Walkability and its association with prevalent and incident diabetes among adults in different regions of Germany: results of pooled data from five German cohorts

BMC Endocr Disord. 2020 Jan 13;20(1):7. doi: 10.1186/s12902-019-0485-x.

Abstract

Background: Highly walkable neighbourhoods may increase transport-related and leisure-time physical activity and thus decrease the risk for obesity and obesity-related diseases, such as type 2 diabetes (T2D).

Methods: We investigated the association between walkability and prevalent/incident T2D in a pooled sample from five German cohorts. Three walkability measures were assigned to participant's addresses: number of transit stations, points of interest, and impedance (restrictions to walking due to absence of intersections and physical barriers) within 640 m. We estimated associations between walkability and prevalent/incident T2D with modified Poisson regressions and adjusted for education, sex, age at baseline, and cohort.

Results: Of the baseline 16,008 participants, 1256 participants had prevalent T2D. Participants free from T2D at baseline were followed over a mean of 9.2 years (SD: 3.5, minimum: 1.6, maximum: 14.8 years). Of these, 1032 participants developed T2D. The three walkability measures were not associated with T2D. The estimates pointed toward a zero effect or were within 7% relative risk increase per 1 standard deviation with 95% confidence intervals including 1.

Conclusion: In the studied German settings, walkability differences might not explain differences in T2D.

Keywords: Built environment; Cardio-metabolic risk factors; Diabetes; Epidemiology; Walkability.

MeSH terms

  • Adult
  • Aged
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diabetes Mellitus, Type 2 / psychology
  • Environment Design
  • Exercise*
  • Female
  • Follow-Up Studies
  • Germany / epidemiology
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Motor Activity / physiology*
  • Obesity / physiopathology*
  • Prevalence
  • Prognosis
  • Residence Characteristics / statistics & numerical data*
  • Walking / statistics & numerical data*