Dietary Intake of Children with Type 1 Diabetes in Bahrain: A Case-Control Study

Authors

  • Fatima Al-Haddad Dietetic Unit for Hospitals, Salmaniya Medical Complex, P.O. Box 12, Manama, Kingdom of Bahrain
  • Abdulrahman Musaiger Nutrition and Health Studies Unit Deanship of Scientific Research, University of Bahrain, P.O. Box 32038, Sakheer, Kingdom of Bahrain
  • S. Mahmood Al-Qallaf Pharmacy Program, College of Health Sciences, University of Bahrain, P.O. Box 32038, Manama, Kingdom of Bahrain
  • Kathryn Hart School of Biosciences and Medicine, University of Surrey, Guilford GU2 7XH, UK

DOI:

https://doi.org/10.6000/1929-4247.2015.04.02.3

Keywords:

Type 1 diabetes mellitus (T1DM), Children, Bahrain, Healthy diet.

Abstract

Background & Objectives: Bahrain is reported to rank amongst the top 10 countries for diabetes prevalence worldwide. In particular, growing numbers of children are being diagnosed with Type 1 diabetes mellitus (T1DM).The objective of this study was to describe the dietary intake of Bahraini children with T1DM as compared to a sample of healthy counterparts and to determine whether the nutrient intakes of Bahraini children with T1DM meet the current recommendations.

Design & Setting: This was a case-control study. Dietary intake, estimated using a24-hour dietary recall, for the cases was gathered from the Pediatric Endocrine and Diabetes Unit at the Salmaniya Medical Complex and compared to the 24-hour recalls of children without diabetes recruited from Local Health Centers.

Patients & Methods: 50 children aged 6-12 years receiving a confirmed diagnosis of T1DM in the years 2009 and 2010 compared with 55 healthy comparators.

Results: Children with T1DM consumed significantly more calories than controls (p<0.001) and significantly more protein relative to their RDA (p<0.029). Both groups failed to meet the RDA values for dietary fiber and for Vitamin D. Sodium intakes were in excess of RDA values although no significant difference was observed between groups (p=0.403).

Conclusion: The diets of both children with and without T1DM were found to contain excess protein and sodium and inadequate fiber, vitamin D and calcium. Children with T1DM also appeared to consume excess energy and fat. There is a need to endorse existing dietary guidelines for children with T1DM.

References

International Diabetes Federation (IDF) Diabetes Atlas 5th Edition, Middle East and North Africa (MENA); 2013 [updated 2014; cited 2013June 3]: Available from: http://www.idf.org/ diabetesatlas/5e/middle-east-and-north-africa.

Ministry of Health (MOH). Statistic on Type 1 Diabetes in Bahrain Pediatric Endocrine & Diabetes Clinic Salmaniya Medical Complex; 2012 [updated 2015; cited 2012 September 10]: Avilable from: http://www.moh.gov.bh/PDF/ Publications/Statistics/HS2008/PDF/CH09-smc_2008.pdf

Dorman J, Laporte R, Kuller L, et al. The Pittsburgh insulin-dependent diabetes mellitus (IDDM) morbidity and mortality study: mortality results. Diabetes 1984; 33: 271-6. http://dx.doi.org/10.2337/diab.33.3.271

Krolewski AS, Warram JH, Valsania P, Martin BC, Laffel L, Christlieb AR. Evolving natural history of coronary artery disease in diabetes mellitus. Am J Med 1991; 90: S56-S61. http://dx.doi.org/10.1016/0002-9343(91)90040-5

Nathan DM. Long-term complications of diabetes mellitus. New Eng J Med 1993; 328: 1676-85. http://dx.doi.org/10.1056/NEJM199306103282306

Laing S, Swerdlow A, Slater S, et al. Mortality from heart disease in a cohort of 23,000 patients with insulin-treated diabetes. Diabetologia 2003; 46: 760-5. http://dx.doi.org/10.1007/s00125-003-1116-6

Schober E, Langergraber B, Rupprecht G, Rami B. Dietary intake of Austrian diabetic children 10 to 14 years of age. J Pediatr Gastr Nutr 1999; 29: 144-7. http://dx.doi.org/10.1097/00005176-199908000-00009

Øverby N, Flaaten V, Veierød M, et al. Children and adolescents with type 1 diabetes eat a more atherosclerosis-prone diet than healthy control subjects. Diabetologia 2007; 50: 307-16. http://dx.doi.org/10.1007/s00125-006-0540-9

Øverby N, Margeirsdottir H, Brunborg C, Andersen L, Dahl-Jørgensen K. The influence of dietary intake and meal pattern on blood glucose control in children and adolescents using intensive insulin treatment. Diabetologia 2007; 50: 2044-51. http://dx.doi.org/10.1007/s00125-007-0775-0

Al-Khudairy L, Stranges S, Kumar S, Al-Daghri N, Rees K. Dietary factors and type 2 diabetes in the middle east: what is the evidence for an association?––a systematic review. Nutrients 2013; 5: 3871-97. http://dx.doi.org/10.3390/nu5103871

Musaiger AO, Gregory WB. Dietary habits of school-children in Bahrain. Perspect Public Heal 1992; 112: 159-62. http://dx.doi.org/10.1177/146642409211200401

Musaiger AO, Bader Z, Al-Roomi K, D'Souza R. Dietary and lifestyle habits amongst adolescents in Bahrain. Food Nutr Res 2011; 55. http://dx.doi.org/10.3402/fnr.v55i0.7122

Gharib N, Rasheed P. Energy and macronutrient intake and dietary pattern among school children in Bahrain: a cross-sectional study. Nutr J 2011; 10: 1-12.

Unites States Department of Agriculture Dietary Reference Intakes (USDA-DRI); 2014 [updated 2015 April 24; cited 2014 September 3]: Available from: http://fnic.nal.usda.gov/ dietary-guidance/dietary-reference-intakes.

Musaiger AO. Changes in food consumption patterns in Bahrain. Nutr Health 1990; 6: 183-8. http://dx.doi.org/10.1177/026010609000600403

Musaiger AO. The State of Food and Nutrition in Bahrain. 1993. Arabian Gulf University Press.

Musaiger AO. State of nutrition in Bahrain. Nutr Health 2000; 14: 63-7. http://dx.doi.org/10.1177/026010600001400107

Abdullah MA. Epidemiology of type I diabetes mellitus among Arab children. Saudi Med J 2005; 26: 911-7.

Pundziūtė-Lyckå A, Persson L-Å, Cedermark G, et al. Diet, growth, and the risk for type 1 diabetes in childhood a matched case-referent study. Diabetes Care 2004; 27: 2784-9. http://dx.doi.org/10.2337/diacare.27.12.2784

Smart C, Aslander‐van Vliet E, Waldron S. Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2009; 10(s12): 100-17. http://dx.doi.org/10.1111/j.1399-5448.2009.00572.x

Nicklas TA. Dietary studies of children and young adults (1973-1988): the Bogalusa Heart Study. Am J Med Sci 199; 5310: S109.

Williams CL, Bollella M, Wynder EL. A new recommendation for dietary fiber in childhood. Pediatrics 1995; 96: 985-8.

Anderson JW, Baird P, Davis Jr RH, et al. Health benefits of dietary fiber. Nutr Rev 2009; 67: 188-205. http://dx.doi.org/10.1111/j.1753-4887.2009.00189.x

Levey AS, Coresh J, Balk E, et al. National kidney foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 2003; 139: 137-47. http://dx.doi.org/10.7326/0003-4819-139-2-200307150-00013

Huang M-C, Chen M-E, Hung H-C, et al. Inadequate energy and excess protein intakes may be associated with worsening renal function in chronic kidney disease. J Renal Nutr 2008; 18: 187-94. http://dx.doi.org/10.1053/j.jrn.2007.08.003

Rolland-Cachera M, Deheeger M, Akrout M, Bellisle F. Influence of macronutrients on adiposity development: a follow up study of nutrition and growth from 10 months to 8 years of age. Int J Obes Relat Metab Disord 1995; 19: 573-8.

Bener A, Alsaied A, Al-Ali M, et al. High prevalence of vitamin D deficiency in type 1 diabetes mellitus and healthy children. Acta diabetologica 2009; 46: 183-9. http://dx.doi.org/10.1007/s00592-008-0071-6

Hyppönen E, Läärä E, Reunanen A, Järvelin M-R, Virtanen SM. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet 2001; 358: 1500-3. http://dx.doi.org/10.1016/S0140-6736(01)06580-1

Stene L, Joner G. Atopic disorders and risk of childhood-onset type 1 diabetes in individuals. Clin Exp Allergy 2004; 34: 201-6. http://dx.doi.org/10.1111/j.1365-2222.2004.01864.x

EURODIAB Substudy 2 Study Group. Vitamin D supplement in early childhood and risk for Type I (insulin-dependent) diabetes mellitus. Diabetologia 1999; 42: 51-4. http://dx.doi.org/10.1007/s001250051112

Seshadri KG, Tamilselvan B, Rajendran A. Role of vitamin D in diabetes. J Endocr Metab 2011; 1: 47-56. http://dx.doi.org/10.4021/jem23w

DeLuca HF. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr 2004; 80: 1689S-96S.

Tuorkey MJ, Abdul-Aziz KK. Strategies for diabetes and pathways of vitamin D. Diabetes Metab Synd: Clin Res Rev 2010; 4: 101-10. http://dx.doi.org/10.1016/j.dsx.2009.07.010

Meneely GR, Battarbee HD. High sodium-low potassium environment and hypertension. Am J Cardiol 1976; 38: 76885. http://dx.doi.org/10.1016/0002-9149(76)90356-8

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Published

2015-06-01

How to Cite

Al-Haddad, F., Musaiger, A., Al-Qallaf, S. M., & Hart, K. (2015). Dietary Intake of Children with Type 1 Diabetes in Bahrain: A Case-Control Study. International Journal of Child Health and Nutrition, 4(2), 83–89. https://doi.org/10.6000/1929-4247.2015.04.02.3

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General Articles