Instituto de Nutrição Josué de Castro (INJC/UFRJ), Rio de Janeiro 21941-590, Brazil.
Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-590, Brazil.
Nutrients. 2024 Jan 26;16(3):364. doi: 10.3390/nu16030364.
To evaluate the association between dietary patterns, obesity, and glycemic control in children and adolescents with type 1 diabetes mellitus (T1DM).
A cross-sectional study was carried out in 2015 at a diabetes reference center in Rio de Janeiro. Sociodemographic data and those related to outpatient follow-ups were obtained from the medical records. The assessment of food consumption was performed using a 24 h food recall. Obesity was defined as body mass index-for-age (BMI-for-age) ≥ +1 z-score. Glycemic control was assessed using glycated hemoglobin (HbA1c). Dietary patterns were generated by factorial analysis, and each individual's adherence to these dietary patterns was determined by the factor loadings and then classified into terciles.
The study population included 120 children and adolescents, among whom 5 dietary patterns were identified. The prevalence of obesity was 31.7% ( = 38), and 64.2% ( = 77) of the participants had inadequate glycemic control. We observed that individuals with higher adherence to dietary pattern five, characterized by a greater consumption of ultra-processed foods, had higher odds of having higher HbA1c levels (OR = 3.49; 95% CI = 1.18-11.16).
Higher consumption of ultra-processed foods can be detrimental to glycemic control in children and adolescents. Thus, food intake monitoring is of paramount importance as part of the multidisciplinary care of patients with T1DM.
评估饮食模式、肥胖与 1 型糖尿病儿童和青少年血糖控制之间的关系。
2015 年在里约热内卢的一家糖尿病参考中心进行了一项横断面研究。从病历中获取了社会人口统计学数据和门诊随访相关数据。通过 24 小时食物回忆法评估食物摄入量。肥胖定义为体重指数-年龄（BMI-for-age）≥+1 z 分数。通过糖化血红蛋白（HbA1c）评估血糖控制情况。通过因子分析生成饮食模式，然后根据因子负荷确定每个人对这些饮食模式的依从性，并将其分为三分位数。
研究人群包括 120 名儿童和青少年，其中确定了 5 种饮食模式。肥胖的患病率为 31.7%（=38），64.2%（=77）的参与者血糖控制不佳。我们观察到，对饮食模式五的依从性较高的个体，其特点是超加工食品的摄入量较高，HbA1c 水平较高的可能性更高（OR=3.49；95%CI=1.18-11.16）。
超加工食品的摄入增加可能对儿童和青少年的血糖控制有害。因此，作为 1 型糖尿病患者多学科治疗的一部分，监测食物摄入至关重要。
