Eureka! Institutional Repository

Introduction The occurrence of cardiovascular disease risk factors is more common in children with T1D than in the rest pediatric population. The prevalence of overweight is also higher in youth with T1D and constitutes a known situation connected to macrovascular complications in the general population. Furthermore, it is not clear, how the components of the medical therapy applied in these patients, like nutrition, education and physical activity, influence the cardiovascular disease risk. Aim This study aims on the one hand to evaluate overweight, nutrition, nutritional knowledge and physical activity in youth with T1D who live in Greece and on the other hand to investigate possible relationships between them and the cardiovascular disease risk factors. Μethods In total, 96 children and adolescents with T1D (girls 57%) and one of their parents, participated in the study. Anthropometric measurements were performed in youth and their physical activity level was evaluated with the use of a questionnaire. Children’s blood pressure and HbA1c levels were also measured. Additionally, information concerning their blood lipid profile, as well as other clinical information, was recorded from their health records. Their dietary intake was examined with the use of a semi quantitative food frequency questionnaire (FFQ) and a single 24 hour recall and its quality with the KIDMED questionnaire. Furthermore, parents and children completed a questionnaire about their nutrition knowledge. Results The prevalence of overweight and obese children was 31% and almost 80% abstained from optimal Mediterranean diet. The total nutrition knowledge score of children was 47% and their parents score was 60%. Youth and especially girls, failed to meet the recommendations on nutrition and physical activity. Overweight and obese children were in higher SBPperc compared to normoweight (68,59±26,58 vs 51,77±26,72 P=0,006). In addition, the KIDMED score had negative association with ΗbA1c (β=-0,176, P<0,001, r2=0,333), while BMIzscore (β=0,295, P=0,002, r2=0,333) and physical activity levels were associated positively with ΗbA1c (β=0,211, P=0,031, r2=0,333), after adjusting for other parameters. Furthermore, higher physical activity level, was associated with lower DBPperc (β=-5,817, P=0,035, r2=0,134). The amount of full fat dairy consumed daily (g) had positive association with TG (β=0,044, P=0,004, r2=0,294) and the amount of red meat consumption had positive association with SBPperc (β=0,353, P=0,016, r2=0,224), after adjusting for other factors. Finally, children’s nutrition score was negatively correlated with TC (r=-0,240, P=0,02) and parents’ nutrition score was negatively correlated with HbA1c (r=-0,209, P=0,045). Conclusion Both total medical therapy and overweight can influence the occurrence of cardiovascular disease risk factors in youth with T1D. Appropriate strategies, emphasizing in the maintenance of a healthy body weight and the improvement of dietary patterns, nutrition education and physical activity in this population, may benefit significantly the prevention of cardiovascular disease risk.