Disordered Eating Behaviors Are Associated with Poorer Diet Quality in Adolescents with Type 1 Diabetes

Abstract

Disordered eating behaviors may pose a risk for poor long-term health outcomes in patients with type 1 diabetes (T1D). This cross-sectional study examined relations of disordered eating behaviors with diet quality, diet-related attitudes, and diabetes management in adolescents with T1D (N=151, 48% female). Participants, recruited July 2008 through February 2009, completed 3-day diet records and survey measures, including the Diabetes Eating Problem Survey (DEPS) and measures of eating-related attitudes. Biomedical data were obtained from medical records. Participants scoring >1 SD above the mean DEPS were classified as at-risk for disordered eating. The Healthy Eating Index-2005 was calculated to assess diet quality. ANCOVA was used to test for differences between risk groups in diet quality, eating attitudes, and diabetes management, controlling for age, sex, and BMI percentile. Youth at-risk for disordered eating were more likely to be overweight/obese (59.1% vs. 40.9% p=0.01). The at-risk group had poorer diet quality (p=0.003), as well as higher intake of total (p=0.01) and saturated (p=0.007) fat than the low-risk group. The at-risk group reported lower self-efficacy (p=0.005), greater barriers (p<0.001), and more negative outcome expectations (p<0.001) for healthful eating, as well as worse dietary satisfaction (p=0.004). The at-risk group had lower diabetes adherence (p<0.01), less frequent blood glucose monitoring (p<0.002), and higher HbA1c (p<0.001). The constellation of excess weight, poorer dietary intake, and poorer diabetes management associated with youth at-risk for disordered eating suggests potential risk of future poor health outcomes. Attention should be given to healthful weight management, especially among overweight youth with T1D.

Cardiovascular Disease Risk Factors in Youth With Diabetes Mellitus

“…These behaviors tend to cluster around increased dietary restraint (conscious restriction of food intake), binge eating, 334 and poor diet quality. 335,336 Many adolescents report weight and body shape concerns, unhealthy weight control behaviors, diminished self-worth, and depression. [337][338][339] Disturbed eating behaviors are more prevalent with increased BMI 335,336 and with the perception of being overweight.…”

“…335,336 Many adolescents report weight and body shape concerns, unhealthy weight control behaviors, diminished self-worth, and depression. [337][338][339] Disturbed eating behaviors are more prevalent with increased BMI 335,336 and with the perception of being overweight. 340 Disturbed eating behaviors, coupled with unhealthy weight control behaviors, have been associated with adverse glucose control.…”

Education and Practice Gaps of Registered Dietitian Nutritionists Working With Clients With Eating Disorders

“…Disordered eating is considered "problematic eating patterns that are not practiced at a high enough frequency or severity to merit the formal diagnosis of an eating disorder." 9 An ED diagnosis is defined in the Diagnostic and Statistical Manual of Mental Disorders with clear parameters of frequency of specific behaviors. 10 Cross-sectional studies have shown a high incidence of disordered eating among adolescents.…”

Quality of food consumption and development of eating disorders among people living with HIV

“…The increased mortality from non-communicable diseases in people with ED was not only restricted to HIV infected patients. A previous study revealed patients with other chronic diseases, such as type 2 diabetes, with a risk of ED development had also an increased mortality rate due to a significantly higher intake of fat and saturated fat compared with type 2 diabetes patients with a low risk of ED development [22]. In addition, our results indicated the average daily sodium consumption was 3,000 mg per day in both high-risk ED and low-risk ED groups, which is similar to the findings of previous studies on intake of sodium in Thailand that is limited to 2,400 mg per day according to the guideline [23,24].…”