Adherence to the Mediterranean Diet Is Associated with Better Metabolic Features in Youths with Type 1 Diabetes.

Valentina Antoniotti,Silvia Savastio,Filipa Patricia Goncalves Correia,Roberta Ricotti,Daniele Spadaccini,Erica Pozzi,Flavia Prodam,Marina Caputo,Simonetta Bellone,Deborah Carrera,Ivana Rabbone

doi:10.3390/nu14030596

Abstract

Our aim was to evaluate adherence to the Mediterranean diet (MedDiet) among children and adolescents with type 1 diabetes (T1D) in relation to metabolic control. Adherence to the MedDiet was assessed with the Mediterranean Diet Quality Index (KIDMED) questionnaire and physical activity by the International Physical Activity Questionnaire for Adolescent (IPAQ-A) on 65 subjects (32 males, 9–18 years) with T1D. Clinical and metabolic evaluation was performed (standardized body mass index (BMI-SDS), hemoglobin A1C (HbA1c), continuous glucose monitoring metrics when present, blood pressure, lipid profile). Parental characteristics (age, body mass index (BMI), socio-economic status) were reported. The adherence to the MedDiet was poor in 12.3%, average in 58.6%, and high in 29.1% of the subjects. Furthermore, 23.4% of patients were overweight/obese. The most impacting factors on BMI-SDS were skipping breakfast and their father’s BMI. HbA1c and time in range % were positively associated with sweets and fish intake, respectively. Additionally, the father’s socio-economic status (SES) and mother’s age were associated with glucose control. Blood pressure was associated with travelling to school in vehicles, extra-virgin olive oil intake and milk/dairy consumption at breakfast. The promotion of the MedDiet, mainly having a healthy breakfast, is a good strategy to include in the management of T1D to improve glucose and metabolic control. This research is valuable for parents to obtain the best results for their children with T1D.

Highlights

IntroductionType 1 diabetes (T1D) is an autoimmune disease that is rapidly increasing worldwide [1]
Introduction published maps and institutional affilType 1 diabetes (T1D) is an autoimmune disease that is rapidly increasing worldwide [1]
Regarding the management of the disease, only 21.9% of subjects were able to maintain a time in range (TIR)% over 70%, and hemoglobin A1C (HbA1c) was >8.5% in 26.2% of subjects

Summary

Introduction

Type 1 diabetes (T1D) is an autoimmune disease that is rapidly increasing worldwide [1]. It is one of the most common chronic diseases in childhood with an estimated prevalence of 1.1 million children and adolescents affected [2]. As well as insulin treatment, a crucial part of T1D patient therapy [3,4,5], another treatment is medical nutritional therapy (MNT). T1D because of the need to adapt insulin therapy to nutrient intake, ensuring satisfactory glucose control [3,5,6]. Increased nutritional awareness of patients and their families is associated with better glucose control and the high quality of the diet in young people [7]. MNT assigned by a dietitian or a registered nutritionist is associated with a 1.0–1.9% decrease in

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