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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Medicine 1/2018

Built environmental characteristics and diabetes: a systematic review and meta-analysis

Zeitschrift:
BMC Medicine > Ausgabe 1/2018
Autoren:
N. R. den Braver, J. Lakerveld, F. Rutters, L. J. Schoonmade, J. Brug, J. W. J. Beulens
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:https://​doi.​org/​10.​1186/​s12916-017-0997-z) contains supplementary material, which is available to authorized users.

Abstract

Background

The built environment influences behaviour, like physical activity, diet and sleep, which affects the risk of type 2 diabetes mellitus (T2DM). This study systematically reviewed and meta-analysed evidence on the association between built environmental characteristics related to lifestyle behaviour and T2DM risk/prevalence, worldwide.

Methods

We systematically searched PubMed, EMBASE.com and Web of Science from their inception to 6 June 2017. Studies were included with adult populations (>18 years), T2DM or glycaemic markers as outcomes, and physical activity and/or food environment and/or residential noise as independent variables. We excluded studies of specific subsamples of the population, that focused on built environmental characteristics that directly affect the cardiovascular system, that performed prediction analyses and that do not report original research. Data appraisal and extraction were based on published reports (PROSPERO-ID: CRD42016035663).

Results

From 11,279 studies, 109 were eligible and 40 were meta-analysed. Living in an urban residence was associated with higher T2DM risk/prevalence (n = 19, odds ratio (OR) = 1.40; 95% CI, 1.2–1.6; I2 = 83%) compared to living in a rural residence. Higher neighbourhood walkability was associated with lower T2DM risk/prevalence (n = 8, OR = 0.79; 95% CI, 0.7–0.9; I2 = 92%) and more green space tended to be associated with lower T2DM risk/prevalence (n = 6, OR = 0.90; 95% CI, 0.8–1.0; I2 = 95%). No convincing evidence was found of an association between food environment with T2DM risk/prevalence.

Conclusions

An important strength of the study was the comprehensive overview of the literature, but our study was limited by the conclusion of mainly cross-sectional studies. In addition to other positive consequences of walkability and access to green space, these environmental characteristics may also contribute to T2DM prevention. These results may be relevant for infrastructure planning.
Zusatzmaterial
Additional file 1: Search strategy (DOCX 21 kb)
12916_2017_997_MOESM1_ESM.docx
Additional file 2: Study characteristics and results of studies with a weak quality rating (DOCX 43 kb)
12916_2017_997_MOESM2_ESM.docx
Additional file 3: Sensitivity analyses (ZIP 120 kb)
12916_2017_997_MOESM3_ESM.zip
Additional file 4: Study characteristics and results of studies investigating combination environmental characteristics. (DOCX 21 kb)
12916_2017_997_MOESM4_ESM.docx
Literatur
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