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Dietary Energy and Nutrient Intake, and T2DM in Children

Is there an association between total energy intake, energy density, dietary nutrient intakes and risk markers for T2DM in children?… 

Researchers used data gathered from the Child Heart and Health Study in England, which determined markers of T2DM risks and their determinants in a group of multi-ethnic children. Participants from that study were asked to take part in this dietary examination. Energy intake, energy density, fat, saturated fat, mono-saturated fat, polyunsaturated fat, carbohydrates, sugars, starch, non-starch polysaccharides, protein, vitamin B12, folate, vitamin C, calcium, and iron were all calculated by the Medical Research Council Human Nutrition Research Center for a 24H collection period for 2, 017 children. Height, weight, waist circumference, multiple skinfold thickness, and bioelectrical impedance were also measured using a Bodystat 1500 body composition analyzer. The children also provided fasting and plasma blood glucose, serum insulin, and HbA1c. Data was analyzed using multi-level linear regression models.

The results showed a positive association with energy intake and insulin resistance but no further associations with energy density, macro or micro nutrients, and insulin or glycemia were observed. There was a 4.40% change in insulin resistance with energy intake. When implausible reporters were removed, the percentage increased to 7.93%. The rest of the coefficients measured showed negative or very minimal associations. The biggest limitation of this study, and the reason why the data was so inconclusive was that the diet was only recorded for one single 24 hour period.

Practice Pearls
  • Energy intake and density are implicated in T2DM risks in adults.
  • The associations between energy intake and type 2 diabetes risk markers show a clear graded relationship that could feasibly be causal but longer dietary recalls need to be done.
  • Insulin resistance and energy intake were the only two with a positive association.

Donin, A. Dietary Energy Intake Is Associated With Type 2 Diabetes Risk Markers in Children. Diabetes Care; 37(1):116-1223. 2014.