title: Relationships of neophobia and pickiness with dietary variety, dietary quality and diabetes management adherence in youth with type 1 diabetes.
abstract: OBJECTIVE
  Neophobia, pickiness and diet variety are associated with diet quality and health outcomes in young children. Limited research has examined these associations among youth with type 1 diabetes (T1D), a population at risk for poor health outcomes when dietary quality is inadequate.
  
  
  METHODS
  Youth (n=252, age 13.2 ± 2.8 years, 92% white, diabetes duration 6.3 ± 3.4 years) with T1D and their parents completed 3-day youth diet records; parents completed questionnaires regarding youth neophobia, pickiness and diabetes management adherence. Medical records provided biomedical data. Dietary quality indicators included Nutrient-Rich Foods Index 9.3 (NRF9.3), Healthy Eating Index-2005 (HEI-2005), Whole Plant Food Density (WPFD) and key single nutrients. Dietary variety was operationalized as a count of 20 recommended food groups consumed. Relationships of dietary quality and diabetes management adherence with neophobia, pickiness and dietary variety as independent variables were examined using multiple linear regression analyses adjusted for total energy intake, age, height and weight.
  
  
  RESULTS
  In multiple linear regression analyses, NRF9.3 and HEI-2005 were each inversely associated with neophobia and pickiness, and positively associated with dietary variety. WPF and potassium were each positively associated and saturated fat was inversely associated with dietary variety. However, in models simultaneously including neophobia, pickiness and dietary variety as independent correlates of dietary quality, only relationships with dietary variety remained significant. Diabetes management adherence was negatively associated with both neophobia and pickiness and positively associated with dietary variety.
  
  
  CONCLUSIONS
  Findings suggest that increasing dietary variety may contribute toward improved dietary quality among youth with T1D, despite potentially adverse influences of neophobia and pickiness.
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, NIH, Department of Health and Human Services, Bethesda, MD, USA.
authors.forename: V
authors.initials: V
authors.lastname: Quick
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, NIH, Department of Health and Human Services, Bethesda, MD, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Lipsky
authors.affiliation: Genetics and Epidemiology Section, Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
authors.forename: L M B
authors.initials: LM
authors.lastname: Laffel
authors.affiliation: Genetics and Epidemiology Section, Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
authors.forename: S N
authors.initials: SN
authors.lastname: Mehta
authors.affiliation: Genetics and Epidemiology Section, Pediatric, Adolescent and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
authors.forename: H
authors.initials: H
authors.lastname: Quinn
authors.affiliation: Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, NIH, Department of Health and Human Services, Bethesda, MD, USA.
authors.forename: T R
authors.initials: TR
authors.lastname: Nansel
mesh_terms: D000293:Adolescent; D001827:Body Height; D001835:Body Weight; D002648:Child; D002755:Choice Behavior / Q000502:physiology*; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy* / Q000453:epidemiology*; D015930:Diet Records; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D005518:Food Preferences / Q000523:psychology*; D006801:Humans; D008297:Male; D010349:Patient Compliance; D011795:Surveys and Questionnaires