Neighborhood resources for physical activity and healthy foods and incidence of type 2 diabetes mellitus: the Multi-Ethnic study of Atherosclerosis.

Full Abstract

BACKGROUND: Despite increasing interest in the extent to which features of residential environments contribute to incidence of type 2 diabetes mellitus, no multisite prospective studies have investigated this question. We hypothesized that neighborhood resources supporting physical activity and healthy diets are associated with a lower incidence of type 2 diabetes. METHODS: Person-level data came from 3 sites of the Multi-Ethnic Study of Atherosclerosis, a population-based, prospective study of adults aged 45 to 84 years at baseline. Neighborhood data were derived from a population-based residential survey. Type 2 diabetes was defined as a fasting glucose level of 126 mg/dL or higher (> or =7 mmol/L) or taking insulin or oral hypoglycemic agents. We estimated the hazard ratio of type 2 diabetes incidence associated with neighborhood (US Census tract) resources. RESULTS: Among 2285 participants, 233 new type 2 diabetes cases occurred during a median of 5 follow-up years. Better neighborhood resources, determined by a combined score for physical activity and healthy foods, were associated with a 38% lower incidence of type 2 diabetes (hazard ratio corresponding to a difference between the 90th and 10th percentiles for resource distribution, 0.62; 95% confidence interval, 0.43-0.88 adjusted for age, sex, family history of diabetes, race/ethnicity, income, assets, educational level, alcohol use, and smoking status). The association remained statistically significant after further adjustment for individual dietary factors, physical activity level, and body mass index. CONCLUSION: Better neighborhood resources were associated with lower incidence of type 2 diabetes, which suggests that improving environmental features may be a viable population-level strategy for addressing this disease.

Author information

Author/s: Auchincloss, Amy H (AH); Diez Roux, Ana V (AV); Mujahid, Mahasin S (MS); Shen, Mingwu (M); Bertoni, Alain G (AG); Carnethon, Mercedes R (MR);

Affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, PA 19102, USA. aha27(-atsign-)drexel.edu

Grants: N01-HC-95159 (Agency:NHLBI NIH HHS) ; N01-HC-95165 (Agency:NHLBI NIH HHS) ; N01-HC-95169 (Agency:NHLBI NIH HHS) ; R01 HL071759 (Agency:NHLBI NIH HHS)

Journal and publication information

Publication Type: Journal Article; Research Support, N.I.H., Extramural

Journal: Archives of internal medicine (Arch Intern Med), published in United States. (Language: eng)

Reference: 2009-Oct; vol 169 (issue 18) : pp 1698-704

Dates: Created 2009/10/13; Completed 2009/11/04;

PMID: 19822827, status: MEDLINE (last retrieval date: 11/4/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Arch Intern Med. 2009 Oct 12;169(18):1653-4. (PMID: 19822820)

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