Mezuk Briana, Li Xinjun, Cederin Klas, Rice Kristen, Sundquist Jan, Sundquist Kristina
Am J Epidemiol. 2016 Jun 15;183(12):1129-37. doi: 10.1093/aje/kwv318. Epub 2016 May 30.
Characteristics of the built environment, including access to unhealthy food outlets, are hypothesized to contribute to type 2 diabetes mellitus (T2D). Swedish nationwide registry data on 4,718,583 adults aged 35-80 years living in 9,353 neighborhoods, each with at least 1 food outlet, were geocoded and linked to commercial registers (e.g., restaurants and grocery stores). Multilevel logistic regression was used to examine the prospective relationship between characteristics of the food environment and T2D from 2005 to 2010. Relative access to health-harming food outlets was associated with greater likelihood of both prevalent and incident T2D in a curvilinear manner, with the highest risk being observed for environments in which one-third of outlets were health-harming. Relative to individuals whose food environment did not change, those who moved into areas with more health-harming food outlets had higher odds of developing T2D (odds ratio = 3.67, 95% confidence interval: 2.14, 6.30). Among those who did not move, living in an area that gained relative access to health-harming food outlets was also associated with higher odds of T2D (odds ratio = 1.72, 95% confidence interval: 1.27, 2.33). These results suggest that local food environment, including changes that result in greater access to unhealthy food outlets, is associated with T2D.
据推测，建筑环境的特征，包括接触不健康食品销售点的机会，会导致2型糖尿病（T2D）。瑞典全国登记数据涵盖了居住在9353个社区的4718583名35至80岁的成年人，每个社区至少有1个食品销售点，这些数据被进行了地理编码，并与商业登记信息（如餐馆和杂货店）相链接。采用多水平逻辑回归分析来研究2005年至2010年期间食品环境特征与T2D之间的前瞻性关系。接触有害健康食品销售点的相对机会与T2D的患病率和发病率呈曲线相关，在三分之一的销售点为有害健康的环境中观察到最高风险。相对于食品环境没有变化的个体，那些搬到有害健康食品销售点更多地区的人患T2D的几率更高（优势比=3.67，95%置信区间：2.14，6.30）。在那些没有搬家的人中，居住在有害健康食品销售点相对增加的地区也与患T2D的几率更高有关（优势比=1.72，95%置信区间：1.27，2.33）。这些结果表明，当地的食品环境，包括导致接触不健康食品销售点机会增加的变化，与T2D有关。
