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Sugar-sweetened beverage intake and cardiovascular risk factor profile in youth with type 1 diabetes: Application of measurement error methodology in the SEARCH Nutrition Ancillary Study
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    The SEARCH Nutrition Ancillary Study aims to investigate the role of dietary intake on the development of long-term complications of type 1diabetes in youth and capitalize on measurement error (ME) adjustment methodology.

    Research Design and Methods

    Using the National Cancer Institute (NCI) method for episodically-consumed foods, we evaluated the relationship of sugar-sweetened beverage (SSB) intake and cardiovascular risk factor profile, applying ME adjustment. The calibration sample included 166 youth with two FFQs and three 24-hour dietary recalls within one month. The full sample included 2,286 youth with type 1 diabetes.


    SSB intake was significantly associated with higher triglycerides, total and LDL-cholesterol, adjusted for energy, age, diabetes duration, race/ethnicity, gender, education. The estimated effect size was larger (model coefficients increased approximately threefold) after application of the NCI method than without ME adjustment. Compared to individuals consuming one serving of SSB every two weeks, those who consumed one serving every two days had 3.7 mg/dL higher triglycerides, 4.0 mg/dL higher total cholesterol and LDL cholesterol, adjusted for ME and covariates. SSB intake was not associated with measures of adiposity and blood pressure.


    Our findings suggest that SSB intake is significantly related to increased lipid levels in youth with type 1diabetes and that estimates of the effect size of SSB on lipid levels are severely attenuated in the presence of measurement error. Future studies in youth with diabetes should consider a design that will allow for the adjustment for measurement error when studying the influence of diet on health status.

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    1U18DP002709/DP/NCCDPHP CDC HHS/United States
    200-2010-35 171/PHS HHS/United States
    5R01DK077949/DK/NIDDK NIH HHS/United States
    8 UL1 TR000077/TR/NCATS NIH HHS/United States
    DK-56 350/DK/NIDDK NIH HHS/United States
    DP-05-069/DP/NCCDPHP CDC HHS/United States
    DP-10-001/DP/NCCDPHP CDC HHS/United States
    P30 DK57516/DK/NIDDK NIH HHS/United States
    R01 DK077949/DK/NIDDK NIH HHS/United States
    U01 DP000244/DP/NCCDPHP CDC HHS/United States
    U01 DP000245/DP/NCCDPHP CDC HHS/United States
    U01 DP000246/DP/NCCDPHP CDC HHS/United States
    U01 DP000247/DP/NCCDPHP CDC HHS/United States
    U01 DP000248/DP/NCCDPHP CDC HHS/United States
    U01 DP000250/DP/NCCDPHP CDC HHS/United States
    U01 DP000254/DP/NCCDPHP CDC HHS/United States
    U18DP000247-06A1/DP/NCCDPHP CDC HHS/United States
    U18DP002708/DP/NCCDPHP CDC HHS/United States
    U18DP002710-01/DP/NCCDPHP CDC HHS/United States
    U18DP002714/DP/NCCDPHP CDC HHS/United States
    U48/CCU419249/PHS HHS/United States
    U48/CCU519239/PHS HHS/United States
    U48/CCU819241-3/PHS HHS/United States
    U48/CCU919219/PHS HHS/United States
    U58/CCU019235-4/PHS HHS/United States
    U58CCU919256/PHS HHS/United States
    UL1 TR000154/TR/NCATS NIH HHS/United States
    UL1 TR001425/TR/NCATS NIH HHS/United States
    UL1 TR00423/TR/NCATS NIH HHS/United States
    UL1RR029882/RR/NCRR NIH HHS/United States
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