Bias in food intake reporting in children and adolescents with type 1 diabetes: the role of body size, age and gender

Abstract

in food intake reporting in children and adolescents with type 1 diabetes: the role of body size, age and gender. Pediatric Diabetes 2017: 18: 213-221.Background: An assessment of total daily energy intake is helpful in planning the overall treatment of children with type 1 diabetes (T1D). However, energy intake misreporting may hinder nutritional intervention. Aims: To assess the plausibility of energy intake reporting and the potential role of gender, body mass index (BMI) z-score (z-BMI), disease duration and insulin requirement in energy intake misreporting in a sample of children and adolescents with T1D. Methods; The study included 58 children and adolescents aged 8-16 yr with T1D. Anthropometry, blood pressure and glycated hemoglobin (HbA1c) were measured. Subjects were instructed to wear a SenseWear Pro Armband (SWA) for 3 consecutive days, including a weekend day and to fill out with their parents a weighed dietary record for the same days. Predicted energy expenditure (pEE) was calculated by age and gender specific equations, including gender, age, weight, height and physical activity level (assessed by SWA). The percent reported energy intake (rEI)/pEE ratio was used as an estimate of the plausibility of dietary reporting. Results: Misreporting of food intake, especially under-reporting, was common in children and adolescents with T1D: more than one-third of participants were classified as under-reporters and 10% as over-reporters. Age, z-BMI and male gender were associated with the risk of under-reporting (model R 2 = 0.5). Waist circumference was negatively associated with the risk of over-reporting (model R 2 = 0.25). Conclusions: Children and adolescents with T1D frequently under-report their food intake. Age, gender and z-BMI contribute to identify potential under-reporters.

Australian children with type 1 diabetes consume high sodium and high saturated fat diets: Comparison with national and international guidelines

“…However, the ACAES has been validated and used in a number of other nutrition studies very similar to ours . Furthermore, it has been found that bias in food reporting in children with T1D is, on average, of modest magnitude . The control group was also made up of some siblings of children with T1D, which could impact the comparison between children with and without T1D as they may have been eating similar diets in the same household.…”

Endocrine and metabolic consequences due to restrictive carbohydrate diets in children with type 1 diabetes: An illustrative case series

“…The families who adopt low carbohydrate diets, as in this case series, are often well educated, yet rely on personal blogs from social media as evidence that such a diet is in the best interest of their child. Furthermore, while under‐reporting of food intake should be considered in any assessment of the nutritional intake of children and adolescents with diabetes, families who follow restricted carbohydrate diets often fastidiously monitor carbohydrate intake. Health professionals face a predicament between trying to maintain a positive patient relationship, while trying to convince the family that the diet may be detrimental to their child's health.…”

Using Personal Mobile Phones to Assess Dietary Intake in Free-Living Adolescents: Comparison of Face-to-Face Versus Telephone Training

“…However, energy intake based on just one day would be insufficient to determine over- or underreporting given the wide day-to-day intake variation especially among adolescents [ 27 ]. Also, there is evidence that adolescents tend to underreport their intake, which becomes more pronounced as weight increases [ 28 , 29 ]. Since some of our participants skipped a meal during the day (6/42, 14%), this could partly explain why median intakes of energy for both groups were lower compared to the EER.…”