Neighbourhood Environments and Lifestyle Behaviours in Adolescents With Type 1 Diabetes

Katerina M Syragakis; Mélanie Henderson; Soren Harnois-Leblanc; Tracie A Barnett; Marie-Eve Mathieu; Vicky Drapeau; Andrea Benedetti; Andraea Van Hulst

doi:10.1016/j.jcjd.2024.07.003

Neighbourhood Environments and Lifestyle Behaviours in Adolescents With Type 1 Diabetes

Can J Diabetes. 2024 Aug 3:S1499-2671(24)00143-6. doi: 10.1016/j.jcjd.2024.07.003. Online ahead of print.

Authors

Katerina M Syragakis¹, Mélanie Henderson², Soren Harnois-Leblanc³, Tracie A Barnett⁴, Marie-Eve Mathieu⁵, Vicky Drapeau⁶, Andrea Benedetti⁷, Andraea Van Hulst⁸

Affiliations

¹ Ingram School of Nursing, McGill University, Montréal, Québec, Canada.
² Azrieli Research Centre of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada; Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada; School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, Québec, Canada.
³ Azrieli Research Centre of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada; Harvard Pilgrim Health Care Institute, Department of Population Medicine, Harvard University, Boston, Massachusetts, United States.
⁴ Azrieli Research Centre of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada; Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada.
⁵ Azrieli Research Centre of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada; School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.
⁶ Department of Kinesiology, Faculty of Medicine, Université Laval, Québec City, Québec, Canada.
⁷ Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
⁸ Ingram School of Nursing, McGill University, Montréal, Québec, Canada. Electronic address: andraea.vanhulst@mcgill.ca.

PMID: 39098660
DOI: 10.1016/j.jcjd.2024.07.003

Abstract

Objectives: Early prevention strategies are needed to mitigate the high risk of cardiovascular disease in adolescents with type 1 diabetes (T1D). Residential neighbourhood features can promote healthy lifestyle behaviours and reduce cardiovascular risk, but less is known about their role in lifestyle behaviours in adolescents with T1D, and no studies used comparisons to healthy controls.

Methods: We examined associations between residential neighbourhood features and lifestyle behaviours in adolescents with T1D and healthy controls. Data were analyzed from the CARdiovascular Disease risk factors in pEdiatric type 1 diAbetes (CARDEA) study, a cross-sectional investigation of 100 adolescents with T1D (14 to 18 years) from a pediatric diabetes clinic in Montréal, Canada, and 97 healthy controls. Outcomes included physical activity and sedentary behaviour (accelerometry), screen time and sleep duration (questionnaires), and dietary habits (24-hour recalls). Cluster analysis of selected neighbourhood indicators computed for participants' postal codes resulted in 2 neighbourhood types: central urban and peri-urban. Central urban neighbourhoods were characterized by very high population density, high active living index, numerous points of interest, higher social deprivation, higher residential mobility, and lower median household income compared with peri-urban neighbourhoods. Associations of neighbourhood type with lifestyle behaviours were estimated with multiple linear regressions and interactions by T1D status were tested.

Results: Living in central urban neighbourhoods was associated with greater daily minutes of moderate-to-vigourous physical activity (beta = 8.61, 95% confidence interval 1.79 to 15.44) compared with living in peri-urban neighbourhoods. No associations were observed for other lifestyle behaviours, and no statistically significant interactions were found between neighbourhood type and T1D status.

Conclusion: Features that characterize central urban built environments appear to promote physical activity in adolescents, regardless of T1D status.

Keywords: adolescents; built environment; diabète de type 1; diabète pédiatrique; environnement urbain; lifestyle; mode de vie; neighbourhood; pediatric diabetes; quartier; type 1 diabetes.