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Title: Self-reported dietary intake of youth with recent onset of type 2 diabetes: Results from the TODAY study

Author
item DELAHANTY, LINDA - Harvard Medical School
item KRISKA, ANDREA - University Of Pittsburgh
item EDELSTEIN, SHARON - George Washington University
item AMODEI, NANCY - University Of Texas At San Antonio
item CHADWICK, JENNIFER - University Of Oklahoma
item COPELAND, KENNETH - University Of Oklahoma Health Sciences Center
item GALVIN, BRYAN - University Of Pittsburgh Medical Center
item EL GHORMLI, LAURE - George Washington University
item HAYMOND, MOREY - Children'S Nutrition Research Center (CNRC)
item KELSEY, MEGAN - Children'S Hospital - Denver, Colorado

Submitted to: Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/20/2012
Publication Date: 3/20/2013
Citation: Delahanty, L., Kriska, A., Edelstein, S., Amodei, N., Chadwick, J., Copeland, K., Galvin, B., El Ghormli, L., Haymond, M.W., Kelsey, M.M. 2013. Self-reported dietary intake of youth with recent onset of type 2 diabetes: Results from the TODAY study. Nutrition and Dietetics. 113(3):431-439.

Interpretive Summary: This study is to assess dietary intake among a variety of young individuals with Type 2 Diabetes, from different environment, physiological, and social factors and to compare their intake to the current recommendations of the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. At the time of entry into the TODAY trial, subjects' diet quality was very poor, with a high intake of saturated fat and very low fruit and vegetable intake. This study will provide an evaluation of a long-term influence of a nutrition and lifestyle intervention on dietary intake and health outcomes of these high-risk youth with Type 2 diabetes.

Technical Abstract: Despite the widely recognized importance of diet in managing diabetes, few studies have documented usual dietary intake in young people with type 2 diabetes. The objective of our study were to assess dietary intake among a large, ethnically diverse cohort of young people with type 2 diabetes and compare intake to current recommendations. The Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study is a multicenter randomized clinical trial of 699 youth aged 10 to 17 years. At baseline, following a run-in period that included standard diabetes education, diet was assessed between 2004 and 2009 using a food frequency questionnaire. Analysis of variance and nonparametric tests were used to compare mean and median nutrient intakes; logistic regression was used to compare the odds of meeting predefined dietary intake recommendation cutpoints between subgroups of age, sex, and race-ethnicity. Percent of energy from saturated fat was consistently 13% to 14% across all subgroups, substantially exceeding national recommendations. Overall, only 12% of youth met Healthy People 2010 guidelines for intake of <10% of energy from saturated fat and only 1% of youth met American Diabetes Association recommendations for intake of <7% of energy from saturated fat. Dietary intake fell substantially below other Healthy People 2010 targets; only 3% met calcium intake goals, 11% met fruit consumption goals, 5% met vegetable consumption goals, and 67% met grain intake goals. Overall, dietary intake in this large cohort of young people with type 2 diabetes fell substantially short of recommendations, in ways that were consistent by sex, age, and race-ethnicity. The data suggest a critical need for better approaches to improve dietary intake of these young people.