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Sugar-sweetened and diet beverage consumption is associated with cardiovascular risk factor profile in youth with type 1 diabetes

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Abstract

The prevalence of cardiovascular disease (CVD) risk factors among youth with type 1 diabetes is high and associated with age, gender, and race/ethnicity. It has also been shown that youth with type 1 diabetes often do not follow dietary recommendations. The objective of this cross-sectional observational study was to explore the association of sugar-sweetened and diet beverage intake with A1c, plasma lipids, adiponectin, leptin, systolic, and diastolic blood pressure in youth with type 1 diabetes. We examined data from 1,806 youth age 10–22 years with type 1 diabetes, of which 22% were minority (10% Hispanic, 8% African Americans, 4% other races) and 48% were female. Sugar-sweetened beverage, diet beverage, and mineral water intake was assessed with a food frequency questionnaire. After adjustment for socio-demographic and clinical covariates, physical activity and total energy intake, high sugar-sweetened beverage intake (at least one serving per day vs. none), was associated with higher levels of total cholesterol, LDL cholesterol, and plasma triglycerides, but not with A1c. High diet beverage intake was associated with higher A1c, total cholesterol, LDL cholesterol, and triglycerides. These associations were partially confounded by body mass index, saturated fat and total fiber intake. High sugar-sweetened beverage intake may have an adverse effect on CVD risk in youth with type 1 diabetes. Diet beverage intake may be a marker of unhealthy lifestyle which, in turn, is associated with worse metabolic control and CVD risk profile in these youth. Youth with diabetes should be encouraged to minimize sugar-sweetened beverage intake.

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Acknowledgments

Grant Support: SEARCH for Diabetes in Youth is funded by the Centers for Disease Control and Prevention (PA number 00097 and DP-05-069) and supported by the National Institute of Diabetes and Digestive and Kidney Diseases. Site Contract Numbers: Kaiser Permanente Southern California (U01 DP000246), University of Colorado Health Sciences Center (U01 DP000247), Pacific Health Research Institute (U01 DP000245), Children’s Hospital Medical Center (Cincinnati) (U01 DP000248), University of North Carolina at Chapel Hill (U01 DP000254), University of Washington School of Medicine (U01 DP000244), Wake Forest University School of Medicine (U01 DP000250). The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases. The SEARCH for Diabetes in Youth Study is indebted to the many youth and their families, and their health care providers, whose participation made this study possible. The authors wish to acknowledge the involvement of General Clinical Research Centers (GCRC) at the following institutions in the SEARCH for Diabetes in Youth Study: Medical University of South Carolina (Grant number M01 RR01070); Cincinnati Children’s Hospital (Grant number M01 RR08084); Children’s Hospital and Regional Medical Center and the University of Washington School of Medicine (Grant numbers M01RR00037 and M01RR001271); Colorado Pediatric General Clinical Research Center (Grant number M01 RR00069).

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC, 29208, USA

    Andrey V. Bortsov, Angela D. Liese, Robert McKeown & Elizabeth J. Mayer-Davis

  2. Center for Research in Nutrition and Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA

    Angela D. Liese

  3. Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA

    Ronny A. Bell

  4. University of Colorado Health Sciences Center, Denver, CO, 80262, USA

    Dana Dabelea, Richard F. Hamman, Georgeanna J. Klingensmith & David M. Maahs

  5. Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA

    Ralph B. D’Agostino Jr

  6. University of Colorado Barbara Davis Center, Denver, CO, 80262, USA

    Georgeanna J. Klingensmith & David M. Maahs

  7. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, 91101, USA

    Jean M. Lawrence

  8. Northwest Lipid Research Laboratories, Department of Medicine, University of Washington, Seattle, WA, 98109, USA

    Santica M. Marcovina

  9. Division of Diabetes Translation, Centers for Disease Control and Prevention/NCCDPHP, Atlanta, GA, 30341, USA

    Desmond E. Williams

  10. Department of Nutrition, University of North Carolina, Chapel Hill, NC, 27599, USA

    Joan Thomas & Elizabeth J. Mayer-Davis

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  1. Andrey V. Bortsov
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  2. Angela D. Liese
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  7. Georgeanna J. Klingensmith
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  8. Jean M. Lawrence
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  12. Joan Thomas
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Correspondence to Angela D. Liese.

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Bortsov, A.V., Liese, A.D., Bell, R.A. et al. Sugar-sweetened and diet beverage consumption is associated with cardiovascular risk factor profile in youth with type 1 diabetes. Acta Diabetol 48, 275–282 (2011). https://doi.org/10.1007/s00592-010-0246-9

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