People living in neighborhoods with sidewalks, parks and cycleways that encourage exercise, and who have access to healthy foods may have a lower risk of developing type 2 diabetes (T2D) in a five-year period, according to researchers at the Drexel University School of Public Health, Philadelphia, USA.
“The worldwide epidemic of type 2 diabetes mellitus is largely driven by the combined rise in obesity, intake of energy-dense or nutrient-poor foods and physical inactivity,” the authors write as background information in the report, Quality of Residential Neighborhood, A Modifiable Risk Factor for Type 2 Diabetes? published in the October 12, 2009 issue of Archives of Internal Medicine.
Dr Amy H. Auchincloss and colleagues decided that, although the causes of T2D included genetic and behavioral risk factors, it made sense to focus on factors that could be modified. They decided to look at what aspects of a person’s immediate neighborhood improved their chances of not developing diabetes.
They studied 2,285 adults aged between 45 and 84 who were already taking part the Multi-Ethnic Study of Atherosclerosis (MESA).
Participants were from three American precincts for which neighborhood level data were already available: Baltimore; Forsyth County, N.C.; and New York City/Bronx.
Blood glucose levels were obtained from study participants at the first assessment (baseline) and at three follow-up examinations. Participants were also assessed for diet, body mass index (BMI) and their levels of physical activity.
Ease Of Walking and Access to Healthy Food
The participants’ neighborhoods had been rated previously by other residents who answered questionnaires about the ease of walking to shops, parks and so on in an area a 20-minute walk or a mile from their homes.
These residents had also been asked about their access to a high-quality selection of fruits, vegetables and other low-fat foods. Each neighborhood was scored from one to five, with five representing the healthiest areas.
Averages for the three neighborhoods the study participants came from were 3.68 for physical activity and 3.36 for healthy foods.
Healthy Neighborhoods Reduce Type 2 Diabetes Risk
During the five-year study, 233 of the 2,285 participants (10.2 percent) developed diabetes. People in the healthiest of neighborhoods experienced a 38 percent lower incidence of T2D, than the general population.
Dr Auchincloss said the results were statistically significant and were similar to the reduced T2D risks of people whose BMI was five points lower than the study participants’.
Neighborhoods Should Encourage Walking
Australian urban planning expert, Dr Glen Searle said neighborhoods which encouraged exercise were also pleasant areas in which to live.
Activity-friendly locales have good sidewalks, and they also have parks, local shops, mass transit stops, bike paths or designated bike areas and other low cost recreational facilities.
“These all contribute to making the walking experience more pleasant,” Dr Searle said.
Access to Low-cost High Quality Food Important
Dr Auchincloss stressed in her article that it was not just the ease of exercise that was important in reducing adults’ risk of developing T2D.
An important factor in the healthy score for each neighborhood was access to a range of quality fresh fruits and vegetables and low fat foods.
Dr Auchincloss and her colleagues said that improvements and rezoning of neighborhoods to allow people to walk more, use public transport or mass transit and not rely so much on their cars were a step in the right direction.
However, it was also important that local authorities were “supporting fresh-food farmers’ markets in low-income, urban neighborhoods and assisting stores in those neighborhoods in improving their selection of healthy foods,” they wrote.
“Unfortunately, in most developed countries today, the environment offers few opportunities for exercise, and highly processed foods are more plentiful than fresh vegetables and raw grains,” Dr Mitchell Katz, of the San Francisco Department of Public Health, wrote in an editorial attached to Dr Auchincloss’ article.
“If we are to decrease the rates of type 2 diabetes, we need to change the environment in ways that make it easy for people to exercise and eat right as part of their daily routine.”
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