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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