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Table 3 Study results of studies investigating physical activity environment, food environment, residential noise and diabetes mellitus

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

Author Exposure Study result 95% confidence interval or p value Adjustment for confounding
Ahern et al., 2011 [46] Food environment: Beta (SE)   Age, obesity rate
1. Percentage of households with no car living more than 1 mile from a grocery store 1. 0.07 (0.01) 1. P < 0.001
2. Fast-food restaurants per 1000 2. 0.41 (0.07) 2. P < 0.001
3. Full service restaurants per 1000 3. -0.15 (0.04) 3. P < 0.01
4. Grocery stores per 1000 4. -0.37 (0.09) 4. P < 0.001
5. Convenience stores per 1000 5. 0.30 (0.06) 5. P < 0.001
6. Direct money made from farm sales per capita 6. -0.01 (0.02) 6. P < 0.01
PA environment:   
7. Recreational facilities per 1000 7. -0.12 (0.21) 7. NS
AlHasan et al., 2016 [69] Food outlet density: Beta (SE)   Age, obesity, PA, recreation facility density, unemployed, education, household with no cars and limited access to stores, race
1. Fast-food restaurant density per 1000 residents 1. -0.55 (0.90) 1. NS
2. Convenience store density 2. 0.89 (0.86) 2. NS
3. Super store density 3. -0.4 (11.66) 3. NS
4. Grocery store density 4. -3.7 (2.13) 4. NS
Astell-Burt et al., 2014 [42] Green space (percent): OR:   Age, sex, couple status, family history, country of birth, language spoken at home, weight, psychological distress, smoking status, hypertension, diet, walking, MVPA, sitting, economic status, annual income, qualifications, neighbourhood affluence, geographic remoteness
1. >81 1. 0.94 1. 0.85–1.03
2. 0–20 2. 1 2. NA
Auchincloss et al., 2009 [47] Neighbourhood resources: HR:   Age, sex, family history, income, assets, education, ethnicity, alcohol, smoking, PA, diet, BMI
1. Healthy food resources 1. 0.63 1. 0.42–0.93
2. PA resources 2. 0.71 2. 0.48–1.05
3. Summary score 3. 0.64 3. 0.44–0.95
Bodicoat et al., 2014 [44] Green space (percent) OR:   Age, sex, area social deprivation score, urban/rural status, BMI, PA, fasting glucose, 2 h glucose, total cholesterol
1. Least green space (Q1) 1. 1 1. NA
2. Most green space (Q4) 2. 0.53 2. 0.35–0.82
Bodicoat et al., 2015 [72]   OR:   Age, sex, area social deprivation score, urban/rural status, ethnicity, PA
1. Number of fast-food outlets (per 2) 1. 1.02 1. 1.00–1.04
2. Density of fast-food outlet (per 200 residents) 2. 13.84 2. 1.60–119.6
Booth et al., 2013 [19] Walkability: HR:   Age, sex, income
Men   
Recent immigrants   
1. Least walkable quintile 1. 1.58 1. 1.42–1.75
2. Most walkable quintile 2. 1 2. NA
Long-term residents   
1. Least walkable quintile 1. 1.32 1. 1.26–1.38
2. Most walkable quintile 2. 1 2. NA
Women   
Recent immigrants   
1. Least walkable quintile 1. 1.67 1. 1.48–1.88
2. Most walkable quintile 2. 1 2. NA
Long-term residents   
1. Least walkable quintile 1. 1.24 1. 1.18–1.31
2. Most walkable quintile 2. 1 2. NA
Braun et al., 2016 [57, 58] Walkability index, after residential relocation Beta (SE)   1. Income, household size, marital status, employment status, smoking status, health problems that interfere with PA 2. Additionally, adjusted for age, sex, ethnicity, education
1. Fixed-effects model 1. -0.011 (0.015) 1. P > 0.05
2. Random-effects model 2. -0.016 (0.010) 2. P > 0.05
Braun et al., 2016 [57, 58] Walkability: within person change in Street Smart Walk Score Beta (SE): 0.999 (0.002) P > 0.05 Age, sex, ethnicity, education, householdincome, employment status, marital status, neighbourhood SES
Cai et al., 2017 [82] Daytime noise (dB) Percentage change in fasting glucose per IQR Daytime noise: 0.2 95% CI, 0.1–0.3
P < 0.05
Age, sex, season of blood draw, smoking status and pack-years, education, employment, alcohol consumption, air pollution
Carroll et al., 2017 [71] Count of fast-food outlets: Beta per SD change:
 − 0.0094
-0.030–0.011 Age, sex, marital status, education, employment status, smoking status
1. Interaction with overweight/obesity 1. −0.002 1. -0.023–0.019
2. Interaction with time 2. 0.0003 2. -0.003–0.004
3. Interaction with time and overweight/obesity 3. -0.002 3. -0.006–0.001
Count of healthful food resources: 0.012 -0.008–0.032
4. Interaction with overweight/obesity 4. 0.021 4. -0.000–0.042
5. Interaction with time 5. -0.003 5. -0.006–0.001
6. Interaction with time and overweight/obesity 6. -0.006 6. -0.009–-0.002
Christine et al., 2015 [48] Neighbourhood physical environment, diet related: HR:   Age, sex, family history, household per capita income, educational level, smoking, alcohol, neighbourhood SES
1. Density of supermarkets and/or fruit and vegetable markets (GIS) 1. 1.01 1. 0.96–1.07
2. Healthy food availability (self-report) 2. 0.88 2. 0.78–0.98
3. GIS and self-report combined measure 3. 0.93 3. 0.82–1.06
Neighbourhood physical environment, PA related:
1. Density of commercial recreational facilities (GIS) 1. 0.98 1. 0.94–1.03
2. Walking environment (self-report) 2. 0.80 2. 0.70–0.92
3. GIS and self-report combined measure 3. 0.81 3. 0.68–0.96
Creatore et al., 2016 [20] Walkability: Absolute incidence rate difference over 12 years FU:   Age, sex, area income, ethnicity
1. Low walkable neighbourhoods (Q1) 1. -0.65 1. -1.65–0.39
2. High walkable neighbourhoods over (Q5) 2. - 1.5 2. -2.6– -0.4
Cunningham-Myrie et al., 2015 [49] Neighbourhood characteristics: OR:   Age, sex, district, fruit and vegetable intake
1. Neighbourhood infrastructure 1. 1.02 1. 0.95–1.1
2. Neighbourhood disorder score 2. 0.99 2. 0.95–1.03
3. Home disorder score 3. 1 3. 0.96–1.03
4. Recreational space in walking distance 4. 1.12 4. 0.86–1.45
5. Recreational space availability 5. 1.01 5. 0.77–1.32
6. Perception of safety 6. 0.99 6. 0.88–1.11
Dalton et al., 2016 [59] Green space: HR:   Age, sex, BMI, parental diabetes, SES Effect modification by urban-rural status and SES was investigated, but association was not moderated by either
1. Least green space (Q1) 1. 1 1. NA
2. Most green space (Q4) 2. 0.81 2. 0.65–0.99
3. Mediation by PA 3. 0.96 3. 0.88–1.06
Dzhambov et al., 2016 [83] Day-evening-night equivalent sound level: OR:   Age, sex, fine particulate matter, benzo alpha pyrene, BMI, family history of T2DM, subjective sleep disturbance, bedroom location
1. 51–70 decibels 1. 1 1. NA
2. 71–80 decibels 2. 4.49 2. 1.39–14.7
Eichinger et al., 2015 [50] Characteristics of built residential environment: Beta:   Age, sex, individual-level SES
1. Perceived distance to local facilities 1. 0.006 1. P < 0.01
2. Perceived availability/maintenance of cycling/walking infrastructure 2. NS  
3. Perceived connectivity 3. NS  
4. Perceived safety with regards to traffic 4. NS  
5. perceived safety from crime 5. NS  
6. Neighbourhood as pleasant environment for walking/cycling 6. NS  
7. Presence of trees along the streets 7. NS  
Eriksson et al., 2014 [85] Aircraft noise level: OR:   Age, sex, family history, SES based on education, PA, smoking, alcohol, annoyance due to noise
1. <50 dB 1. 1 1. NA
2. ≥55 dB 2. 0.94 2. 0.33–2.70
Flynt et al., 2015 [73] Clusters (combination of number of counties, urban-rural classification, population density, income, SES, access to food stores, obesity rate, diabetes rate): Median standardised diabetes mellitues rate: IQR: -
1 1. 0 1. -0.05 - 0.7
2 2. 0 2. -0.04–0.7
3 3. 0 3. -0.08–0.01
4 4. -0.04 4. -1.01–0.6
5 5. -0.08 5. -1.5–-0.04
ANOVA: p < 0.001
Frankenfeld et al., 2015 [74] RFEI ≤ 1 clusters: Predicted prevalence:   Demographic and SES variables
1. Grocery stores 1. 7.1 1. 6.3–7.9
2. Restaurants 2. 5.9 2. 5.0–6.8, p < 0.01
3. Specialty foods 3. 6.1 3. 5.0–7.2, p < 0.01
RFEI >1:   
4. Restaurants and fast-food 4. 6.0 4. 4.9–7.1, p < 0.01
5. Convenience stores 5. 6.1 5. 4.9–7.3, p < 0.01
Freedman et al., 2011 [68] Built environment: OR:   Age, ethnicity, marital status, region of residence, smoking, education, income, childhood health, childhood SES, region of birth, neighbourhood scales
Men:   
1. Connectivity (2000 Topologically Integrated 1. 1.06 1. 0.86–1.29
Geographic Encoding and Referencing system) 2. 1.05 2. 0.89–1.24
2. Density (number of food stores, restaurants, housing units per square mile)   
Women:   
3. Connectivity 3. 1.01 3. 0.84–1.20
4. Density 4. 0.99 4. 0.99–1.17
Fujiware et al., 2017 [60] Count within neighbourhood unit (mean 6.31 ± 3.9 km2) OR per IQR increase:   Age, sex, marital status, household number, income, working status, drinking, smoking, vegetable consumption, walking, going-out behaviour, frequency of meeting, BMI, depression
1. Grocery stores 1. 0.97 1. 0.88–1.08
2. Parks 2. 1.16 2. 1–1.34
Gebreab et al., 2017 [61] Density within 1-mile buffer: HR:   Age, sex, family history of diabetes, SES, smoking, alcohol consumption, physical activity, diet
1. Favourable food stores 1. 1.03 1. 0.98–1.09
2. Unfavourable food stores 2. 1.07 2. 0.99–1.16
3. PA resources 3. 1.03 3. 0.98–1.09
Glazier et al., 2014 [21] Walkability index: Rate ratio:   Age, sex
1. Q1 1. 1 1. NA
2. Q5 2. 1.33 2. 1.33–1.33
Index components:   
1. Population density (Q1: Q5) 1. 1.16 1. 1.16–1.16
2. Residential density (Q1: Q5) 2. 1.33 2. 1.33–1.33
3. Street connectivity (Q1: Q5) 3. 1.38 3. 1.38–1.38
4. Availability of walkable destinations (Q1: Q5) 4. 1.26 4. 1.26–1.26
Heidemann et al., 2014 [86] Residential traffic intensity: OR:   Age, sex, smoking, passive smoking, heating of house, education, BMI, waist circumference, PA, family history
1. No traffic 1. 1 1. NA
2. Extreme traffic 2. 1.97 2. 1.07–3.64
Hipp et al., 2015 [78] Food deserts Correlation: NR NS
Lee et al., 2015 [45] Walkability: OR:   Age, sex, smoking, alcohol, income level
1. Community 1 1. 1 1. NA
2. Community 2 2. 0.86 2. 0.75–0.99
Loo et al., 2017 [62] Walkability (walk score)
Difference between Q1 and Q4
Beta for HbA1C:   Age, sex, current smoking status, BMI, relevant medications and medical diagnoses, neighbourhood violent crime rates and neighbourhood indices of material deprivation, ethnic concentration, dependency, residential instability
1. -0.06 1. -0.11–0.02
Beta for fasting glucose:  
2. 0.03 2. -0.04–0.1
Maas et al., 2009 [66] Green space: OR:   Demographic and socioeconomic characteristics, urbanicity
1. Q1 1. 1 1. NA
2. Q4 2. 0.84 2. 0.83–0.85
Mena et al., 2015 [53]   Correlation:  
1. Distance to parks 1. NR 1. NA
2. Distance to markets 2. -0.094 2. P < 0.05
Mezuk et al., 2016 [70] Ratio of the number of health-harming food outlets to the total number of food outlets within a 1000-m buffer of each person OR per km2: 2.11 1.57–2.82 Age, sex, education, household income
Morland et al., 2006 [75] Presence of: Prevalence ratio:   Age, sex, income, education, ethnicity, food stores and service places, PA
1. Supermarkets 1. 0.96 1. 0.84–1.1
2. Grocery stores 2. 1.11 2. 0.99–1.24
3. Convenience stores 3. 0.98 3. 0.86–1.12
Müller-Riemenschneider et al., 2013 [65] Walkability (1600 m buffer): OR:   Age, sex, education, household income, marital status
1. High walkability 1. 0.95 1. 0.72–1.25
2. Low walkability 2. 1 2. NA
Walkability (800 m buffer):   
3. High walkability 3. 0.69 3. 0.62–0.90
4. Low walkability 4. 1 4. NA
Myers et al., 2017 [63] Physical activity: Beta:   Age
1. Recreation facilities per 1000 1. -0.457 1. -0.809– -0.104
2. Natural amenities (1–7) 2. 0.084 2. 0.042–0.127
Food:   
3. Grocery stores and supercentres per 1000 3. 0.059 3. -0.09–0.208
4. Fast-food restaurants per 1000 4. -0.032 4. -0.125–0.062
Ngom et al., 2016 [64] Distance to green space: Prevalence ratio:   Age, sex, social and environmental predictors
1. Q1 (0–264 m) 1. 1 1. NA
2. Q4 (774–27781 m) 2. 1.09 2. 1.03–1.13
Paquet et al., 2014 [54] Built environment attributes: RR:   Age, sex household income, education, duration of FU, area-level SES
1. RFEI 1. 0.99 1. 0.9–1.09
2. Walkability 2. 0.88 2. 0.8–0.97
3. POS   
a. POS count a. 1 a. 0.92–1.08
b. POS size b. 0.75 b. 0.69–0.83
c. POS greenness c. 1.01 c. 0.9–1.13
d. POS type d. 1.09 d. 0.97–1.22
Schootman et al., 2007 [56] Neighbourhood conditions (objective): OR:   Age, sex, income, perceived income adequacy, education, marital status, employment, length of time at present address, own the home, area
1. Housing conditions 1. 1.11 1. 0.63–1.95
2. Noise level from traffic, industry, etc. 2. 0.9 2. 0.48–1.67
3. Air quality 3. 1.2 3. 0.66–2.18
4. Street and road quality 4. 1.03 4. 0.56–1.91
5. Yard and sidewalk quality 5. 1.05 5. 0.59–1.88
Neighbourhood conditions (subjective):   
6. Fair–poor rating of the neighbourhood 6. 1.04 6. 0.58–1.84
7. Mixed or terrible feeling about the neighbourhood 7. 1.1 7. 0.6–2.02
8. Undecided or not at all attached to the neighbourhood 8. 0.68 8. 0.4–1.18
9. Slightly unsafe–not at all safe in the neighbourhood 9. 0.61 9. 0.35–1.06
Sørensen et al., 2013 [84] Exposure to road traffic noise per 10 dB: Incidence rate ratio:   Age, sex, education, municipality SES, smoking status, smoking intensity, smoking duration, environmental tobacco smoke, fruit intake, vegetable intake, saturated fat intake, alcohol, BMI, waist circumference, sports, walking, pollution
1. At diagnosis 1. 1.08 1. 1.02–1.14
2. 5 years preceding diagnosis 2. 1.11 2. 1.05–1.18
Sundquist et al., 2015 [22] Walkability: OR:   Age, sex, income, education, neighbourhood deprivation
1. D1 (low) 1. 1.16 1. 1.00–1.34
2. D10 (high) 2. 1 2. NA
  1. BMI body mass index, CI Confidence interval, GIS graphical information system, HR hazard ratio, IQR interquartile range, NA not applicable, NR not reported, NS not significant, OR odds ratio, PA physical activity, MVPA moderate to vigorous physical activity, POS Public open space, RFEI Retail Food Environment Index, RR relative risk, SD standard deviation, SE standard error, SES socioeconomic status, FU follow-up