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

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.