title: Lipid profile and nutritional intake in children and adolescents with Type 1 diabetes improve after a structured dietician training to a Mediterranean-style diet.
abstract: OBJECTIVE
  To evaluate if nutritional intakes and lipid profile fulfill international guidelines and recommendations before and after a structured dietician training to a Mediterranean- style diet in an Italian pediatric population with Type 1 diabetes.
  
  
  METHODS
  A 6-month prospective cohort study. Baseline and after-intervention nutritional intakes, lipid profile, glycated hemoglobin (HbA(1c)), and clinical parameters of 96 children and adolescents with Type 1 diabetes were assessed. A comparative computerized system which was approved and validated by the Italian Diabetologist Association was used to define the amounts of nutrients.
  
  
  RESULTS
  At baseline mean daily dietary intakes of carbohydrates, proteins, and lipids were respectively (mean ± SEM) 51.8 ± 0.5, 15.9 ± 0.2, 33.8 ± 0.6%, with a contribution of cholesterol of 248.7 ± 12.5 mg/day. Fiber assumption was 18.0 ± 0.4 g/day. The 64.5% and 29.1% (p<0.0001) of subjects had at least one lipid parameter higher than 75(th) and 95(th) percentiles, respectively, of selected cut points (American Diabetes Association guidelines for total and LDL-cholesterol and American Academy of Pediatrics standards for HDL-cholesterol and triglycerides). Six months after the dietician intervention, dietary lipids and cholesterol decreased (p<0.0001) while fibers (p<0.0001) increased. LDL-cholesterol, non-HDL-cholesterol, and total cholesterol:HDL-cholesterol ratios significantly decreased (p<0.001) with a reduction of rate of subjects with at least one pathological lipid parameter (p<0.01) independently by weight and glucose control.
  
  
  CONCLUSIONS
  Italian pediatric subjects with Type 1 diabetes present a balanced diet with exception of lipids intake and a suboptimal lipid profile. A structured dietician training to a Mediterranean-style diet improves the quality of nutrient intakes being followed by a reduction of LDL-cholesterol, non- HDL-cholesterol, and total cholesterol:HDL-cholesterol ratios.
authors.affiliation: Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Cadario
authors.forename: F
authors.initials: F
authors.lastname: Prodam
authors.forename: S
authors.initials: S
authors.lastname: Pasqualicchio
authors.forename: S
authors.initials: S
authors.lastname: Bellone
authors.forename: I
authors.initials: I
authors.lastname: Bonsignori
authors.forename: I
authors.initials: I
authors.lastname: Demarchi
authors.forename: A
authors.initials: A
authors.lastname: Monzani
authors.forename: G
authors.initials: G
authors.lastname: Bona
mesh_terms: D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena / Q000187:drug effects; D002648:Child; D002664:Child Nutritional Physiological Phenomena / Q000187:drug effects; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000178:diet therapy* / Q000378:metabolism; D038441:Diet, Mediterranean; D004041:Dietary Fats / Q000494:pharmacology; D004043:Dietary Fiber / Q000494:pharmacology; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects / Q000502:physiology; D008055:Lipids / Q000032:analysis / Q000097:blood*; D008297:Male; D010353:Patient Education as Topic / Q000379:methods; D040242:Risk Reduction Behavior; D055815:Young Adult
chemical_list: D004041:Dietary Fats; D004043:Dietary Fiber; D008055:Lipids