Background

This study aimed to examine cross-sectional and longitudinal associations between consumption of low-calorie sweetened beverages (LCSB) and diet in youth with type 2 diabetes (T2D).

Methods

Data were collected from 476 participants age 10-17yrs during the first two years of the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study, a randomized, double-blind, multisite, trial designed to compare effects of three interventions on glycemic control in youth with T2D.Diet was assessed at baseline using a modified Block-Kids’ food-questionnaire. Energy and macronutrients were compared at baseline and two-year follow-up among low(1-4 servings/week), medium(5-11 servings/week), and high(≥12 servings/week) LCSB consumers. Baseline associations were assessed using multivariable linear regression, adjusted for age, sex, race/ethnicity, household education, and body mass index. Longitudinal associations were further adjusted for month 24 BMI, randomized treatment group, the baseline value of the outcome, and baseline LCSB consumption.

Results

At baseline, energy, carbohydrate, total and saturated fat, and protein intake (grams) were higher among high LCSB consumers compared to non-consumers. No association between change in LCSB and change in energy intake between baseline and follow-up was observed, yet participants who decreased LCSB consumption reported greater increases in total sugar, and specifically, sugar-sweetened beverage, intake.

Conclusions

These findings suggest that LCSB consumption is positively associated with total energy intake in youth with T2D, and that, over-time, those who reduce LCSB consumption increase sugar intake. Findings underscore the need for experimental studies investigating effects of LCSB consumption on diet in youth with T2D.