Correlates of Medical Nutrition Therapy and Cardiovascular Outcomes in Youth With Type 1 Diabetes |
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| Authors: | Natalie S. The Jamie L. Crandell Joan Thomas Sarah C. Couch Amy S. Shah David M. Maahs Dana Dabelea Santica M. Marcovina Ralph B. D’Agostino Elizabeth J. Mayer-Davis |
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| Affiliation: | 1. Department of Health Sciences, Furman University, Greenville, SC;2. Department of Biostatistics, Gillings School of Global Public Health, School of Nursing, University of North Carolina, Chapel Hill, NC;3. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC;4. Department of Nutritional Sciences, College of Allied Health, University of Cincinnati, Cincinnati, OH;5. Division of Endocrinology, Cincinnati Children''s Hospital Medical Center, Cincinnati, OH;6. Barbara Davis Center and Department of Pediatrics, School of Medicine, University of Colorado Denver, Aurora, CO;7. Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO;8. Northwest Metabolism and Diabetes Research Laboratories, University of Washington, Seattle, WA;9. Department of Biostatistical Sciences, School of Medicine, Wake Forest University, Winston-Salem, NC;1. School of Family and Consumer Science, University of Idaho, Moscow, ID;2. Extension Supplemental Nutrition Assistance Program-Education, Washington State University, Pullman, WA;3. Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO;1. Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA;2. Regional Food and Nutrition Security Program for Central America, San Salvador, El Salvador;3. Department of Public Health and Community Medicine, Tufts University, Boston, MA;1. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA;2. Division of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA;3. Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Promotion, Centers for Disease Control and Prevention, Atlanta, GA;1. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;2. Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;3. Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD |
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| Abstract: | ObjectivesTo examine whether the types of medical nutrition therapies (MNTs) taught to and used by youth with type 1 diabetes (T1D) vary by sociodemographic characteristics and cardiovascular (CVD) risk factors.DesignCross-sectional study.SettingThe SEARCH for Diabetes in Youth study is a population-based cohort of individuals with clinical diagnosed diabetes.ParticipantsA total of 1,191 individuals with T1D.Main Outcome MeasuresTypes of MNTs and frequency of use.AnalysisBivariate analysis and multivariate linear regression (P < .05)ResultsMore race/ethnic minorities (vs whites), individuals with parents with less than a high school education (vs high school or higher education), and overweight/obese (vs underweight/normal weight) were taught additional MNTs. For underweight/normal weight individuals exclusively taught carbohydrate counting, those who used this approach “often” had lower hemoglobin A1c (8.6% vs 8.9%) and triglycerides (73.5 vs 84.1 mg/dL) than those who used it “sometimes/never.” “Often” use of additional MNTs beyond carbohydrate counting was not associated with better mean values for CVD risk factors.Conclusions and ImplicationsIn individuals with T1D, race/ethnic minorities, individuals with parents with less than a high school education, and overweight/obese individuals are taught more MNTs. Further research is needed to understand the effectiveness of the various MNTs on CVD risk factors, and to identify how to translate nutrition knowledge to behavior and metabolic status. |
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| Keywords: | medical nutrition therapy type 1 diabetes cardiovascular risk child |
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