Changes in diet and physical activity in adolescents with and without type 1 diabetes over time

International Journal of Pediatric Endocrinology

David M Maahs¹  Nhung Nguyen¹  Janet Snell-Bergeon¹  R Paul Wadwa¹  Franziska K Bishop¹ 

[1] Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, MS F527, 80045 Aurora, CO, USA

关键词: Adolescents;    Screen time;    Type 1 diabetes;    Physical activity;    Diet;   

Others  :  1135803
DOI  :  10.1186/1687-9856-2014-17

 received in 2013-11-22, accepted in 2014-06-25,  发布年份 2014

【 摘 要 】

Background

Diet and physical activity (PA) are fundamental aspects of care in type 1 diabetes, but scant longitudinal data exist on these behaviors in adolescents with type 1 diabetes, especially compared to non-diabetic controls.

Methods

Data in 211 adolescents with type 1 diabetes (baseline age = 15.3 ± 2.2 years, diabetes duration = 8.8 ± 3.1 years, A1c = 9.0 ± 1.5%, 51% male) and 67 non-diabetic (age = 14.9 ± 1.7 years, 52% male) controls were collected at baseline (V1) and again at 2-year follow-up (V2) (mean follow up = 2.2 ± 0.4 years). Diet data (meals/day, snacks/day, and weekly consumption of breakfast, fruit, vegetables and fried foods), and PA were collected using interviewer administered questionnaires. T-tests and chi-squared tests were used for comparisons.

Results

Both adolescents with type 1 diabetes and non-diabetic controls reported increased vegetable (2.8 v. 3.6 and 3.1 v. 3.8 times weekly, respectively, p < 0.0001) and fruit (2.9 v. 3.8, both groups, p < 0.0001) intake (times per week) and increased PA (hours/day; 1.8 v. 2.2, p = 0.005 and 1.5 v. 1.9, p = 0.008, respectively) from V1 to V2. Adolescents with type 1 diabetes reported eating breakfast (3.3 v. 3.8 weekly, p = 0.0002) but also fried foods (1.9 v. 2.3, p = 0.0005) weekly more often from V1 to V2. Adolescents with and without type 1 diabetes met PA recommendations of 60 minutes or more of moderate-to-hard PA daily at both V1 (74% v. 70%, respectively, p = 0.58) and V2 (70% v. 78%, respectively, p = 0.78).

Conclusions

Over 2 years, adolescents with and without type 1 diabetes had a healthier diet with increased fruit and vegetable intake and increased PA. However, neither group met the guidelines of daily breakfast, fruit and vegetable intake. Some diet and PA improvements were seen in adolescents with type 1 diabetes over a 2-year period. Therefore, adolescence could be a beneficial time to target diet and lifestyle interventions to take advantage of this time period when behaviors are being modified.

【 授权许可】

   
2014 Bishop et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Rovner AJ, Nansel TR: Are children with type 1 diabetes consuming a healthful diet?: a review of the current evidence and strategies for dietary change. Diabetes Educ 2009, 35:97-107.
• [2]Smart C, Slander-van VE, Waldron S: Nutritional management in children and adolescents with diabetes. Pediatr Diabetes 2009, 10(Suppl 12):100-117.
• [3]Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, Franz MJ, Hoogwerf BJ, Lichtenstein AH, Mayer-Davis E, Mooradian AD, Wheeler ML: Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care 2008, 31(Suppl 1):S61-S78.
• [4]Franz MJ, Bantle JP, Beebe CA, Brunzell JD, Chiasson JL, Garg A, Holzmeister LA, Hoogwerf B, Mayer-Davis E, Mooradian AD, Purnell JQ, Wheeler M: Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care 2003, 26(Suppl 1):S51-S61.
• [5]USDA: USDA Guidelines for Americans. 2010. http://www.cnpp.usda.gov/dietaryguidelines.htm webcite. 1-31-2011
• [6]Gidding SS, Dennison BA, Birch LL, Daniels SR, Gillman MW, Lichtenstein AH, Rattay KT, Steinberger J, Stettler N, Van HL: Dietary recommendations for children and adolescents: a guide for practitioners. Pediatrics 2006, 117(2):544-559.
• [7]Mayer-Davis EJ, Nichols M, Liese AD, Bell RA, Dabelea DM, Johansen JM, Pihoker C, Rodriguez BL, Thomas J, Williams D: Dietary intake among youth with diabetes: the SEARCH for Diabetes in Youth Study. J Am Diet Assoc 2006, 106:689-697.
• [8]Krebs-Smith SM, Guenther PM, Subar AF, Sharon LK, Dodd KW: American do not meet federal dietary recommendations. J Nutr 2010, 140(10):1832-1838.
• [9]Kirkpatrick SI, Dodd KW, Reedy J, Krebs-Smith SM: Income and race/ethnicity are associated with adherence to food-based dietary guidance among US adults and children. J Acad Nutr Diet 2012, 112:624-635.
• [10]U.S. Department of Agriculture: Continuing Survey of Food Intakes by Individuals 1994-96. 1998.
• [11]Eaton DK, Kann L, Kinchen S, Shanklin S, Ross J, Hawkins J, Harris WA, Lowry R, McManus T, Chyen D, Lim C, Whittle L, Brener ND, Wechsler H: Youth Risk Behavior Surveillance - U.S. 2010. 2010.
• [12]Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, Deeb L, Grey M, Anderson B, Holzmeister LA, Clark N: Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 2005, 28:186-212.
• [13]Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F: Evidence based physical activity for school-age youth. J Pediatr 2005, 146:732-737.
• [14]American Academy of Pediatrics: Children, adolescents, and television. Pediatrics 2001, 107:423-426.
• [15]Margeirsdottir HD, Larsen JR, Brunborg C, Sandvik L, Dahl-Jorgensen K: Strong association between time watching television and blood glucose control in children and adolescents with type 1 diabetes. Diabetes Care 2007, 30:1567-1570.
• [16]Specht BJ, Wadwa RP, Snell-Bergeon JK, Nadeau KJ, Bishop FK, Maahs DM: Estimated insulin sensitivity and cardiovascular disease risk factors in adolescents with and without type 1 diabetes. J Pediatr 2013, 162:297-301.
• [17]Clements SA, Anger MD, Bishop FK, McFann KK, Klingensmith GJ, Maahs DM, Wadwa RP: Lower A1c among adolescents with lower perceived A1c goal: a cross-sectional survey. Int J Pediatr Endocrinol 2013, 2013:17. BioMed Central Full Text
• [18]Maahs DM, Prentice N, McFann K, Snell-Bergeon JK, Jalal D, Bishop FK, Aragon B, Wadwa RP: Age and sex influence cystatin C in adolescents with and without type 1 diabetes. Diabetes Care 2011, 34:2360-2362.
• [19]Nansel TR, Haynie DL, Lipsky LM, Laffel LM, Mehta SN: Multiple indicators of poor diet quality in children and adolescents with type 1 diabetes are associated with higher body mass index percentile but not glycemic control. J Acad Nutr Diet 2012, 112:1728-1735.
• [20]Snell-Bergeon JK, Chartier-Logan C, Maahs DM, Ogden LG, Hokanson JE, Kinney GL, Eckel RH, Ehrlich J, Rewers M: Adults with type 1 diabetes eat a high-fat atherogenic diet that is associated with coronary artery calcium. Diabetologia 2009, 52:801-809.
• [21]O’Brecht L, Streisand R, Holmes CS, Mackey ER: Nutrition intake in early adolescents with type 1 diabetes. PES Abstract [abstract]. PES 2013. Abstract 1522.291
• [22]Wood JR, Miller KM, Maahs DM, Beck RW, Dimeglio LA, Libman IM, Quinn M, Tamborlane WV, Woerner SE: Most youth with type 1 diabetes in the T1D exchange clinic registry do not meet American Diabetes Association or International Society for Pediatric and Adolescent Diabetes Clinical Guidelines. Diabetes Care 2013, 36:2035-2037.
• [23]Aman J, Skinner TC, de Beaufort CE, Swift PG, Aanstoot HJ, Cameron F: Associations between physical activity, sedentary behavior, and glycemic control in a large cohort of adolescents with type 1 diabetes: the Hvidoere Study Group on Childhood Diabetes. Pediatr Diabetes 2009, 10:234-239.
• [24]Overby NC, Margeirsdottir HD, Brunborg C, Anderssen SA, Andersen LF, Dahl-Jorgensen K: Physical activity and overweight in children and adolescents using intensified insulin treatment. Pediatr Diabetes 2009, 10:135-141.
• [25]Song M, Carroll DD, Fulton JE: Meeting the 2008 physical activity guidelines for americans among U.S. youth. Am J Prev Med 2013, 44:216-222.
• [26]America’s Health Rankings: United Health Foundation. Colorado 2012. 2012.
• [27]Eaton DK, Kann L, Kinchen S, Shanklin S, Flint KH, Hawkins J, Harris WA, Lowry R, McManus T, Chyen D, Whittle L, Lim C, Wechsler H: Youth risk behavior surveillance - United States, 2011. MMWR Surveill Summ 2012, 61:1-162.
• [28]Colorado Department of Public Health and Environment: Colorado Child Health Survey. Colorado: Department of Public Health and Environment; 2010.
• [29]2007 National Survey of Children’s Health 2007. http://www.childhealthdata.org/docs/nsch-docs/childhealthmeasures_03_vs_07_v2_508-pdf.pdf webcite. Online source
• [30]Bishop FK, Maahs DM, Snell-Bergeon JK, Ogden LG, Kinney GL, Rewers M: Lifestyle risk factors for atherosclerosis in adults with type 1 diabetes. Diab Vasc Dis Res 2009, 6:269-275.