"Better neighborhood resources, determined by a combined score for physical activity and healthy foods, were associated with a 38 percent lower incidence of type 2 diabetes," the authors write. This was similar to the reduction in risk observed among individuals whose BMI was five points lower. "The association remained statistically significant after further adjustment for individual dietary factors, physical activity level and body mass index."

The increasing prevalence of type 2 diabetes in the past 30 years makes it urgent to identify environmental features that may mitigate risk, the authors conclude. "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," they write.

"There is unlikely to be a panacea for the obesity epidemic and rising epidemic of type 2 diabetes. However, 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."

Source: JAMA and Archives Journals