title: Changes in diet and physical activity in adolescents with and without type 1 diabetes over time.
abstract: 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.
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, MS F527, 80045 Aurora, CO, USA.
authors.forename: Franziska K
authors.initials: FK
authors.lastname: Bishop
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, MS F527, 80045 Aurora, CO, USA.
authors.forename: R Paul
authors.initials: RP
authors.lastname: Wadwa
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, MS F527, 80045 Aurora, CO, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: Snell-Bergeon
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, MS F527, 80045 Aurora, CO, USA.
authors.forename: Nhung
authors.initials: N
authors.lastname: Nguyen
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, 1775 Aurora Ct, MS F527, 80045 Aurora, CO, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Maahs
keywords: Adolescents; Diet; Physical activity; Screen time; Type 1 diabetes