Neighborhood Resources for Physical Activity and Healthy Foods and Their Association With Insulin Resistance
Abstract
OBJECTIVE: : Little is known about the influence of the built environment, and in particular neighborhood resources, on health. We hypothesized that neighborhood resources for physical activity and healthy foods are associated with insulin resistance. METHODS: : Person-level data (n = 2026) came from 3 sites of The Multi-Ethnic Study of Atherosclerosis, a study of adults aged 45-84 years. Area-level data were derived from a population-based residential survey. The homeostasis model assessment index was used as an insulin resistance measure among persons not treated for diabetes. We used linear regression to estimate associations between area features and insulin resistance. RESULTS: : Greater neighborhood physical activity resources consistently were associated with lower insulin resistance. Adjusted for age, sex, family history of diabetes, race/ethnicity, income and education, insulin resistance was reduced by 17% (95% confidence interval = -31% to -1%) for an increase from the 10th to 90th percentiles of resources. Greater healthy food resources were also inversely related to insulin resistance, although the association was not robust to adjustment for race/ethnicity. Analyses including diet, physical activity, and body mass index suggested that these variables partly mediated observed associations. Results were similar when impaired fasting glucose/diabetes was considered as the outcome variable. CONCLUSION: : Diabetes prevention efforts may need to consider features of residential environment.
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In 2 studies evaluating metabolic risk markers, after multivariable adjustment including race/ethnicity, neighborhood availability of healthier foods was not significantly associated with insulin resistance or adiposity.
“In 2 studies evaluating metabolic risk markers, after multivariable adjustment including for race/ethnicity, neighborhood availability of healthier foods was not significantly associated with insulin resistance or adiposity; greater shelf space for energy-dense snack foods was positively associated with BMI.317,318”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [317]
In 2 studies evaluating metabolic risk markers, greater shelf space for energy-dense snack foods was positively associated with BMI.
“In 2 studies evaluating metabolic risk markers, after multivariable adjustment including for race/ethnicity, neighborhood availability of healthier foods was not significantly associated with insulin resistance or adiposity; greater shelf space for energy-dense snack foods was positively associated with BMI.317,318”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [317]
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- Authors
- Auchincloss, A. H., Diez Roux, A. V., Brown, D. G., Erdmann, C. A., & Bertoni, A. G.
- Affiliations
- University of Michigan (US)
- Wake Forest University Health Sciences (US)
- Corresponding author
- Auchincloss, Amy H.
- Erdmann, Christine A.
- Venue
- Epidemiology
- Published
- 2008-01
- Volume
- 19
- Issue
- 1
- Pages
- 146-157
- ISSN
- 1044-3983 (ISSN-L)
- OpenAlex
- W2097353971
- Cited by
- 167
- References
- 61
- Citations by year
- 2024: 7 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 10 · 2019: 10 · 2018: 11 · 2017: 13 · 2016: 18 · 2015: 12 · 2014: 12 · 2013: 10 · 2012: 13
- FWCI
- 29.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Funders
- National Institutes of Health (n01hc95166-21-0-1, n01hc95159-40-0-1)
- National Heart, Lung, and Blood Institute (N01 HC-95159, N01‐HC‐95166)
- Topics
- Social Sciences › Transportation › Urban Transport and Accessibility
- Social Sciences › Health › Health disparities and outcomes
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Urban Green Space and Health
- Keywords
- insulin resistance, neighborhood built environment, physical activity resources, healthy food access, diabetes prevention, residential environment, HOMA, impaired fasting glucose, body mass index
- MeSH terms
- Aged, Cross-Sectional Studies, Diabetes Mellitus, Diet, Environment Design, Female, Humans, Insulin Resistance, Interviews as Topic, Life Style, Male, Middle Aged, Motor Activity, Nutrition Surveys, Residence Characteristics, United States, Body Mass Index
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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