Lipid profile and nutritional intake in children and adolescents with type 1 diabetes improve after a structured dietician training to a mediterranean-style diet

Auteur(s) :
Cadario F., Prodam F., Pasqualicchio S.
Date :
Mai, 2011
Source(s) :
J ENDOCRINOL INVEST. # p
Adresse :
Division of Pediatrics, Department of Medical Science, University of Piemonte Orientale, Novara, Italy

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Aim.
To evaluate if nutritional intakes and lipid profile fulfill international guidelines and recommendations before and after a structured dietician training to a Mediterranean-style diet in an Italian pediatric population with type 1 diabetes.

Methods.
A 6 months prospective cohort study. Baseline and after-intervention nutritional intakes, lipid profile, HbA1c, and clinical parameters of 96 children and adolescents with type 1 diabetes were assessed. A comparative computerized system which was approved and validated by the Italian Diabetologist Association was used to define the amounts of nutrients. Results. At baseline mean daily dietary intakes of carbohydrates, proteins and lipids were respectively (mean±SEM) 51.8±0.5, 15.9±0.2, 33.8±0.6%, with a contribution of cholesterol of 248.7±12.5 mg/day. Fiber assumption was 18.0±0.4 g/day. The 64.5% and 29.1% (p<0.0001) of subjects had at least one lipid parameter higher than 75th and 95th percentiles, respectively, of selected cut points (ADA guidelines for total and LDL-cholesterol and American Academy of Pediatrics standards for HDL-cholesterol and triglycerides). Six months after the dietician intervention, dietary lipids and cholesterol decreased (p<0.0001) while fibers (p<0.0001) increased. LDL-cholesterol, non-HDL-cholesterol and total cholesterol:HDL-cholesterol ratios significantly decreased (p<0.001) with a reduction of rate of subjects with at least one pathological lipid parameter (p<0.01) independently by weight and glucose control.

Conclusions.
Italian pediatric subjects with type 1 diabetes present a balanced diet with exception of lipids intake and a suboptimal lipid profile. A structured dietician training to a Mediterranean-style diet improves the quality of nutrient intakes being followed by a reduction of LDL-cholesterol, non- HDL-cholesterol and total cholesterol:HDL-cholesterol ratios

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