title: The association between neighbourhood greenspace and type 2 diabetes in a large cross-sectional study.
abstract: OBJECTIVE
  To investigate the relationship between neighbourhood greenspace and type 2 diabetes.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  3 diabetes screening studies conducted in Leicestershire, UK in 2004-2011. The percentage of greenspace in the participant's home neighbourhood (3 km radius around home postcode) was obtained from a Land Cover Map. Demographic and biomedical variables were measured at screening.
  
  
  METHODS
  10,476 individuals (6200 from general population; 4276 from high-risk population) aged 20-75 years (mean 59 years); 47% female; 21% non-white ethnicity.
  
  
  METHODS
  Screen-detected type 2 diabetes (WHO 2011 criteria).
  
  
  RESULTS
  Increased neighbourhood greenspace was associated with significantly lower levels of screen-detected type 2 diabetes. The ORs (95% CI) for screen-detected type 2 diabetes were 0.97 (0.80 to 1.17), 0.78 (0.62 to 0.98) and 0.67 (0.49 to 0.93) for increasing quartiles of neighbourhood greenspace compared with the lowest quartile after adjusting for ethnicity, age, sex, area social deprivation score and urban/rural status (Ptrend=0.01). This association remained on further adjustment for body mass index, physical activity, fasting glucose, 2 h glucose and cholesterol (OR (95% CI) for highest vs lowest quartile: 0.53 (0.35 to 0.82); Ptrend=0.01).
  
  
  CONCLUSIONS
  Neighbourhood greenspace was inversely associated with screen-detected type 2 diabetes, highlighting a potential area for targeted screening as well as a possible public health area for diabetes prevention. However, none of the risk factors that we considered appeared to explain this association, and thus further research is required to elicit underlying mechanisms.
  
  
  BACKGROUND
  This study uses data from three studies (NCT00318032, NCT00677937, NCT00941954).
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Danielle H
authors.initials: DH
authors.lastname: Bodicoat
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Gary
authors.initials: G
authors.lastname: O'Donovan
authors.affiliation: University of East Anglia, Norwich Medical School, Norwich Research Park, Norwich, Norfolk, UK MRC Epidemiology Unit, UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK.
authors.forename: Alice M
authors.initials: AM
authors.lastname: Dalton
authors.affiliation: University of Leicester, Department of Health Sciences, Leicester Diabetes Centre, Leicester General Hospital, Gwendolen Road, Leicester, Leicestershire, UK.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Gray
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Yates
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Edwardson
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Sian
authors.initials: S
authors.lastname: Hill
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: David R
authors.initials: DR
authors.lastname: Webb
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Khunti
authors.affiliation: University of Leicester, Diabetes Research Centre, Leicester Diabetes Centre, Leicester General Hospital, Leicester, Leicestershire, UK.
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Davies
authors.affiliation: University of East Anglia, Norwich Medical School, Norwich Research Park, Norwich, Norfolk, UK MRC Epidemiology Unit, UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Jones
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000517:prevention & control*; D004777:Environment; D004779:Environment Design; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012307:Risk Factors; D006113:United Kingdom
keywords: DIABETES & ENDOCRINOLOGY; EPIDEMIOLOGY; PUBLIC HEALTH