Abstract P134: Dietary Intake and Vascular Function and Myocardial Structure in Canadian Youth With and Without Type 1 Diabetes: The Cardea Study
Authors: Harnois-Leblanc Soren , Drapeau Vicky , Van Hulst Andraea , Barnett Tracie A , McNealis Vanessa , Friedrich Matthias , Bigras Jean-Luc , Nuyt Anne Monique , Benedetti Andrea , Mathieu Marie-Ève , Henderson Melanie 
Published: March 2023

Introduction:
People living with T1D are disproportionally more affected by CVD than the general population. As emerging evidence points to direct effects of diet on vascular function and cardiac structure, dietary interventions may be effective strategies to mitigate CVD risk early on.

Hypothesis:
We tested the hypothesis that specific dietary components and diet quality are associated with early markers of vascular and cardiac structure and function in youth with T1D. We compared these to associations in healthy controls.

Methods:
Cross-sectional study of 100 youth with T1D aged 14-18 yrs recruited at the Diabetes Clinic at Sainte-Justine Hospital University Center (Montreal, Canada) and 97 age and sex-matched healthy controls. Pulse-wave velocity (PWV) estimated arterial stiffness; velocity time integral (VTI) and acceleration during a flow-mediated dilation test assessed endothelial function. We measured left ventricular mass/height (LVMH), papillary mass, and wall thickness with cardiac MRI. Diet was measured with 3 x 24-h dietary recalls. Nutrients and foods were analyzed with the CANDAT software based on the Canadian Nutrient File. We assessed daily consumption of fruits, vegetables, fish, red meat, sugar-sweetened beverages and juices (SBJs), and sweets and chips. Food groups were all adjusted for total energy intake. We used the Diet Quality Index-International (DQI-I) to assess overall diet quality. We estimated linear regression models for each diet variable/outcome combination separately in youth with T1D and healthy controls adjusting for age, sex, ethnicity, parental education, physical activity and sedentary time (by accelerometer), and heart rate.

Results:
Girls comprised 48% of the sample; the mean age was 16.3 yrs (SD=1.3). The T1D group included more youth having overweight or obesity (43% vs. 20%), and was more ethnically diverse (White: 60% vs. 72%), compared to controls. Average glycated hemoglobin was 8.5% (SD=1.4) and median diabetes duration 6 yrs (IQR=3-10) in youth with T1D.
In youth with T1D
: Consuming more fruits was associated with lower PWV (beta [95% CI] per serving: -0.21 [-0.40; -0.02] m/s). Greater SBJ intake was paradoxically associated with higher VTI (per % total energy intake: 0.34 [0.04; 0.65] cm). DQI-I was related to a higher LVMH (per unit: 0.5 [0.1; 0.9] g/m).
In controls
: Eating more fruit was associated with a greater LVMH (per serving: 2.5 [0.1; 4.7] g/m). Higher SBJ intake was associated with a lower wall thickness (per % total energy intake: -0.10 [-0.20; -0.01] mm).

Conclusions:
Findings suggest that consuming more fruit could prevent arterial stiffening in youth with T1D. We previously reported that youth with T1D had lower LVMH than controls, and findings herein suggest that better diet quality could help compensate for this deficit. Overall, our results provide evidence on diet as a potential strategy to lower CVD risk in youth with T1D.