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Epidemiology

Associations of dietary intake patterns identified using reduced rank regression with markers of arterial stiffness among youth with type 1 diabetes

European Journal of Clinical Nutrition volume 68, pages 1327–1333 (2014)Cite this article

Subjects

Abstract

Background/Objectives:

Youth with type 1 diabetes (T1DM) are at substantially increased risk for adverse vascular outcomes, but little is known about the influence of dietary behavior on cardiovascular disease (CVD) risk profile. We aimed to identify dietary intake patterns associated with CVD risk factors and evaluate their impact on arterial stiffness (AS) measures collected thereafter in a cohort of youth with T1DM.

Subjects/Methods:

Baseline diet data from a food frequency questionnaire and CVD risk factors (triglycerides, low density lipoprotein-cholesterol, systolic blood pressure, hemoglobin A1c, C-reactive protein and waist circumference) were available for 1153 youth aged ⩾10 years with T1DM from the SEARCH for Diabetes in Youth Study. A dietary intake pattern was identified using 33 food groups as predictors and six CVD risk factors as responses in reduced rank regression (RRR) analysis. Associations of this RRR-derived dietary pattern with AS measures (augmentation index (AIx75), n=229; pulse wave velocity, n=237; and brachial distensibility, n=228) were then assessed using linear regression.

Results:

The RRR-derived pattern was characterized by high intakes of sugar-sweetened beverages (SSB) and diet soda, eggs, potatoes and high-fat meats and low intakes of sweets/desserts and low-fat dairy; major contributors were SSB and diet soda. This pattern captured the largest variability in adverse CVD risk profile and was subsequently associated with AIx75 (β=0.47; P<0.01). The mean difference in AIx75 concentration between the highest and the lowest dietary pattern quartiles was 4.3% in fully adjusted model.

Conclusions:

Intervention strategies to reduce consumption of unhealthy foods and beverages among youth with T1DM may significantly improve CVD risk profile and ultimately reduce the risk for AS.

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Acknowledgements

The SEARCH Nutrition Ancillary Study and the SEARCH for Diabetes in Youth Study are indebted to the many youth and their families and their health-care providers, whose participation made this study possible. The SEARCH Nutrition Ancillary Study (R01 DK 077949, PI Mayer-Davis) is funded by the NIDDK. SEARCH for Diabetes in Youth is funded by the Centers for Disease Control and Prevention (PA numbers 00097, DP-05-069, and DP-10-001) and supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The SEARCH AIR Ancillary study (R01 ES 019168, PI Puett) is funded by the National Institute of Environmental Health Sciences. The SEARCH CVD study (R01DK078542, PI Dabelea) is funded by NIDDK.

Author information

Authors and Affiliations

  1. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA

    A P Lamichhane, L M Jaacks & E J Mayer-Davis

  2. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

    A D Liese & A T Merchant

  3. Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    E M Urbina

  4. Departments of Nursing and Biostatistics, University of North Carolina, Chapel Hill, NC, USA

    J L Crandell

  5. Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA

    D Dabelea

  6. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA

    M H Black

  7. School of Medicine, University of North Carolina, Chapel Hill, NC, USA

    E J Mayer-Davis

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  1. A P Lamichhane
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Correspondence to A P Lamichhane.

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Lamichhane, A., Liese, A., Urbina, E. et al. Associations of dietary intake patterns identified using reduced rank regression with markers of arterial stiffness among youth with type 1 diabetes. Eur J Clin Nutr 68, 1327–1333 (2014). https://doi.org/10.1038/ejcn.2014.96

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