Greater diet quality is associated with more optimal glycemic control in a longitudinal study of youth with type 1 diabetest
Greater diet quality is associated with more optimal glycemic control in a longitudinal study of youth with type 1 diabetest
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DOI：
10.3945/ajcn.115.126136
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发表时间：
2016-07-01
影响因子：
7.1
通讯作者：
Liu, Aiyi
中科院分区：
文献类型：
--
作者：
Nansel, Tonja R.;Lipsky, Leah M.;Liu, Aiyi
背景资料：尽管营养在1型糖尿病的管理中处于中心地位，但饮食质量和大量营养素分布与血糖控制的关系尚不明确。目的：本研究纵向研究了参与行为营养干预研究的1型糖尿病青年的饮食摄入与血糖控制的多个指标之间的关系。设计：一项行为营养干预随机临床试验的参与者[n = 136;平均+/- SD年龄：12.8 +/- 2.6岁;糖化血红蛋白（HbA 1c）：8.1% +/- 1.0%; 69.1%使用胰岛素泵]在基线和第3、6、9、12和18个月完成了3-d饮食记录;在使用Medtronic iPro CGM系统的同时获得了设盲的动态血糖监测（CGM）数据。每3个月获得HbA 1c;每6个月获得1，5-脱水葡萄糖醇。线性混合效应回归模型估计协会随时间变化的饮食摄入量变量随时间变化的血糖控制指标，控制年龄，身高，体重，性别，坦纳阶段，糖尿病病程，方案，频率的血糖监测，体力活动，和治疗assignment.Results：HbA 1c呈负相关的碳水化合物和天然糖，正相关的蛋白质和不饱和脂肪。1，5-脱水葡萄糖醇与纤维摄入量和天然糖呈正相关。更大的血糖控制，表示>= 1 CGM变量与更高的健康饮食指数-2005年，全植物食物密度，纤维，碳水化合物，天然糖和较低的血糖指数和不饱和fat.Conclusions：整体饮食质量和常量营养素分布与更优化的血糖控制。与长期血糖控制的生物标志物相比，与饮食摄入同时获得的CGM变量的相关性更一致。这些研究结果表明，血糖控制可以通过增加高纤维，低血糖指数，碳水化合物的食物摄入量来改善。
Background: Despite the centrality of nutrition in the management of type 1 diabetes, the association of diet quality and macronutrient distribution with glycemic control is ambiguous.Objective: This study examined longitudinally the association of dietary intake with multiple indicators of glycemic control in youth with type 1 diabetes participating in a behavioral nutrition intervention study.Design: Participants in a randomized clinical trial of a behavioral nutrition intervention [n = 136; mean +/- SD age: 12.8 +/- 2.6 y; glycated hemoglobin (HbA1c): 8.1% +/- 1.0%; 69.1% using an insulin pump] completed 3-d diet records at baseline and months 3, 6, 9, 12, and 18; masked continuous glucose monitoring (CGM) data were obtained concurrently with the use of the Medtronic iPro CGM system. HbA1c was obtained every 3 mo; 1,5-anhydroglucitol was obtained every 6 mo. Linear mixed-effects regression models estimated associations of time-varying dietary intake variables with time varying glycemic control indicators, controlling for age, height, weight, sex, Tanner stage, diabetes duration, regimen, frequency of blood glucose monitoring, physical activity, and treatment assignment.Results: HbA1c was associated inversely with carbohydrate and natural sugar, and positively with protein and unsaturated fat. 1,5-Anhydroglucitol was associated positively with fiber intake and natural sugar. Greater glycemic control as indicated by >= 1 CGM variable was associated with higher Healthy Eating Index-2005, whole plant food density, fiber, carbohydrate, and natural sugar and lower glycemic index and unsaturated fat.Conclusions: Both overall diet quality and macronutrient distribution were associated with more optimal glycemic control. Associations were more consistent for CGM variables obtained concurrently with dietary intake than for biomarkers of longer-term glycemic control. These findings suggest that glycemic control may be improved by increasing intake of high-fiber, low glycemic-index, carbohydrate containing foods.