Friday, October 16, 2009

Where You Live Can Affect Your Risk for Diabetes


You can drastically reduce your risk of developing type 2 diabetes simply by choosing to reside in a neighborhood that promotes exercise and offers easy access to healthy foods. In fact, people who live in “healthy” neighborhoods that provide safe sidewalks, plentiful parks, and readily accessible fresh fruits and vegetables, along with dependable public transportation, are 38 percent less likely to develop type 2 diabetes than people who live in less healthy neighborhoods.

Amy Auchincloss, PhD, MPH, of Drexel University in Philadelphia, and colleagues, conducted a study of 2,285 people, ages 45 to 84, who were living in neighborhoods in Forsyth County, North Carolina, Baltimore, Maryland, and New York City/Bronx. The neighborhoods of the study participants were evaluated by making inquiries among residents as to whether taking a walk in their community was easy and pleasant, and whether or not local stores had a well-stocked variety of high-quality fruits, vegetables, and low-fat foods. Participants were also asked if it was common to see other residents exercising.

Findings showed that the average neighborhood scores were 3.68 for physical activity, and 3.36 for healthy foods. In addition, the research revealed that those people who were living in healthy neighborhoods were much less likely to develop type 2 diabetes after completion of the five-year cohort study that included controls for factors such as age, income, race, and education. During the five-year follow-up period, 10 percent of the study participants were diagnosed with type 2 diabetes.

Participants in the analysis underwent baseline health exams during the years 2000 to 2002, with additional exams being given roughly every 18 months. Among the standard physical assessments included in the exams was a fasting blood glucose measurement. Other data collected included Sociodemographic data and each participant’s description of their normal diet and exercise routines.

According to the study authors, “The strength of the association was considerable and equivalent to a reduction in type 2 diabetes incidence associated with a BMI (Body Mass Index) of 5 [points] lower in this sample.” With the obesity epidemic at an all-time high, along with the sharp increase in occurrence of cases of type 2 diabetes, they noted, “altering our environments so that healthier behaviors and lifestyles can be easily chosen may be one of the key steps in arresting and reversing these epidemics.” The full report can be found in the Archives of Internal Medicine.

The researchers acknowledged that further research would be necessary to determine the true impact of the healthy neighborhood environment. According to Auchincloss, “The next step is to look at changes in physical activity with neighborhood changes over time.” She pointed out that another research group at Drexel has already begun this analysis, and that it will also study changes in diet.

Auchincloss explained that several neighborhood improvement initiatives are currently under way in Philadelphia, as well as in other cities. These include placing farmers' markets and full-size supermarkets in low-income neighborhoods, as well as the development of bike lanes and other reasonably low-cost projects that would encourage exercise. In their report, the researchers wrote, “Current efforts to foster health-promoting environments include designing and modifying physical environments, such as zoning residential neighborhoods to require safe sidewalks, creating parks and attractive public green spaces and improving public transportation so that residents rely less on their cars; supporting fresh-food farmers' markets in low-income, urban neighborhoods; and assisting stores in those neighborhoods in improving their selection of healthy foods.”

Within the United States alone, the prevalence of type 2 diabetes has steadily increased over the past three decades. An estimated 23.6 million Americans, as well as 246 million people around the globe have diabetes. Of these, the majority suffers from the type 2 condition.

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