• High availability of fast-food restauran

    From ScienceDaily@1:317/3 to All on Fri Oct 29 21:30:38 2021
    High availability of fast-food restaurants across all US neighborhood
    types linked to higher rates of typediabetes

    Date:
    October 29, 2021
    Source:
    NYU Langone Health / NYU Grossman School of Medicine
    Summary:
    A new nationwide study suggests that living in neighborhoods with
    higher availability of fast-food outlets across all regions of
    the United States is associated with higher subsequent risk of
    developing type 2 diabetes.



    FULL STORY ==========================================================================
    An increasing number of studies suggest a link between a neighborhood's
    built environment and the likelihood that its residents will develop
    chronic diseases such as heart disease, type 2 diabetes (T2D) and certain
    types of cancers. A new nationwide study led by researchers from NYU
    Grossman School of Medicine published online today in JAMA Network
    Open suggests that living in neighborhoods with higher availability of fast-food outlets across all regions of the United States is associated
    with higher subsequent risk of developing type 2 diabetes.


    ========================================================================== Findings also indicated that the availability of more supermarkets
    could be protective against developing T2D, particularly in suburban
    and rural neighborhoods.

    The study -- notable for its large geographic breadth -- uses data
    from a cohort of more than 4 million veterans living in 98 percent of
    U.S. census tracts across the country. It counted fast-food restaurants
    and supermarkets relative to other food outlets, and is the first,
    according to the researchers, to examine this relationship in four
    distinct types of neighborhoods (high- density urban, low-density urban, suburban, and rural) at the hyperlocal level nationwide.

    "Most studies that examine the built food environment and its relationship
    to chronic diseases have been much smaller or conducted in localized
    areas," said Rania Kanchi, MPH, a researcher in the Department of
    Population Health at NYU Langone and lead author of the study. "Our
    study design is national in scope and allowed us to identify the
    types of communities that people are living in, characterize their food environment, and observe what happens to them over time. The size of our
    cohort allows for geographic generalizability in a way that other studies
    do not." How the Study was Conducted The research team used data from the
    U.S. Veterans Health Administration (the largest single-payer healthcare
    system in the country) that captures more than 9 million veterans seen
    at more than 1,200 health facilities around the country. Using this
    data, the researchers then constructed a national cohort of more than 4
    million veterans without diabetes from the VA electronic health records
    (EHR) between 2008 and 2016. Each veteran's health status was followed
    through 2018 or until the individual either developed diabetes, died,
    or had no appointments for more than two years.



    ========================================================================== Within each of four distinct neighborhood types, the proportion of
    restaurants that were fast food, and the proportion of food outlets that
    were supermarkets were tabulated within a one-mile walk in high- density
    urban neighborhoods, a two-mile drive in low-density urban neighborhoods,
    a six-mile drive in suburban communities, and a 10-mile drive in rural communities.

    Veterans were followed for a median of five and a half years. During
    that time, 13.2 percent of the cohort were newly diagnosed with
    T2D. Males developed T2D more frequently than females (13.6 versus 8.2 percent). Non-Hispanic Black adults had the highest incidence (16.9
    percent), compared to non-Hispanic Whites (12.9 percent), non-White
    Asian and Hispanics (12.8 percent), Native Hawaiian and Pacific Islanders
    (15 percent), and Native American and Alaskan Indians (14.2 percent).

    When stratifying by community types, 14.3 percent of veterans living
    in high density urban communities developed T2D, while the lowest
    incidence was among those living in suburban and small town communities
    (12.6 percent).

    Overall, the team concluded that the effect of the food environment on
    T2D incidence varied by how urban the community was, but did not vary
    further by region of the country.

    "The more we learn about the relationship between the food environment
    and chronic diseases like type 2 diabetes, the more policymakers can
    act by improving the mix of healthy food options sold in restaurants
    and food outlets, or by creating better zoning laws that promote optimal
    food options for residents," said Lorna Thorpe, PhD, MPH, professor in
    the Department of Population Health at NYU Langone and senior author of
    the study.

    One limitation of the study, according to the authors, is that the
    study may not be fully generalizable to non-veteran populations, as
    U.S. veterans tend to be predominantly male and have substantially
    greater health burdens and financial instability than the civilian
    population. They are also at greater risk of disability, obesity, and
    other chronic conditions.

    The next phase of the research, say Thorpe and Kanchi, will be to
    better understand the impacts of the built environment on diabetes risk
    by subgroups.

    They plan to examine whether or not the relationships between
    fast-food restaurants, supermarkets and community types vary by gender, race/ethnicity, and socioeconomic status.

    Funding for the study was provided by the Centers for Disease Control
    and Prevention.

    In addition to Thorpe and Kanchi, other NYU Langone researchers include Priscilla Lopez, MPH; Pasquale E. Rummo, PhD; David C. Lee, MD; Samrachana Adhikari, PhD; Mark D. Schwartz, MD, and Brian Elbel, PhD. Other research support was provided by Sanja Avramovich, PhD, Department of Health Administration and Policy, George Mason University; Karen R. Siegel,
    PhD; Deborah B. Rolka, MS and Giuseppina Imperatore from the Division
    of Diabetes Translation at the Centers for Disease Control and Prevention.

    ========================================================================== Story Source: Materials provided by NYU_Langone_Health_/_NYU_Grossman_School_of_Medicine.

    Note: Content may be edited for style and length.


    ========================================================================== Journal Reference:
    1. Rania Kanchi, Priscilla Lopez, Pasquale E. Rummo, David C. Lee,
    Samrachana Adhikari, Mark D. Schwartz, Sanja Avramovic, Karen
    R. Siegel, Deborah B. Rolka, Giuseppina Imperatore, Brian Elbel,
    Lorna E. Thorpe.

    Longitudinal Analysis of Neighborhood Food Environment and
    Diabetes Risk in the Veterans Administration Diabetes Risk
    Cohort. JAMA Network Open, 2021; 4 (10): e2130789 DOI:
    10.1001/jamanetworkopen.2021.30789 ==========================================================================

    Link to news story: https://www.sciencedaily.com/releases/2021/10/211029114022.htm

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