If you are what you eat, you may also be a product of where you live: Living in a neighborhood where it's pleasant and easy to walk and fresh fruits and vegetables are close at hand can slash a person's risk of developing type 2 diabetes, new research shows.

In fact, the risk of diabetes associated with living in such a healthy 'hood was 38% lower than for people who lived in the unhealthiest places, Dr. Amy H. Auchincloss of Drexel University School of Public Health in Philadelphia and her colleagues found.

The findings raise the possibility, Auchincloss told Reuters Health, that changing people's environments could help improve their health. There's certainly a lot of potential for making an impact, she added, pointing to initiatives like improving public transportation, increasing green space, making sidewalks safer, and opening farmer's markets in urban neighborhoods where supermarkets are scarce.

Efforts to tackle obesity and type 2 diabetes at the individual level have had mixed results, Auchincloss and her team note in their report. They investigated whether a neighborhood's resources might influence health at a broader level by following 2,285 people 45 to 84 years old living in Baltimore, Maryland; The Bronx, New York; and Winston-Salem, North Carolina. During five years of follow-up, 233 developed diabetes, the team reports in the Archives of Internal Medicine.

The researchers also surveyed a different group of people in these cities by telephone about how easy it was to be physically active in their neighborhoods, and how easily they could obtain healthy foods in the area. The survey included nine yes-or-no questions, among them: My neighborhood offers many opportunities to be physically active, In my neighborhood, it is easy to walk places, and A large selection of fresh fruits and vegetables is available in my neighborhood.

The risk of developing type 2 diabetes for those living in the top 10 percent of neighborhoods based on resources for physical activity was about half of the risk for those living the areas where it was the hardest to be active. And people living in the 10% of neighborhoods with the best access to healthy food were about half as likely to develop type 2 diabetes than those who lived in the worst 10 percent.

The healthier neighborhoods also tended to be wealthier, with a greater proportion of white residents, Auchincloss noted. When she and her colleagues adjusted for factors such as race, ethnicity, family income, and wealth, the relationship between neighborhood and type 2 diabetes risk was weakened somewhat, but remained.

Not everyone can choose where they live, the researcher conceded, and making communities healthier will require multiple players. There's unlikely to be a single bullet that will fix these epidemics, Auchincloss said. Nevertheless, she added, the potential for large scale interventions to have an effect is heartening.

SOURCE: Archives of Internal Medicine, October 12, 2009.

New York Medicine