title: Associations of dietary intake patterns identified using reduced rank regression with markers of arterial stiffness among youth with type 1 diabetes.
abstract: OBJECTIVE
  Youth with type 1 diabetes (T1DM) are at substantially increased risk for adverse vascular outcomes, but little is known about the influence of dietary behavior on cardiovascular disease (CVD) risk profile. We aimed to identify dietary intake patterns associated with CVD risk factors and evaluate their impact on arterial stiffness (AS) measures collected thereafter in a cohort of youth with T1DM.
  
  
  METHODS
  Baseline diet data from a food frequency questionnaire and CVD risk factors (triglycerides, low density lipoprotein-cholesterol, systolic blood pressure, hemoglobin A1c, C-reactive protein and waist circumference) were available for 1153 youth aged ⩾10 years with T1DM from the SEARCH for Diabetes in Youth Study. A dietary intake pattern was identified using 33 food groups as predictors and six CVD risk factors as responses in reduced rank regression (RRR) analysis. Associations of this RRR-derived dietary pattern with AS measures (augmentation index (AIx75), n=229; pulse wave velocity, n=237; and brachial distensibility, n=228) were then assessed using linear regression.
  
  
  RESULTS
  The RRR-derived pattern was characterized by high intakes of sugar-sweetened beverages (SSB) and diet soda, eggs, potatoes and high-fat meats and low intakes of sweets/desserts and low-fat dairy; major contributors were SSB and diet soda. This pattern captured the largest variability in adverse CVD risk profile and was subsequently associated with AIx75 (β=0.47; P<0.01). The mean difference in AIx75 concentration between the highest and the lowest dietary pattern quartiles was 4.3% in fully adjusted model.
  
  
  CONCLUSIONS
  Intervention strategies to reduce consumption of unhealthy foods and beverages among youth with T1DM may significantly improve CVD risk profile and ultimately reduce the risk for AS.
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: A P
authors.initials: AP
authors.lastname: Lamichhane
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Liese
authors.affiliation: Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: E M
authors.initials: EM
authors.lastname: Urbina
authors.affiliation: Departments of Nursing and Biostatistics, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Crandell
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Jaacks
authors.affiliation: Department of Epidemiology, Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA.
authors.forename: D
authors.initials: D
authors.lastname: Dabelea
authors.affiliation: Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Black
authors.affiliation: Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
authors.forename: A T
authors.initials: AT
authors.lastname: Merchant
authors.affiliation: 1] Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA [2] School of Medicine, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: E J
authors.initials: EJ
authors.lastname: Mayer-Davis
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005247:Feeding Behavior / Q000502:physiology*; D006801:Humans; D016014:Linear Models; D010865:Pilot Projects; D063177:Pulse Wave Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D059289:Vascular Stiffness / Q000502:physiology*; D055105:Waist Circumference / Q000502:physiology; D055815:Young Adult