TİP 1 DİYABETLİ ADÖLESANLARIN DİYET KALİTESİNİ ETKİLEYEN FAKTÖRLER ÜZERİNE KESİTSEL BİR ARAŞTIRMA

Year 2021, , 552 - 558, 01.10.2021

Gülsüm Şahin Bodur , Alev Keser , Zeynep Şıklar Merih Berberoğlu

https://doi.org/10.26650/IUITFD.2021.823857

Abstract

Amaç: Tip 1 diyabetli adölesanların diyet kalitesi bazı bireysel faktörlere göre değişebilmektedir. Bunlar yaş, cinsiyet, sosyodemografik özellikler, yaşam tarzı alışkanlıkları ve diyabet tedavisine uyumu içerir. Bu çalışmanın amacı, tip 1 diyabetli adölesanların diyet kalitesini etkileyen faktörleri incelemektir. Gereç ve Yöntemler: Bu çalışmanın örneklemini, Temmuz 2017- Ocak 2018 tarihleri arasında Ankara Üniversitesi Tıp Fakültesi Çocuk Endokrinolojisi Anabilim Dalı’nda takip edilen tip 1 diyabetli adolesanlar oluşturmuştur. Araştırma verileri yüz yüze görüşme tekniği kullanılarak toplanmıştır. Bireylerin fiziksel aktivite düzeyleri ‘24 saatlik fiziksel aktivite düzeyi tespit formu (kısa) ‘ile belirlenmiştir. Üç günlük besin tüketim kayıtları alınmış ve BeBis ile değerlendirilmiştir. Diyet kalitesini belirlemek için Sağlıklı Yeme İndeksi-2010 kullanılmıştır. Bulgular: Çalışma, 10-19 yaş aralığında (ortalama: 14,0±2,40 yıl) 57’si erkek (%51,8), 53’ü kadın (%48,2) olmak üzere toplam 110 tip 1 diyabetli adolesan ile gerçekleştirilmiştir. Tüm bireylerin sadece %15,5’i iyi diyet kalitesine sahipti. Diyet kalitesinin cinsiyete göre dağılımı istatistiksel olarak anlamlı değildi. (p>0,05). Bireylerin egzersiz durumu, fiziksel aktivite türü ve PAL değeri değişkenlerinden oluşan doğrusal regresyon modelinde egzersiz durumu ile diyet kalitesi arasında pozitif yönde anlamlı bir ilişki bulunmuştur (χ2 (1,n=110)=1,392, p<0,05). Sonuç: Sonuç olarak, bu çalışmada, katılımcıların çoğunun diyet kalitelerini iyileştirmesi gerektiği ve egzersizin tip 1 diyabetli adölesanların diyet kalitesini etkilediği saptanmıştır. Buna ek olarak, hem diyabet yönetiminde hem de diyet kalitesinin iyileştirilmesinde önemli rolü olan egzersiz düzeylerinin artırılması gerektiği sonucuna varılmıştır.

Keywords

Tip 1 diyabet, adolesanlar, diyet kalitesi, egzersiz

A CROSS-SECTIONAL STUDY ON FACTORS AFFECTING DIETARY QUALITY OF ADOLESCENTS WITH TYPE 1 DIABETES

Abstract

Objective: The diet quality of adolescents with type 1 diabetes is shaped by some individual factors. These include age, gender, sociodemographic characteristics, lifestyle habits, and adaptation to diabetes treatment. This study aims to investigate the factors affecting the diet quality of adolescents with type 1 diabetes. Material and Methods: The sample in this study consisted of adolescents with type 1 diabetes who were followed in the Department of Pediatric Endocrinology of the Faculty of Medicine at the University of Ankara between July 2017-January 2018. The research data was collected using the face-to-face interview technique with a questionnaire. The physical activity levels of the individuals were determined using a ‘24-hour physical activity level detection form (short)’. Three-day food consumption records were taken and evaluated via BeBiS. The Healthy Eating Index-2010 was used to determine diet quality. Results: The study was conducted with a total of 110 adolescents (M:51.8%; F:48.2%) with type 1 diabetes in the 10-19 age range (mean age:14.0±2.40 years). Only 15.5% of all individuals have good diet quality. In a linear regression model formed by the variables of exercise status, physical activity type, and PAL value of individuals, a positive significant relationship was found between exercise status and diet quality (χ2 (1,n=110)=1.392, p<0.05). Conclusion: As a result, it was found that the majority of individuals needed to improve their diet quality and that exercise affected the diet quality of type 1 diabetic adolescents. In addition, exercise levels, which have an important role in both diabetes management and improvement of diet quality, should be increased.

Keywords

Type 1 diabetes, adolescents, diet quality, exercise

References

• 1. American Diabetes Association/ADA. Nutrition recommendations and interventions for diabetes. Diabetes Care 2018;31(1):61-78.
• 2. Smart CE, Annan F, Higgins LA, Jelleryd E, Lopez M, Acerini CL. ISPAD Clinical Practice Consensus Guidelines 2018: Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2018;19(Suppl 27):136-54. [CrossRef]
• 3. Tse J, Nansel TR, Haynie DL, Mehta SN, Laffel LM. Disordered eating behaviors are associated with poorer diet quality in adolescents with type 1 diabetes. J Acad Nutr Diet 2012;112(11):1810-4. [CrossRef]
• 4. Guerrerro M, Pérez-Rodríguez F. Diet Quality Indices for Nutrition Assessment: Types and Applications, Functional Food, 2017. Available from: URL: https://www. intechopen.com/books/functional-food-improve-healththrough- adequate-food/diet-quality-indices-for-nutritionassessment- types-and-applications [CrossRef]
• 5. Lipsky L, Nansel T, Haynie D, Mehta S, Laffel L. Associations of food preferences and household food availability with dietary intake and quality in youth with type 1 diabetes. Appetite 2012;59(2):218-23. [CrossRef]
• 6. Nansel TR, Lipsky LM, Liu A, Laffel LM, Mehta SN. Contextual factors are associated with diet quality in youth with type 1 diabetes mellitus. J Acad Nutr Diet 2014;114(8):1223-9. [CrossRef]
• 7. Story M, Kaphingst KM, Robinson-O’Brien R, Glanz K. Creating healthy food and eating environments: policy and environmental approaches. Annu Rev Public Health 2008;29:253-72. [CrossRef]
• 8. Winpenny E, Greenslade S, Corder K, van Sluijs E. Diet Quality through Adolescence and Early Adulthood: Cross- Sectional Associations of the Dietary Approaches to Stop Hypertension Diet Index and Component Food Groups with Age. Nutrients 2018;10(11):1585. [CrossRef]
• 9. Antonogeorgos G, Panagiotakos DB, Grigoropoulou D, Papadimitriou A, Anthracopoulos M, Nicolaidou P, et al. The mediating effect of parents’ educational status on the association between adherence to the Mediterranean diet and childhood obesity: the PANACEA study. Int J Public Health 2013;58(3):401-8. [CrossRef]
• 10. Granado-Casas M, Alcubierre N, Martín M, Real J, Ramírez- Morros AM, Cuadrado M, et al. Improved adherence to Mediterranean Diet in adults with type 1 diabetes mellitus. Eur J Nutr 2019;58(6):2271-9. [CrossRef]
• 11. World Health Organization/WHO. Human energy requirements. Rome: Food and Nutrition Tech. Rep. Ser., 2004. Available from: URL: http://www.fao.org/3/y5686e/ y5686e00.htm
• 12. National Cancer Enstitute/NCE. Developing the healthy eating index. Available from: URL: https://epi.grants. cancer.gov/SYİ/developing.html.
• 13. Guenther PM, Kirkpatrick SI, Reedy J, Krebs-Smith SM, Buckman DW, Dodd KW, et al. The Healthy Eating Index-2010 is a valid and reliable measure of diet quality according to the 2010 Dietary Guidelines for Americans. J Nutr 2014;144(3):399-407. [CrossRef]
• 14. World Health Organization/WHO. Adolescent health and development. Available from: URL: http://www.searo.who. int/entity/child_adolescent/topics/adolescent_health/en/.
• 15. Milenković T, Smokovski I, Bozhinovska N, Rahelić D, Jovanovska Misevska S, Bitovska Mileva I, et al. Effects of Structured Diabetes Education Program on diabetes knowledge and metabolic control in insulin-treated diabetes patients from Republic of Macedonia. Endocrinol Metab 2017;3(1):4-13. [CrossRef]
• 16. Golley RK, Hendrie GA, McNaughton SA. Scores on the dietary guideline index for children and adolescents are associated with nutrient intake and socio-economic position but not adiposity. J Nutr 2011;141(7):1340-7. [CrossRef]
• 17. Kleiser C, Mensink GB, Scheidt-Nave C, Kurth BM. HuSKY: a healthy nutrition score based on food intake of children and adolescents in Germany. Br J Nutr 2009;102(4):610-8. [CrossRef]
• 18. American Diabetes Association/ADA. 4. Lifestyle Management: Standards of Medical Care in Diabetes-2018. Diabetes Care 2018;41(Suppl 1):S38-S50. [CrossRef]
• 19. Karaguzel G, Bircan I, Erisir S, Bundak R. Metabolic control and educational status in children with type 1 diabetes: effects of a summer camp and intensive insulin treatment. Acta Diabetol 2005;42(4):156-61. [CrossRef]
• 20. Lipsky LM, Nansel TR, Haynie DL, Liu D, Li K, Pratt CA, et al. Diet quality of US adolescents during the transition to adulthood: changes and predictors. Am J Clin Nutr 2017;105(6):1424-32. [CrossRef]
• 21. Berge JM, MacLehose RF, Larson N, Laska M, Neumark- Sztainer D. Family Food Preparation and Its Effects on Adolescent Dietary Quality and Eating Patterns. J Adolesc Health 2016;59(5):530-6. [CrossRef]
• 22. Gagliardino JJ, Chantelot JM, Domenger C, Ramachandran A, Kaddaha G, Mbanya JC, et al. Impact of diabetes education and self-management on the quality of care for people with type 1 diabetes mellitus in the Middle East (the International Diabetes Mellitus Practices Study, IDMPS). Diabetes Res Clin Pract 2019;147:29-36. [CrossRef]
• 23. Mohammed J, Deda L, Clarson CL, Stein RI, Cuerden MS, Mahmud FH. Assessment of habitual physical activity in adolescents with type 1 diabetes. Can J Diabetes 2014;38(4):250-5. [CrossRef]
• 24. Storey KE, Forbes LE, Fraser SN, Spence JC, Plotnikoff RC, Raine KD, et al. Diet quality, nutrition and physical activity among adolescents: the Web-SPAN (Web-Survey of Physical Activity and Nutrition) project. Public Health Nutr 2009;12(11):2009-17. [CrossRef]
• 25. An R. Diet quality and physical activity in relation to childhood obesity. Int J Adolesc Med Health 2017;29(2). [CrossRef]