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Healthful Diets for Youths With Type 1 Diabetes Can Be Hard for Parents to Obtain

Patients with type 1 diabetes often need to modify their eating habits, but many youths with type 1 diabetes don't consume a healthful diet. To learn more about the challenges their parents may face in providing them with a more healthful diet, researchers set out to discover the availability of healthful food options and the price difference of those food items at stores frequented by families in northeastern Kansas and western Missouri.

Common barriers that clinicians hear as to why more nutritious diets aren't followed include not knowing which foods to buy or prepare, not having the time, or not having enough money.
To determine if a healthful diet really was more expensive, researchers from the University of Kansas Medical Center in Kansas City, Kansas, and Children's Mercy Kansas City, in Kansas City, Missouri, recruited families with children aged 1 to 6, at least six months beyond his or her type 1 diabetes diagnosis, and on an intensive insulin regimen. A total of 23 families were included in the final results.

During a home study visit, parents provided demographic information and details on the primary store at which they shop. Master's students in dietetics, who were blinded to the study questions, were dispatched to each of the stores to collect the lowest nonsale prices for 164 food items on the USDA Thrifty Food Plan (R-TFP) and a modified healthful version of the Thrifty Food Plan (H-TFP) to determine food prices for two standard shopping lists.

"Our results showed that a more healthful market basket cost 18% more than a standard basket. Moreover, families can face barriers in finding specific healthful foods at their local stores," says lead author Susana R. Patton, PhD, CDE, of the department of pediatrics at the University of Kansas Medical Center.

Small and independent markets were found to have a higher percentage of foods missing from the shopping lists compared with chain and big box stores. Consistent with parents' perceptions, the H-TFP was more expensive than the R-TFP; average cost for the R-TFP was $324.71 vs $380.07 for H-TFP, a $57.62 difference. The greatest differences in cost were observed for proteins and grains.

Based on these results, the researchers suggest nutrition counseling strategies such as reframing food purchases in terms of nutrition per dollar, providing recipes and teaching families how to cook lower-cost substitutes for higher-priced foods, and providing information on local stores that offer a wide selection of healthful foods. However, the research in this study was somewhat narrow in its scope and the results may not extend to other populations. More research will be required to extend these conclusions more broadly.

— Source: Society for Nutrition Education and Behavior