Dietary modifications to improve micronutrient status of Indian children and adolescents with type 1 diabetes.

Introduction: 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.

Objectives: 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.

Conclusion: 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.