A Holistic Picture of the Relations Between Dietary Intake with Physical and Behavioral Health in Youth with Type 1 Diabetes Mellitus

Abstract

Both physical and mental health concerns are becoming increasingly prominent among youth with Type 1 Diabetes Mellitus (T1DM). Nutrition has been identified as an element that influences these non-diabetes related outcomes, but the role of specific food groups and nutrients have not been elucidated in the T1DM population. Thus, the purpose of this study was to examine the relations between dietary intake, physical health, and teacher-reported socialemotional functioning in children with T1DM. Canonical correlation analysis demonstrated a statistically significant multivariate shared relationship between these variable sets, and suggested that youth in this sample who had lower glycemic load, consumed more sugar, dairy, meat/poultry/fish, but less legumes, fruit, and saturated fat, were associated with less Externalizing Problems and higher BMI. Additionally, multiple regression analysis implicated diet in uniquely accounting for a modest amount of variance in physical and emotional health while controlling for gender, race, age, socioeconomic status, duration of T1DM, and glycemic control. These findings call for the need to emphasize diet in T1DM management, not only for healthful eating in maintaining glycemic control, but also to reduce the physical and mental health morbidities for which individuals with T1DM are most at-risk. Moreover, physical and behavioral health services in the schools should be considered in supporting the social-emotional well-being of these students. Given the novelty of the present study, directions for future research are also discussed, which include more exhaustive assessment of physical health parameters, multi-rater psychosocial functioning, and comprehensive dietary intake patterns, as well as dietary RCTs that utilize whole, nutrient-rich foods to investigate physical and behavioral outcomes.