Thursday, October 20, 2011

Diet Records: A Note from the TEDDY Staff -- Part 2

This is part two to the questions and tips on recording diet, part one can be found here.

What if I just can’t get two weekdays?

As noted before, we request two weekdays and one weekend day for each diet record because we feel this will give us the most accurate picture of your child’s diet. However, we understand that there may be reasons why this isn’t possible for you. For example, there are a few daycare providers who do not have the time or inclination to assist with this portion of the study. We do not want any of our TEDDY families to jeopardize their relationships with their daycare providers in an attempt to get this information! There may also be other reasons why you are unable to complete a diet record according to these specifications. If the ideal diet record of two weekdays and one weekend day is not an option for you, we do understand. The computer system mentioned before is unable to analyze days that are incomplete – for example, days with breakfast and dinner only, but no information about lunch and snacks. So our preference in this case would be to use days when the child is with you all day or with someone who is willing to help you keep track of what your child eats. If, at the time of the visit, you do not have all three days completed, please just bring us the days that you have. We can always work with you to get the remaining day(s) at a later (hopefully more convenient) date, or we can use the data that you do have. We would not want to waste the effort that you put into a diet record simply because it does not meet our guidelines exactly. And for those of you with children who will be starting school soon (or are already in school), we are currently working on some tools and tips for collecting diet information from the time your child spends at school. Please feel free to ask your clinician for an update at your next visit!

Does my diet record reflect a normal diet for my child?

Finally, some parents are concerned that the diet records they are giving us are unrepresentative. Possibly without even meaning to, they think they are giving their child foods that are more easily measured, or using recipes with fewer ingredients, to help them more easily report what their child eats. Of course, we all know that the idea behind the diet records is to provide the study with an accurate picture of your child’s eating patterns. And we would like to extend an extra thank you to those families who are making a conscious effort not to change their child’s diet for ease of reporting. However, if you do worry that changes like the ones mentioned above are showing up on your child’s diet records, please do not feel bad. Even though these kinds of changes may seem substantial, the truth is that those changes are probably not making as big of a difference at the micronutrient level as you might think. Your basic philosophies regarding food preparation and eating are still in place. A family who usually uses salt only sparingly will not add large amounts of salt to their child’s food on a diet record day.

Other related concerns involve the days on which a diet record falls. For example, we heard a lot of comments around Halloween that the candy eaten around this time of year really does not represent the child’s candy intake during the rest of the year. We understand this. It might help to not think of us analyzing any one particular day, or any one particular diet, alone. When we look at the data, we will be looking, not just at your most recent diet record, but at all of the diet records you’ve given us in the past, and all of the diet records that you will give us in the future. Imagine throwing all of these days into a big pot, and then adding all of the past and future diet record days that we have received and will receive from thousands of other children, and then stirring it all up. We will look at that big soup of diet records for our analysis, not at any one particular record or day. So even though your child’s diet record may have fallen on Halloween this year, someone has to represent Halloween in order to give us the bigger picture of TEDDY children’s diets around that time of the year. But there are many, many other diet records that we receive all year round from days other than Halloween, so those other days will be represented in our analysis, too.

Why am I doing this, again?

To conclude, we know that diet records can be difficult. We do not want you to regret your participation in this study because of them. Please, first and foremost, do what you need to do to maintain your sanity! Hopefully the paragraphs above will give you some peace of mind about what many families consider to be “imperfections” in their diet reporting. We at the TEDDY Study do not expect you to be superhuman when it comes to diet records. All we ask for is your best effort, and that best effort may look a little different from day to day, and from family to family. We admire each and every one of you for the help you give us toward the ultimate goal of preventing diabetes. The diet records you complete are an incredibly important step in achieving this goal. Researchers believe that certain elements in a child’s diet could possibly play a key role in determining whether or not a child with high risk genes for type 1 diabetes goes on to develop the illness. Unfortunately, we still do not know which elements of a child’s diet are the determining factors. We would love to be able to tell all of our TEDDY parents that, by increasing or decreasing their child’s exposure to certain foods or nutrients, or by altering their feeding patterns, they can improve their child’s chances of never developing diabetes. I know everyone in this study wishes that we had that kind of information at our disposal. But it is the work that you do in maintaining these diet records that will give us the best shot at being able to provide this kind of information to parents in the future.

The TEDDY Study Staff