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Resemblance of Diet Quality in Families of Youth with Type 1 Diabetes Participating in a Randomized Controlled Behavioral Nutrition Intervention Trial in Boston, MA (2010-2013): A Secondary Data Analysis

Published:October 31, 2018DOI:



      Parent–child diet quality resemblance is unknown in families of youth with type 1 diabetes, for whom nutrition is central to disease management.


      Examine diet quality resemblance in families of youth with type 1 diabetes participating in a behavioral nutrition intervention trial and investigate whether treatment assignment or family meal frequency modifies resemblance.


      This is a secondary data analysis from an 18-month randomized controlled trial conducted August 2010 to May 2013.


      Parent-youth dyads (N=136, child age=12.3±2.5 years) were recruited from a northeast US diabetes center.

      Main outcome measures

      Parent and child Healthy Eating Index-2005 (HEI-2005, reflecting adherence to 2005 Dietary Guidelines for Americans) and whole plant food density (WPFD, reflecting intervention target foods) were calculated from 3-day food records collected every 6 months.

      Statistical analysis

      Linear random effects models adjusting for demographics and disease characteristics investigated parent–child diet quality resemblance. Separate models examined whether treatment assignment or family meal frequency modified resemblance. Three-way interaction terms examined whether resemblance changed over time by treatment assignment.


      Time-varying parent and child HEI-2005 and WPFD were positively associated (P<0.001), and there were no interactions with family meals. Parent–child HEI-2005 resemblance was similar across treatment groups; however, parent–child WPFD resemblance was stronger in the intervention (β±standard error [SE]=.30±.06) vs control families (β±SE=.12±.05). Parent–child HEI-2005 resemblance was similar over time by treatment assignment, whereas parent–child WPFD resemblance increased over time for families in the intervention group (three-way interaction term β±SE=.03±.01).


      Parent and youth diet quality were positively correlated in families of youth with type 1 diabetes. Resemblance was stronger in the intervention group for target foods, but not for a general measure of diet quality. The lack of effect modification by family meal frequency suggests that family diet quality resemblance is not contingent on shared meals.


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      L. M. Lipsky is a staff scientist, Social and Behavioral Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.


      D. L. Haynie is a staff scientist, Social and Behavioral Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.


      T. R. Nansel is a senior investigator, Social and Behavioral Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.


      A. Liu is a senior investigator, Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.