Plain language summary
Cardiovascular disease (CVD) is the major cause of mortality and morbidity in patients with type 1 diabetes, whose risk is several-fold higher than the general population. The objective of this study was to investigate relationships of CVD biomarkers with overall diet quality, and its dietary components in youth with type 1 diabetes. This study is a secondary analysis of a randomised controlled trial of a family-based behavioural nutrition intervention. The control group had an equal frequency of contact with the research staff but did not receive any nutrition advice besides that included as part of regular type 1 diabetes care. Results indicate that greater intake of whole grains and whole fruits, and lower added sugar and polyunsaturated fatty acids were associated with more favourable CVD biomarkers. Authors conclude that overall diet quality was not associated with CVD biomarkers in youth with type 1 diabetes. However, specific dietary components were associated with CVD biomarkers, independent of glycaemic control.
Abstract
Despite cardioprotective effects of a healthy diet in the general population, few studies have investigated this relationship in individuals with type 1 diabetes, who are at elevated risks of cardiovascular disease (CVD) due to hyperglycemia. The objective of this study was to examine the association of CVD biomarkers with overall diet quality, as measured by the Healthy Eating Index-2015 (HEI-2015), and its dietary components in youth with type 1 diabetes. Youth with type 1 diabetes (n = 136, 8⁻16.9 years) were enrolled in an 18-month behavioral nutrition intervention trial. Dietary intake from three-day diet records, CVD biomarkers (total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C); triglycerides (TG), C-reactive protein (CRP), 8-iso-prostaglandin-F2alpha (8-iso-PGF2α), systolic and diastolic blood pressure (SBP and DBP, respectively), and glycated hemoglobin (HbA1c) were assessed at baseline, 6, 12 and 18 months. Linear mixed-effects models estimated associations of dietary intake with CVD biomarkers, adjusting for HbA1c and other covariates. Separate models estimated associations of time-varying change in dietary intake with time-varying change in CVD biomarkers. HEI-2015 was not associated with CVD biomarkers, but whole grain intake was inversely associated with TC, HDL-C and DBP, and a greater increase in whole fruit intake was associated with lower DBP. Added sugar, saturated fat and polyunsaturated fat were positively related to serum TG, HDL-C, and DBP, respectively. Findings suggest that the intake of specific dietary components, including whole grains, whole fruits, added sugar and PUFA, may influence cardiometabolic health in youth with type 1 diabetes, independent of glycemic control.
Methodological quality
Jadad score
:
3
Allocation concealment
:
Yes
