Assessments of energy, macro and micronutrient intakes in children and adolescents with type 1 diabetes mellitus
Yıl 2023,
, 235 - 241, 31.05.2023
Volkan Ozkaya
,
Sebnem Ozgen Ozkaya
Öz
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.
Kaynakça
- 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.
Yıl 2023,
, 235 - 241, 31.05.2023
Volkan Ozkaya
,
Sebnem Ozgen Ozkaya
Kaynakça
- 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.