Jennifer Horwitz1, Ravi Retnakaran2,3,4. 1. Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada. 2. Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Canada. ravi.retnakaran@sinaihealth.ca. 3. Division of Endocrinology, University of Toronto, Toronto, Canada. ravi.retnakaran@sinaihealth.ca. 4. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada. ravi.retnakaran@sinaihealth.ca.
Abstract
PURPOSE OF REVIEW: We aim to evaluate whether the current literature supports (i) a causal relationship between neighbourhood walkability and risk of diabetes or instead (ii) a strictly epidemiologic association. RECENT FINDINGS: Both cross-sectional and longitudinal studies have reported that neighbourhoods that are scored as having higher levels of walkability have lower rates of prevalent and incident diabetes, respectively. However, other studies have been inconclusive, with more nuanced findings suggesting that this association may be limited to particular demographic groups defined by age and socio-economics. Key factors limiting this literature include disparities in the measurement of walkability, the necessary reliance on observational study designs (recognizing the infeasibility of randomized controlled trials for addressing this question), and the difficulty of disentangling the potential concomitant effects of other components of the built environment. At this time, causality cannot be ascertained in the relationship between neighbourhood walkability and risk of diabetes.
PURPOSE OF REVIEW: We aim to evaluate whether the current literature supports (i) a causal relationship between neighbourhood walkability and risk of diabetes or instead (ii) a strictly epidemiologic association. RECENT FINDINGS: Both cross-sectional and longitudinal studies have reported that neighbourhoods that are scored as having higher levels of walkability have lower rates of prevalent and incident diabetes, respectively. However, other studies have been inconclusive, with more nuanced findings suggesting that this association may be limited to particular demographic groups defined by age and socio-economics. Key factors limiting this literature include disparities in the measurement of walkability, the necessary reliance on observational study designs (recognizing the infeasibility of randomized controlled trials for addressing this question), and the difficulty of disentangling the potential concomitant effects of other components of the built environment. At this time, causality cannot be ascertained in the relationship between neighbourhood walkability and risk of diabetes.
Authors: Sarah E Conderino; Justin M Feldman; Benjamin Spoer; Marc N Gourevitch; Lorna E Thorpe Journal: Am J Prev Med Date: 2021-06-06 Impact factor: 5.043