Reported dietary intakes of patients with insulin-dependent diabetes mellitus: limitations of dietary recall
Alemzadeh, R.; Goldberg, T.; Fort, P.; Recker, B.; Lifshitz, F.
Nutrition 8(2): 87-93
1992
ISSN/ISBN: 0899-9007 PMID: 1591458 Document Number: 401953
Reported dietary intakes were assessed in young patients with insulin-dependent diabetes mellitus (IDDM). 44 IDDM patients (24 males, 20 females), mean+or-s.d. 13.2+or-4.5 years old were studied and compared with 44 healthy controls. Estimated intakes from 24-h dietary recall were analysed in relation to body weight and degree of diabetes control. The reported mean energy intake of the IDDM patients with >120% ideal body weight (IBW) for height was 66% (95% confidence interval (CI) 59 to 88) of recommended daily allowance whereas those with IBW <120% reported 90% (95% confidence interval (CI) 67 to 120) (P<0.01). Patients with increased weights in comparison with IBW had higher haemoglobin A1c (HbA1c) levels (11.9+or-2.7%) than those with weights more appropriate for IBW (9.7+or-2.4%, P<0.025). IDDM patients reported overconsumption of protein and fat, but their carbohydrate intake was low. Analysis of dietary recalls revealed high protein intake (mean+or-s.d., 20.0+or-5.0% of total energy intake), especially in older (27+or-4%) compared with younger (19+or-2% to 19+or-4%, P<0.01) patients. Proportions of carbohydrate, protein and fat did not correlate with variations in body weight and/or HbA1c. The reported intake of protein per kg body weight was not significantly different between appropriate-weight and overweight IDDM patients. All IDDM patients reported a high intake of saturated fats, vitamins and minerals. There was no significant difference in reported total energy intakes of IDDM patients and controls. However, the IDDM patients in various age-groups reported lower carbohydrate intake (46+or-8%) than controls (53+or-7%, P<0.001), although they reported higher intake of protein as a percentage of energy (19+or-2%) than controls (15+or-4%, P<0.001). Alternatively, analysis of dietary fat intake as a percentage of energy did not reveal any difference between the IDDM patients (35+or-8%) and controls (33+or-7%). 24-h dietary recall appears useful for assessing dietary intake in IDDM patients who have an appropriate body weight for height. However, underreporting may be prevalent among those patients with excess body weight for height, similar to that observed in the nondiabetic obese population.