Abstract
BACKGROUND: Few studies have evaluated the prospective association of eating frequency with HbA1c levels and cardiovascular disease risk markers among youth with diabetes. OBJECTIVE: To examine the 5-year longitudinal association of eating frequency with HbA1c and serum lipid levels among youth with type 1 diabetes (T1D) or type 2 diabetes (T2D). METHODS: One-thousand and forty-nine youth (≥10-year old) with incident T1D (n = 821) or T2D (n = 228) who participated in the SEARCH for Diabetes in Youth study were included. Eating frequency (≤3, 4-5, or 6-10 times/d) measured at baseline and follow-up visits was related to HbA1c and serum lipid levels measured repeatedly over 5 years. RESULTS: Increased eating frequency was associated with larger increases in HbA1c among youth T1D. For example, for youth with T1D who ate ≤3 times/d at the outset and ate 6-10 times/d 5 years later, the longitudinal model predicted greater absolute increases in HbA1c (2.77%); whereas for youth with T1D who ate 6-10 times/d at the outset and ate ≤3 times/d 5 years later, the model predicted lesser absolute increases in HbA1c (1.33%). Eating frequency was not associated with changes in serum lipid levels among youth with T1D or T2D. CONCLUSIONS: Youth with T1D who increased their eating frequency vs those who decreased it had larger increases in HbA1c over 5 years.