Dietary modifications to improve micronutrient status of Indian children and adolescents with type 1 diabetes.
BACKGROUND
Diet plays a crucial role for maintaining normal growth and development while optimizing glycemic control in children with diabetes. Dietary restrictions, in a diabetic child's diet may lead to micronutrient deficiencies.


OBJECTIVE
To examine dietary nutritional deficiencies of Asian Indian children with Type 1 diabetes mellitus and develop micronutrient-rich recipes suitable for them.


METHODS
Anthropometry, diet (3-day recall) of 70 children with diabetes (24 boys) was recorded. Daily nutrient intakes and nutrient content of recipes were estimated using CDIET version 2.0.


RESULTS
Mean intake amongst children for energy was 79% of Indian Recommended Dietary Allowance (RDA), protein was 105% RDA, but fat intakes were high (143% RDA). Mean intakes of riboflavin, β carotene, zinc, iron were less than 50%, and thiamin and calcium were around 60% RDA suggesting a possible multiple micronutrient deficiency. Based on popularly consumed snacks, 20 healthy recipes were devised that can be incorporated in children's diet. Mean energy content of new recipes was similar to routine snacks (281±28 kcal/100 g vs 306±27 kcal/100 g cooked weight). However, the mean vitamin and mineral content of new recipes was significantly higher (p<0.01). There was a five-fold increase in total mineral content (zinc, calcium and iron) and twofold increase in total vitamin content (β carotene, vitamin C, vitamin B-1, B-2, and B-3) in new recipes compared with the routine snacks.


CONCLUSIONS
Multiple dietary micronutrient deficiencies are observed in diabetic children. Addition of newly developed recipes in their everyday diet may help to enhance micronutrient intakes without increasing their energy load.
Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32 Sassoon Road, Pune.411 001, India.
Lavanya S
LS
Parthasarathy
Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32 Sassoon Road, Pune.411 001, India.
Shashi A
SA
Chiplonkar
Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32 Sassoon Road, Pune.411 001, India. Email: anuradhavkhadilkar@gmail.com.
Anuradha V
AV
Khadilkar
Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, 32 Sassoon Road, Pune.411 001, India.
Vaman V
VV
Khadilkar
D000293:Adolescent; D002648:Child; D003296:Cooking; D003922:Diabetes Mellitus, Type 1 / Q000178:diet therapy*; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage* / Q000172:deficiency; D008903:Minerals / Q000008:administration & dosage; D009752:Nutritional Status; D064167:Recommended Dietary Allowances; D014815:Vitamins / Q000008:administration & dosage
D004041:Dietary Fats; D004044:Dietary Proteins; D018977:Micronutrients; D008903:Minerals; D014815:Vitamins