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Hope D. Bercaw, MS
Student
University of South Carolina
Greensboro, North Carolina, United States
Disclosure: Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.
Andrew Ortaglia, PhD
University of South Carolina
Brie M. Turner-McGrievy, PhD
University of South Carolina
Beth A. Reboussin, Ph.D., Sc.M., B.S.
Wake Forest University School of Medicine
Winston-Salem, North Carolina, United States
Katherine A. Sauder, PhD
Assistant Professor
University of Colorado
Aurora, Colorado, United States
Elizabeth J. Mayer-Davis, PhD, RD
Cary C Boshamer Distinguished Professor of Nutrition and Medicine
UNC-Chapel Hill
Chapel Hill, North Carolina, United States
Ronny A. Bell, PhD
Wake Forest School of Medicine
Amy S. Shah, MD
Cincinnati Children's Hospital Medical Center and University of Cincinnati
Dana Dabelea, MD, PhD
University of Colorado
Aurora, Colorado, United States
Eva Lustigova, MPH
Kaiser Permanente Southern California
Faisal Malik, M.D., M.S.H.S.
Seattle Children's Research Institute
Seattle, Washington, United States
Angela D. Liese, Ph.D.
Professor, Epidemiology and Biostatistics
University of South Carolina
Columbia, South Carolina, United States
This study aims to examine whether longitudinal changes in diet quality are associated with changes in glycemic control, assessed as hemoglobin A1c (HbA1c) in youth and young adults (YYA) with type 1 (T1D) and type 2 diabetes (T2D) across 19 years of data collection.
Methods: An analysis of the SEARCH for Diabetes in Youth Study consisted of 1429 YYA with T1D and 289 YYA with T2D (mean baseline age: 11.6 ± 4.4 years) who participated in at least 2 study visits between 2001 and 2019. Healthy Eating Index-2015 (HEI) scores were derived from a food frequency questionnaire for moderation (limit consumption) and adequacy (maximize consumption) of dietary components; HbA1c was measured from a blood sample. Repeated-measures linear mixed-effects analyses were performed to examine the longitudinal association between changes in HEI scores and HbA1c.
Results: Across 41 to 127 months diabetes duration, YYA with T1D experienced a 0.7 ± 2.1 percentage point increase in HbA1c (p=0.04) and a 0.7 ± 12.1 point increase in total HEI score (p=0.04), whereas YYA with T2D experienced a 1.4 ± 2.9 percentage point increase in HbA1c (p< 0.01) and a 1.16 ± 12.8 point increase in total HEI score (p=0.13). Among YYA with T1D and T2D, HEI scores (range 0-100 points) at both baseline and final visits averaged below 55 points. Change in HEI scores (total, adequacy, moderation) from 41 to 127 months diabetes duration, were not significantly associated with changes in HbA1c; however, increased consumption of seafood and plant proteins were associated with reduced HbA1c among YYA with T1D (β= -0.08, p=0.04). Among YYA with T2D, there was no significant association between HEI components and HbA1c.
Conclusions: There were minor improvements in diet quality across time among YYA with T1D and T2D, and no significant association between diet quality and glycemic control, except for seafood and plant proteins among YYA with T1D. Our results indicate that dietary improvements, either by reducing moderation component consumption or increasing adequacy component consumption, are not significantly associated with changes in glycemic control among YYA with diabetes.
Funding Sources:
SEARCH for Diabetes in Youth is funded by the Centers for Disease Control and Prevention and supported by the National Institute of Diabetes and Digestive and Kidney Diseases.