Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, NIH, Department of Health and Human Services, Bethesda, MD, USA.
Genetics and Epidemiology Section, Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
Eur J Clin Nutr. 2014 Jan;68(1):131-6. doi: 10.1038/ejcn.2013.239. Epub 2013 Nov 20.
BACKGROUND/OBJECTIVES: Neophobia, pickiness and diet variety are associated with diet quality and health outcomes in young children. Limited research has examined these associations among youth with type 1 diabetes (T1D), a population at risk for poor health outcomes when dietary quality is inadequate.
SUBJECTS/METHODS: Youth (n=252, age 13.2 ± 2.8 years, 92% white, diabetes duration 6.3 ± 3.4 years) with T1D and their parents completed 3-day youth diet records; parents completed questionnaires regarding youth neophobia, pickiness and diabetes management adherence. Medical records provided biomedical data. Dietary quality indicators included Nutrient-Rich Foods Index 9.3 (NRF9.3), Healthy Eating Index-2005 (HEI-2005), Whole Plant Food Density (WPFD) and key single nutrients. Dietary variety was operationalized as a count of 20 recommended food groups consumed. Relationships of dietary quality and diabetes management adherence with neophobia, pickiness and dietary variety as independent variables were examined using multiple linear regression analyses adjusted for total energy intake, age, height and weight.
In multiple linear regression analyses, NRF9.3 and HEI-2005 were each inversely associated with neophobia and pickiness, and positively associated with dietary variety. WPF and potassium were each positively associated and saturated fat was inversely associated with dietary variety. However, in models simultaneously including neophobia, pickiness and dietary variety as independent correlates of dietary quality, only relationships with dietary variety remained significant. Diabetes management adherence was negatively associated with both neophobia and pickiness and positively associated with dietary variety.
Findings suggest that increasing dietary variety may contribute toward improved dietary quality among youth with T1D, despite potentially adverse influences of neophobia and pickiness.
背景/目的:在幼儿中,对新事物的恐惧、挑食和饮食多样性与饮食质量和健康结果有关。有限的研究考察了这些关联在 1 型糖尿病(T1D)青少年中的表现,T1D 人群在饮食质量不足时健康结果较差的风险较高。
受试者/方法:252 名青少年(年龄 13.2±2.8 岁,92%为白人,糖尿病病程 6.3±3.4 年)及其父母完成了 3 天的青少年饮食记录;父母完成了关于青少年对新事物的恐惧、挑食和糖尿病管理依从性的调查问卷。医疗记录提供了生物医学数据。饮食质量指标包括富含营养素食物指数 9.3(NRF9.3)、健康饮食指数-2005(HEI-2005)、全植物食物密度(WPFD)和关键单一营养素。饮食多样性通过 20 种推荐食物组的摄入量来计算。使用多元线性回归分析,以饮食质量和糖尿病管理依从性作为因变量,以新事物恐惧、挑食和饮食多样性作为独立变量,在调整总能量摄入、年龄、身高和体重后进行分析。
多元线性回归分析显示,NRF9.3 和 HEI-2005 与新事物恐惧和挑食呈负相关,与饮食多样性呈正相关。WPFD 和钾与饮食多样性呈正相关,而饱和脂肪与饮食多样性呈负相关。然而,在同时包含新事物恐惧、挑食和饮食多样性作为饮食质量独立相关因素的模型中,只有与饮食多样性的关系仍然具有统计学意义。糖尿病管理依从性与新事物恐惧和挑食呈负相关,与饮食多样性呈正相关。
研究结果表明,尽管新事物恐惧和挑食可能会产生不利影响,但增加饮食多样性可能有助于改善 T1D 青少年的饮食质量。