Eating behaviors and estimated body fat percentage among adolescents with type 1 diabetes.

Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: thanhnt@live.unc.edu. Translational Research Institute, AdventHealth, Orlando, FL, USA. Electronic address: daria.igudesman@adventhealth.com. Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: ksburger@email.unc.edu. Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: jbigelow@email.unc.edu. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: dmaahs@stanford.edu. Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical School, Cincinnati, OH, USA. Electronic address: michael.seid@cchmc.org. Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: mayerdav@email.unc.edu.

Diabetes research and clinical practice. 2024;:111070
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Abstract

AIMS: Estimate associations between select eating behaviors and estimated body fat percentage (eBFP) and explore effect modification by sex among adolescents with type 1 diabetes (T1D). METHODS This analysis included 257 adolescents (mean age 14.9 ± 1.14 years; 49.8 % female) with baseline hemoglobin A1c (HbA1c) between 8 and 13 % (64 mmol/mol-119 mmol/mol) from a randomized trial designed to improve glycemia. Eating behaviors and eBFP were determined from surveys and validated equations respectively. Linear mixed models were used to estimate associations. Effect modification was assessed via stratified plots, stratified associations, and interaction terms. RESULTS Disordered eating, dietary restraint, and eBFP were significantly higher among females while external eating was higher among males. Disordered eating (β: 0.49, 95 %CI: 0.24, 0.73, p = 0.0001) and restraint (β: 1.11, 95 %CI: 0.29, 1.92, p = 0.0081) were positively associated with eBFP while external eating was not (β: -0.19, 95 %CI: -0.470, 0.096, p = 0.20). Interactions with sex were not significant (p-value range: 0.28-0.64). CONCLUSION Disordered eating and dietary restraint were positively associated with eBFP, highlighting the potential salience of these eating behaviors to cardiometabolic risk for both female and male adolescents. Prospective studies should investigate whether these eating behaviors predict eBFP longitudinally to inform obesity prevention strategies in T1D.