Date of Award


Document Type


Degree Name

Master of Arts (MA)



First Advisor

Amy Hughes Lansing


Introduction Regular consumption of pro-inflammatory foods at the expense of cardioprotective, i.e., anti-inflammatory, foods may accelerate inflammation-mediated macrovascular disease among adolescents with type 1 diabetes (T1D). In community samples of adolescents, proinflammatory food consumption is driven in part by the adolescent's food environment. However, the association of the food environment with pro-inflammatory food consumption among adolescents with T1D remains unexplored. The present study examined associations of adolescent and caregiver perceptions of the availability, accessibility, affordability, and acceptability of food in the home and consumer food environments with pro-inflammatory food consumption among adolescents with T1D. Methods Adolescents with T1D (N=49) aged 13-17 participated in a baseline assessment as part of studies examining physical activity and T1D outcomes. Adolescents and a primary caregiver completed survey measures that assessed their perceptions of their home and external nutrition environments. Adolescents also completed a measure of dietary intake that provided a literature-validated dietary inflammatory index score. Bivariate correlations examined associations between primary study variables. Adjusted linear regression models were used to examine unique associations of the food environment and adolescent dietary inflammation index scores after adjusting for caregiver highest level of education. Results Significant associations were observed between three aspects of the adolescent and caregiver perceptions of the home food environment and greater adolescent dietary inflammatory index scores: (1) greater adolescent perceptions of the availability of salty snack foods (r= .35, p= .02), (2) greater adolescent perceptions of the availability of sugar-sweetened beverages (r= .45, p< .01), and (3) greater caregiver perception of the accessibility of pro-inflammatory food (r= .35, p= .02). In adjusted regression models, each significant predictor continued to explain adolescent dietary inflammatory index scores after adjusting for caregiver highest level of education. Although there were no other statistically significant associations observed, there were potentially clinically meaningful effect sizes worthy of future investigation for caregiver reports on the external food environment. Specifically, there was a pattern of higher dietary inflammation scores and increased accessibility and availability of proinflammatory foods as well as increased accessibility, availability, affordability, and acceptability of cardioprotective foods in the external food environment, especially for older adolescents. Conclusion Adolescents with T1D with lower availability and accessibility of pro-inflammatory foods in the home food environment consumed diets of lower inflammatory potential. In addition, for older adolescents with T1D, a more abundant external food environment for both cardioprotective and pro-inflammatory foods may be associated with diets of higher inflammatory potential. Interventions to increase cardioprotective food consumption for adolescents with T1D might consider targeting the home food environment. Further research is needed to clarify the external environmental determinants of dietary behaviors across adolescence for youth with T1D toward developing multi-level interventions that also target structural factors.



Number of Pages

43 p.

Available for download on Friday, May 15, 2026