Dietary intake among youth with diabetes: The SEARCH for diabetes in youth study

Objective To describe dietary intake among a large cohort of youth with type 1 or type 2 diabetes and to compare their intake with current nutrition recommendations. Design SEARCH for Diabetes in Youth is a multicenter study of diabetes in youth. Diet was assessed among youth aged 10 to 22 years who attended a SEARCH research clinic visit and completed a previous-week food frequency questionnaire that included foods to reflect the ethnic and regional diversity represented by the cohort. Subjects/setting Included were 1,697 youth with physician-diagnosed diabetes mellitus (89% type 1 diabetes, 11% type 2 diabetes), with diabetes mellitus duration of at least 12 months. Statistical analyses Descriptive data and comparisons with nutrition recommendations were unadjusted. Analyses of covariance with adjustment for total energy, clinic site, sex, race/ethnicity, age, and parental education were used to compare intake according to diabetes type. Results Percent of energy from total fat was consistent at 37% to 38% across subgroups of age (10 to 14 years, > 15 years) and diabetes type (ie, type I or type 2). Youth with type 2 diabetes consumed less calcium, magnesium, and vitamin E than youth with type I diabetes (P < 0.01 for each). Intake of sweetened carbonated beverages among older (aged > 15 years) youth with type 2 diabetes was twice that of older youth with type 1 diabetes (P < 0.01). Only 6.5% of the cohort met American Diabetes Association recommendations of < 10% of energy from saturated fat. Less than 50% met recommendations for total fat, vitamin E, fiber, fruits, vegetables, and grains, although a majority met recommendations for vitamin C, calcium, and iron. Conclusions Overall, dietary intake in this large cohort of youth with diabetes substantially failed to meet current recommendations. There is a critical need for improvement in dietary intake in youth with diabetes.