Neighborhood resources for physical activity and healthy foods and their association with insulin resistance
Neighborhood resources for physical activity and healthy foods and their association with insulin resistance
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DOI：
10.1097/ede.0b013e31815c480
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发表时间：
2008-01-01
期刊：
影响因子：
5.4
通讯作者：
Bertoni, Alain G.
中科院分区：
文献类型：
--
作者：
Auchincloss, Amy H.;Roux, Ana V. Diez;Bertoni, Alain G.
目标：人们对建筑环境，特别是社区资源对健康的影响知之甚少。我们假设用于身体活动和健康食品的社区资源与胰岛素抵抗有关。方法：个人水平数据（n = 2026）来自动脉粥样硬化多种族研究的 3 个地点，该研究针对 45-84 岁的成年人。地区级数据来自基于人口的居住调查。稳态模型评估指数被用作未接受糖尿病治疗的人的胰岛素抵抗指标。我们使用线性回归来估计区域特征与胰岛素抵抗之间的关联。结果：较大的社区体育活动资源始终与较低的胰岛素抵抗相关。根据年龄、性别、糖尿病家族史、种族/民族、收入和教育程度进行调整后，资源从第 10 个百分位数增加到第 90 个百分位数，胰岛素抵抗降低了 17%（95% 置信区间 = -31% 到 -1%）。更多的健康食品资源也与胰岛素抵抗呈负相关，尽管这种关联对于种族/民族的调整并不强健。包括饮食、体力活动和体重指数在内的分析表明，这些变量部分介导了观察到的关联。当将空腹血糖受损/糖尿病视为结果变量时，结果相似。结论：糖尿病预防工作可能需要考虑居住环境的特征。
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.