ArticleEnvironmental research2022
Impact of land use and food environment on risk of type 2 diabetes: A national study of veterans, 2008-2018.
Article in Environmental research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 8 citations in OpenAlex.
- Google Places API-Based US Built Environment Retail (UBER) Index and Its Spatial Association With Diabetes Prevalence Across US Counties: Cross-Sectional Ecological Study.Journal of medical Internet research · 2026Article
- Local environmental attributes and type 2 diabetes: Green amenities, walkability indicators, and air pollution are associated with incidence.Environment international · 2025Article
- Effects of the leisure-time physical activity environment on odds of glycemic control among a nationwide cohort of United States veterans with a new type-2 diabetes diagnosis.Preventive medicine · 2025Article
- Article
- Assessing the association between food environment and dietary inflammation by community type: a cross-sectional REGARDS study.International journal of health geographics · 2023Article
- Concepts, Characterizations, and Cautions: A Public Health Guide and Glossary for Planning Food Environment Measurement.The open public health journal · 2023Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundLarge-scale longitudinal studies evaluating influences of the built environment on risk for type 2 diabetes (T2D) are scarce, and findings have been inconsistent.
objectiveTo evaluate whether land use environment (LUE), a proxy of neighborhood walkability, is associated with T2D risk across different US community types, and to assess whether the association is modified by food environment.
methodsThe Veteran's Administration Diabetes Risk (VADR) study is a retrospective cohort of diabetes-free US veteran patients enrolled in VA primary care facilities nationwide from January 1, 2008, to December 31, 2016, and followed longitudinally through December 31, 2018. A total of 4,096,629 patients had baseline addresses available in electronic health records that were geocoded and assigned a census tract-level LUE score. LUE scores were divided into quartiles, where a higher score indicated higher neighborhood walkability levels. New diagnoses for T2D were identified using a published computable phenotype. Adjusted time-to-event analyses using piecewise exponential models were fit within four strata of community types (higher-density urban, lower-density urban, suburban/small town, and rural). We also evaluated effect modification by tract-level food environment measures within each stratum.
resultsIn adjusted analyses, higher LUE had a protective effect on T2D risk in rural and suburban/small town communities (linear quartile trend test p-value <0.001). However, in lower density urban communities, higher LUE increased T2D risk (linear quartile trend test p-value <0.001) and no association was found in higher density urban communities (linear quartile trend test p-value = 0.317). Particularly strong protective effects were observed for veterans living in suburban/small towns with more supermarkets and more walkable spaces (p-interaction = 0.001).
conclusionAmong veterans, LUE may influence T2D risk, particularly in rural and suburban communities. Food environment may modify the association between LUE and T2D.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.