title: Sweets, snacking habits, and skipping meals in children and adolescents on intensive insulin treatment.
abstract: OBJECTIVE
  To examine the association between skipping meals and snacking events and dietary and clinical characteristics in children and adolescents using modern insulin treatment.
  
  
  METHODS
  Dietary intake was recorded for 4 d in food diaries in 655 young diabetic patients. Number of meals and snacking events was recorded in a separated questionnaire, while clinical data were obtained from case record forms. Skipping meals refer to consuming a main meal (e.g., breakfast) five times a week or less.
  
  
  RESULTS
  Modern insulin treatment may favor a more flexible lifestyle. This study shows that there are fewer young diabetic patients who skip meals than non-diabetic controls (p < 0.001) even when using modern intensified insulin treatment. However, skipping meals among young diabetic patients was associated with negative characteristics such as having suboptimal hemoglobin A1c (HbA1c) (OR 4.7, p = 0.02), higher low-density lipoprotein (LDL) cholesterol levels (OR 4.0, p < 0.001), watching more TV (OR 3.6, p < 0.001), being overweight (OR 2.8, p = 0.03), as well as having a higher intake of added sugar (OR 2.1, p = 0.01) and lower intake of fiber (OR 0.2, p = 0.04) compared with those not skipping meals. Having more than two snacking events during the day was associated with higher HbA1c, higher intake of added sugar and sweets, and spending more hours in front of the TV or personal computer.
  
  
  CONCLUSIONS
  In general, fewer children and adolescents with type 1 diabetes skip meals compared with healthy peers. Those who skip meals and have more snacking events have poorer glycemic control and less healthy dietary and leisure habits.
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway. ninaco@medisin.uio.no
authors.forename: N C
authors.initials: NC
authors.lastname: Øverby
authors.forename: H D
authors.initials: HD
authors.lastname: Margeirsdottir
authors.forename: C
authors.initials: C
authors.lastname: Brunborg
authors.forename: K
authors.initials: K
authors.lastname: Dahl-Jørgensen
authors.forename: L F
authors.initials: LF
authors.lastname: Andersen
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004435:Eating; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007899:Leisure Activities; D008019:Life Style; D008297:Male
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin