Declining adherence to dietary guidelines and associated food insecurity among young people with T1D

Food insecurity is associated with reduced adherence to fiber and sodium guidelines among youth and young Americans (YYA). type 1 diabetes It can lead to complications of diabetes and other chronic diseases (T1D), according to new results from the SEARCH for Diabetes in You study.

The survey results are Journal of the Academy of Nutrition and Dietetics.

Previous studies have shown that household food insecurity is associated with poor dietary intake in the general population. However, “little is known about this association in people with diabetes,” the authors wrote.

Children and adults in general have also been shown to consume excess sodium and saturated fat. The author points out that they were food insecure at the time.

To better understand the association between food insecurity and dietary intake in YYA, adolescents with diabetes, researchers evaluated 10 major nutrients and dietary components. They also analyzed adherence to the Dietary Reference Intakes (DRI) and the Dietary Guidelines for Americans 2020-2025 (DGA).

A total of 1197 YYA with T1D and 319 YYA with type 2 diabetes (T2D) were included in the study. The mean age of the first cohort was approximately 21 years and the mean age of the second cohort was approximately 25 years. All participants completed the USDA Household Food Security Survey module. 3 or more positives indicate food insecurity.

All YYA age groups ranged from 10 to 35 years, and most participants were female. The mean duration of diabetes among patients with type 1 diabetes was 11.2 years. The average duration of T2D patients he had was 10.4 years. Patients with T1D were mostly Caucasian and those with T2D were predominantly Black.

Analysis revealed:

• Less than 40% of participants did not meet guideline recommendations for 8 of the 10 nutrients and dietary components.
• Vitamin C and added sugars showed high adherence rates of over 47%
• At YYA with T1D, those with dietary instability were more likely to meet recommendations for calcium, magnesium, and vitamin E (P. < .05), unlikely sodium (P. < .05) than those with food security
• In the adjusted model, YYA in food safe type 1 diabetes had closer median adherence to sodium (P. = .002) and fiber (P. = .042) Guidelines from those who were food insecure
• No association between YYA and T2D was observed

Furthermore, the data show that “of all participants, 20.3% lived in food-insecure households, with the majority of people with type 2 diabetes affected (type 1 diabetes: 17.5%; type 2 diabetes: 17.5%; Food-deficient subjects had higher energy intake than food-deficient subjects (T1D: 235.1 kcal/day; T2D: 179.3 kcal/day).

The researchers noted that the results of the current study are consistent with previous findings in the diabetic population. “Guideline adherence was very low overall for fiber, magnesium, vitamin D, vitamin E, and saturated fat, and moderate overall for vitamin C.

They also found that more than half of YYA with diabetes adhered to sugar consumption guidelines, compared with 32.6% of the general population. The authors write that it could be because they need to be more careful.

“Undernutrition is prominent in YYA with diabetes in the United States, with small differences between food safety/insecurity, except for marked differences among racial/ethnic minorities and by socioeconomic status. There is,” the researchers concluded.

“Further research highlighting the social contexts that contribute to undernourishment in YYA with diabetes is needed to inform effective interventions for disproportionately affected populations. based on economic status or race/ethnicity,” they said.

reference

Bercaw H, Reid LA, Mendoza JA, et al. Food insecurity and dietary adequacy in adolescents and young adults with juvenile-onset type 1 and type 2 diabetes. J AcadNutr DietPublished online March 27, 2023. doi:10.1016/j.jand.2023.03.013