kersting M, et al. Carbohydrate intake in relation to BMI, HbA1c and lipid profile in children and adolescents with Type 1 diabetes. Clin Nutr 2014;33:75-8. doi: 10.1016/j.clnu.2013.03.017.
• WHO AnthroPlus for personal computers Manual: Software for assessing growth of the world’s children and adolescents. Geneva: WHO, 2009. Available from http://www.who.int/ growthref/tools/en/) [accessed March 01, 2023].
• WHO, Growth reference data for 5-19 years, Available from:https://www.who.int/toolkits/growth-reference-datafor- 5to19 – years/indicators/bmi-for-age [accessed March 01, 2023].
• Styne DM, Arslanian SA, Connor EL, et al. Pediatric obesity— assessment, treatment, and prevention: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 2017; 102: 709-57. doi: 10.1210/jc.2016-2573
• Nutrition Information System (Bebis 8.2) Bebispro for Windows and Turkish Version. İstanbul, 2020
• Turkey Dıetary Guıdelınes. Ministry of Turkey Health Publication No: 1046: 51-60, 163-288, Turkey ISBN : 978-975- 590-619-5, 2015. Available from: https://dosyasb.saglik.gov.tr/ Eklenti/10922,17ocaktuberingilizcepdf.pdf?0 [accessed June 15, 2020].
• Chow SC, Chiu ST. Design and analysis of clinical trials: Concepts and methodologies, Second Edition, Wiley- Interscience. ISBN 047.124.9858 2005
• Mackey ER, O’Brecht L, Holmes CS, et al. Teens with type 1 diabetes: How does their nutrition measure up? J Diabetes Res 2018;2018:5094569. doi: 10.1155/2018/5094569
• Mackey ER, Rose M, Tully C, et al. The current state of parent feeding behavior, child eating behavior, and nutrition intake in young children with type 1 diabetes. Pediatr Diabetes. 2020;21:841-5. doi: 10.1111/pedi.12997.
• Seckold R, Howley P, King BR, et al. Dietary intake and eating patterns of young children with type 1 diabetes achieving glycemic targets. BMJ Open Diabetes Res Care. 2019;7:e000663. doi: 10.1136/bmjdrc-2019-000663.
• Delahanty LM, Nathan DM, Lachin JM, et al. Association of diet with glycated hemoglobin during intensive treatment of Type 1 diabetes in the Diabetes Control and Complications Trial. Am J Clin Nutr 2009; 89: 518-24. doi: 10.3945/ ajcn.2008.26498
• Helgeson VS, Viccaro L, Becker D, et al. Diet of adolescents with and without diabetes: Trading candy for potato chips? Diabetes Care 2006;29:982–7. doi: 10.2337/diacare.295982.
• Cherubini V, Marino M, Marigliano M, et al. rethinking carbohydrate ıntake and time in range in children and adolescents with type 1 diabetes. Nutrients 2021;13:3869. doi: 10.3390/nu13113869.
• Stechova K, Hlubik J, Pithova P, et al. Comprehensive analysis of the real lifestyles of t1d patients for the purpose of designing a personalized counselor for prandial ınsulin dosing. Nutrients 2019;11:1148. doi: 10.3390/nu11051148.
• Lamichhane AP, Crandell JL, Jaacks LM, et al. Longitudinal associations of nutritional factors with glycated hemoglobin in youth with Type 1 diabetes: the SEARCH Nutrition Ancillary Study, Am J Clin Nutr 2015;101:1278-85. doi: 10.3945/ ajcn.114.103747
• Thomson R, Adams L, Anderson J, et al. Australian children with type 1 diabetes consume high sodium and high saturated fat diets: Comparison with national and international guidelines. J Paediatr Child Health 201955:1188-93. doi: 10.1111/jpc.14373.
• Parthasarathy LS, Chiplonkar SA, Khadilkar AV, et al. Dietary modifications to improve micronutrient status of Indian children and adolescents with Type 1 diabetes. Asia Pac J Clin Nutr 2016;24:73-82. doi: 10.6133/apjcn.2015.24.1.0
• Koç B, Baş M, Eliuz Tipici B, et al. Determination the nutritional status of children and adolescents with type 1 diabetes and the relation of nutritional patterns with metabolic profiles. Turkiye Klinikleri J Pediatr 2018;27:59-69 doi: 10.5336/pediatr.2018-60826
• Mosso C, Halabi V, Ortiz T, et al. Dietary intake, body composition, and physical activity among young patients with Type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2015;28:895-902. doi: 10.1515/jpem-2014-0334.