SAT-264 Food Healthiness Influences Dietary Choice in Type 1 Diabetes Youth Whereas Only Tastiness Influences Dietary Choice in Controls

Background: Nearly 40% of youth with Type 1 diabetes mellitus (T1DM) are overweight or obese, which could increase cardiovascular disease risk and impair glycemic control. The ability to control food desire could contribute to whether a child becomes obese. Our objective is to study dietary choice in children with and without T1DM. Methods: 24 T1DM youth (10.8 ± 1.6y, 58% male, Tanner 2.4 ± 1.4, BMI percentile 74.9 ± 25.1) were matched with 24 healthy controls (11.2 ± 1.5y, 58% male, Tanner 2.1 ± 1.0, BMI percentile 72.4 ± 28.4). T1DM youth had an HbA1c of 7.7 ± 1.2% with no difference between lean and non-lean T1DM. Participants performed a food choice task with computer mouse-tracking (MATLAB), rating 60 food cues (30 high-calorie, 30 low-calorie) for tastiness and healthiness, then choosing between 100 food choice pairs that were generated based on individual participant ratings. Cursor-trajectory analyses pinpointed when tastiness and healthiness food attributes influenced the choice process. Self-control was deemed positive when the healthier food was chosen in a choice trial. Parents/guardians of participants completed the Child Eating Behavior Questionnaire (CEBQ) and participants completed the Yale Food Addiction Scale (YFAS). Results: In both T1DM and control youth, tastiness significantly influenced the dietary choice earlier than healthiness. However, in T1DM there was a much smaller difference between the processing speed of tastiness and healthiness (252 vs. 640 msec in controls), with both taste and health significantly influencing the dietary choice trajectory in T1DM. In controls, tastiness alone influenced dietary choice. In T1DM youth, the time difference between the processing speed of tastiness and healthiness predicted dietary self-control (R(2)= 0.27, p < 0.01), whereas in control youth there was no correlation. On the CEBQ, T1DM youth had higher scores for emotional overeating compared to controls (p < 0.05). On the YFAS, there were no T1DM youth who reported “the way I eat has made me unhealthy”, while 36% of control youth did (p < 0.01). Conclusions: T1DM youth have much closer processing speeds of tastiness and healthiness food attributes during dietary choice compared to controls, with healthiness only influencing dietary decision-making in T1DM youth and not in controls. T1DM youth also exhibit differences regarding ratings for emotional overeating and their perceptions concerning healthy eating, compared to control youth. This could reflect nutritional counseling and attention towards food and/or carbohydrates in T1DM.