Dietary Patterns in Underprivileged Indian Children and Adolescents with Type 1 Diabetes

Author(s): Shashi Chiplonkar, Neha Kajale, Nikhil Lohiya, Lavanya Parthasarhty, Vaman Khadilkar, Anuradha Khadilkar*

Journal Name: Current Nutrition & Food Science

Volume 16 , Issue 6 , 2020


Become EABM
Become Reviewer
Call for Editor

Graphical Abstract:


Abstract:

Background: Children with diabetes are likely to have different food and nutrient composition due to dietary restrictions. Studies on dietary intakes in Indian underprivileged children with Type1 diabetes are scarce.

Objective: To study dietary patterns and nutrient intakes of underprivileged children and adolescents with type1 diabetes in comparison with their healthy siblings.

Methods: Cross-sectional study, diet assessed by 24-h recall on 3-non-consecutive days in 120 children with type1 diabetes (11.2 ± 3.8 yrs) and 65-age-gender matched healthy siblings. Dietary patterns determined by cluster analysis. Nutrient composition was compared by one-way ANOVA.

Results: Children with diabetes belonged to middle/lower economic class. Mean HbA1C of children with diabetes was 9.7 ± 2.0% with higher intakes of whole cereals, milk, fruits, vegetables and lower intakes of refined cereals, pulses, animal products than healthy siblings (P <0.05). Four diet patterns were characterized on the basis of major foods: i) wheat, ii) millets, iii) rice and pulse and iv) milk and fruits. Though patterns were similar in both groups, significantly higher intakes of vitamin C (35 ± 23 vs. 24.7 ± 16.3 mg/d), zinc (5.6 ± 2 vs. 4.5 ± 2.3 mg/d), thiamin (812 ± 383 vs. 570 ± 254 μg/d), riboflavin (782 ± 341 vs. 352 ± 182 μg/d) and calcium (673 ± 272 vs. 461 ± 253 mg/d) noted in children with diabetes. Total energy, protein and carbohydrate intakes were comparable; fat consumption was significantly lower amongst children with diabetes, though above recommended daily allowance (RDA) 41.6 ± 14.1 gm vs. 47.4 ± 18.9 gm, P=0.029.

Conclusion: Underprivileged children with diabetes and siblings had similar dietary patterns; children with diabetes consumed healthier diet than siblings, still glycemic control was not optimum. Dietary interventions are needed to improve micronutrient intake and reduce fat intake in underprivileged children with type1 diabetes to improve their glycemic control.

Keywords: Children, diabetes, dietary composition, Hba1c, India, recommended daily allowance.

[1]
Kumar KM, Kumar P. Incidence trends for childhood type 1 diabetes in India. Indian J Endocrinol Metab 2015; 19(Suppl. 1): S34-5.
[http://dx.doi.org/10.4103/2230-8210.155378] [PMID: 25941646]
[2]
Anandakumar A, Kalpana T, Mohan V. Childhood and Adolescent Onset Type 1 Diabetes in India. MGM J Med Sci 2013; 1(1): 46-53.
[3]
Marjerrison S, Cummings EA, Glanville NT, Kirk SF, Ledwell M. Prevalance and associations of food insecurity in children with diabetes mellitus. J Pediatr 2011; 158(4): 607-11.
[http://dx.doi.org/10.1016/j.jpeds.2010.10.003] [PMID: 21126743]
[4]
Marín-Peñalver JJ, Martín-Timón I, Sevillano-Collantes C, Del Cañizo-Gómez FJ. Update on the treatment of type 2 diabetes mellitus. World J Diabetes 2016; 7(17): 354-95.
[http://dx.doi.org/10.4239/wjd.v7.i17.354] [PMID: 27660695]
[5]
Indu M, Kumari A, Kumar A. A study on food consumption pattern of pre-school children of Khagaria district of Bihar. Asian J Home Sci 2010; 5: 114-7.
[6]
Tupe R, Chiplonkar SA. Diet patterns of lactovegetarian adolescent girls: need for devising recipes with high zinc bioavailability. Nutrition 2010; 26(4): 390-8.
[http://dx.doi.org/10.1016/j.nut.2009.05.018] [PMID: 19628369]
[7]
Verma S, Boora P, Khetarpaul N. Assessment of food consumption pattern and nutritional status of pre-school children. Asian J Home Sci 2009; 4: 209-15.
[8]
Pruitt SL, Leonard T, Xuan L, et al. Who is food insecure? implications for targeted recruitment and outreach, national health and nutrition examination survey, 2005-2010. Prev Chronic Dis 2016; 13:E143.
[9]
Dudala SR. Updated Kuppuswamy’s socioeconomic scale for 2012. J NTR Univ Health Sci 2013; 2: 201-2.
[http://dx.doi.org/10.4103/2277-8632.117195]
[10]
Khadilkar VV, Khadilkar AV, Cole TJ, Sayyad MG. Crosssectional growth curves for height, weight and body mass index for affluent Indian children, 2007. Indian Pediatr 2009; 46(6): 477-89.
[PMID: 19556658]
[11]
Bangstad HJ, Danne T, Deeb L, Jarosz-Chobot P, Urakami T, Hanas R. Insulin treatment in children and adolescents with diabetes. Pediatr Diabetes 2009; 10(12)(Suppl. 12): 82-99.
[http://dx.doi.org/10.1111/j.1399-5448.2009.00578.x] [PMID: 19754621]
[12]
C Diet. : version 2 Xenios Technology 2012.
[13]
Chiplonkar SA, Agte VV. Extent of error in estimating nutrient intakes from food tables versus laboratory estimates of cooked foods. Asia Pac J Clin Nutr 2007; 16(2): 227-39.
[PMID: 17468077]
[14]
Gopalan C, Ramasastri BB, Balasubramanyam SC. Nutritive value of Indian food Hyderabad: National Institute of Nutrition (Indian Council of Medical Research; ICMR) . 1999.
[16]
Indian Council of Medical research (ICMR). Nutrient requirements and recommended dietary allowances for Indians, A report of the expert group of the Indian Council of Medical Research 2010. Hyderabad, India: National Institute of Nutrition 2010.
[17]
Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002; 13(1): 3-9.
[http://dx.doi.org/10.1097/00041433-200202000-00002] [PMID: 11790957]
[18]
Galli-Tsinopoulou A, Grammatikopoulou MG, Stylianou C, Kokka P, Emmanouilidou E. A preliminary case-control study on nutritional status, body composition, and glycemic control of Greek children and adolescents with type 1 diabetes. J Diabetes 2009; 1(1): 36-42.
[http://dx.doi.org/10.1111/j.1753-0407.2008.00002.x] [PMID: 20923518]
[19]
Overby NC, Flaaten V, Veierød MB, et al. Children and adolescents with type 1 diabetes eat a more atherosclerosis-prone diet than healthy control subjects. Diabetologia 2007; 50(2): 307-16.
[http://dx.doi.org/10.1007/s00125-006-0540-9] [PMID: 17136391]
[20]
Walker AF. Potential micronutrient deficiency lacks recognition in diabetes. Br J Gen Pract 2007; 57(534): 3-4.
[PMID: 17244416]
[21]
Chehade J, Sheikh-Ali M, Mooradian A. The role of micronutrients in managing diabetes. Diabetes Spectr 2009; 22: 214-8.
[http://dx.doi.org/10.2337/diaspect.22.4.214]
[22]
Srihari G, Eilander A, Muthayya S, Kurpad AV, Seshadri S. Nutritional status of affluent Indian school children: what and how much do we know? Indian Pediatr 2007; 44(3): 204-13.
[PMID: 17413196]
[23]
Helgeson VS, Viccaro L, Becker D, Escobar O, Siminerio L. Diet of adolescents with and without diabetes: trading candy for potato chips? Diabetes Care 2006; 29(5): 982-7.
[http://dx.doi.org/10.2337/dc05-2197] [PMID: 16644624]
[24]
Gesuita R, Skrami E, Bonfanti R, et al. The role of socio-economic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey. Pediatr Diabetes 2017; 18(3): 241-8.
[http://dx.doi.org/10.1111/pedi.12378] [PMID: 26990605]


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 16
ISSUE: 6
Year: 2020
Published on: 25 November, 2019
Page: [945 - 952]
Pages: 8
DOI: 10.2174/1573401315666191126091201
Price: $65

Article Metrics

PDF: 15
HTML: 3
EPUB: 1
PRC: 1