(DCP055) NEIGHBOURHOOD ENVIRONMENTS AND LIFESTYLE BEHAVIOURS IN ADOLESCENTS WITH AND WITHOUT TYPE 1 DIABETES - THE CARDEA STUDY

Background: Early signs of cardiovascular disease have been observed in adolescents with type 1 diabetes (T1D), highlighting the need for prevention strategies for this at-risk population. Some residential neighbourhood features are known to promote healthy lifestyle behaviours and reduce cardiovascular risk; however, little is known on the role of the neighbourhood environments on lifestyle behaviours in adolescents with T1D, and it is unknown whether adolescents with T1D are more vulnerable to neighbourhood environments compared to adolescents without T1D. This study aimed to explore associations between residential neighbourhood features and lifestyle behaviours in adolescents with T1D and in healthy controls.

METHODS AND RESULTS: This study is a secondary analysis of data from CARDEA, a cross-sectional study of 100 adolescents with T1D aged 14-18 years from a pediatric diabetes clinic in Montreal, and 97 age- and sex-matched healthy controls from the Greater Montreal Area (Quebec, Canada). Lifestyle behaviour outcomes included accelerometer-measured physical activity and sedentary behaviour, self-reported screen time and sleep duration, and fruit and vegetable intake and diet quality from three 24-hour diet recalls. Neighbourhood indicators were computed from publicly available geographical data for participants’ postal codes and circumscribed within 750m road network buffers centered on postal codes. Cluster analysis of selected neighbourhood indicators resulted in 2 distinct neighbourhood types: central urban and peri-urban. Central urban neighbourhoods were characterized by very high population density, high active living index, and numerous points of interest, and had higher social deprivation, higher residential mobility, and lower median household income compared to peri-urban neighbourhoods. Associations of neighbourhood type with each lifestyle behaviours were estimated with multivariable linear regression models. Living in central urban neighbourhoods was associated with higher daily minutes of moderate-to-vigorous physical activity (beta = 8.61, 95% CI [1.79, 15.44]) compared to living in peri-urban neighbourhoods. This association was observed in adolescents with T1D and in healthy controls, with no interaction between T1D status and neighbourhood type. No associations were observed for other lifestyle behaviours.

Conclusion: Features that are characteristic of central urban built environments appear to promote physical activity in adolescents, regardless of T1D status. Future studies should explore these associations using longitudinal data and larger samples. Next steps include testing whether neighbourhood features are associated with cardiometabolic outcomes in adolescents with T1D, in order to inform neighbourhood-level interventions to improve cardiovascular outcomes through healthy lifestyle behaviours in this population.