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Lower risk of type 2 diabetes has been linked to areas where physical exercise and wholesome diets are easily accessible, according to previous studies. In a recent study, which was published in JAMA Network Open, researchers sought to determine whether a neighborhood's access to fast food outlets and grocery stores may have an impact on the likelihood of getting type 2 diabetes.
"We found that the availability of fast-food restaurants was associated with a higher risk of diabetes in all kinds of communities, including urban, suburban, or rural," says Rania Kanchi, a data analyst at New York University's Langone Medical Center, Department of Public Health, and one of the researchers on this study. "Supermarkets were associated with a lower risk of diabetes in suburban and rural communities."
With a median age of about 59 years, the longitudinal cohort study included more than 4 million US veterans who did not have type 2 diabetes. Researchers looked at the incidence of type 2 diabetes over time in different neighborhoods, comparing the number of fast-food restaurants and supermarkets concerning other food outlets to obtain measures they called "neighborhood food environments." They discovered that neighborhoods with more fast-food restaurants were positively associated with a modestly increased risk of type 2 diabetes in all communities, whether urban or rural. And type 2 diabetes was less common in rural and suburban regions with more supermarkets.
"The availability of food stores and restaurants in the neighborhood could potentially affect the kind of food people choose to eat, and thus could impact their risk of disease," explains Kanchi.
The owner of Sound Bites Nutrition, Lisa Andrews, MEd, RD, LD, says she is not shocked by the study's findings. Neighborhoods with a high concentration of fast food restaurants but few groceries may be harmful to people's health. According to her, these conditions may limit access to and consumption of fruits, vegetables, whole grains, lean protein sources, and low-fat dairy items, resulting in an intake of processed foods that are less nutrient-dense.
"When individuals lack easy access to nutritious, affordable food, they often must rely on fast-food restaurants or convenience stores to eat," Andrews says. "The regular consumption of high-calorie, processed foods may lead to obesity or metabolic syndrome, which raise the risk for type 2 diabetes and other chronic illnesses."
Food deserts or food apartheid are regions with a disproportionate number of fast-food establishments but few grocers. Some residents of these places have poor incomes, which may prevent them from having access to transportation to a store.
"Food deserts usually occur in low-income communities in both big cities and rural towns scattered across the U.S.," says Cheryl Mussatto MS, RD, LD, a clinical dietitian at Cotton O'Neil Endocrinology Clinic in Topeka, Kansas, and blogger at Eatwelltobewell.com
According to Mussatto, the availability of a wide range of foods is constrained when there is only one grocery shop in a community. Meanwhile, fast food businesses that serve conventional American fare in the form of oversized portions of meals heavy in fat, sugar, and sodium are frequently seen at local eateries.
"What ends up happening in food deserts is the residents usually buy the cheapest and most readily available foods—fatty, fried take-out, high-sodium prepared meals, candy, and soda," says Mussatto. "This way of eating sets up an unhealthy pattern of gaining excess weight putting people at a greater risk of serious chronic diseases such as type 2 diabetes."
People who can least afford to get sick are also most likely to experience chronic illness in these circumstances, according to Mussatto.
A national priority should be to increase access to healthy food in food deserts, and policy changes may be necessary to control the distribution of supermarkets and fast-food outlets across American neighborhoods. According to the findings of the current study, specific interventions are required to target the availability of supermarkets. In the meanwhile, restricting fast food outlets might be beneficial in all kinds of communities. Small adjustments made in various communities may help to lower the risk of type 2 diabetes.
"Increasing affordable healthy food options in supermarkets or improving transportation in suburban and rural communities could improve access to healthy food," says Kanchi. "Also, making healthier meal options more available in fast-food restaurants and policies like healthy beverage default laws could affect the choices people make when they eat out."
Numerous people are working on remedies for areas that experience food apartheid. Andrews reports seeing an increase in Freedges, which are public refrigerators where people can give, take, and share perishable food.Mussatto mentions grassroots initiatives like community gardens, food co-ops, and farmers' markets that are springing up in food deserts to increase access to nutritious food. She has also witnessed localities build up mobile markets, where trucks travel to areas that are food insecure and sell produce and other groceries, frequently allowing customers to pay using SNAP benefits.
"Some convenience stores have started stocking fresh fruit, low-fat yogurt, sandwiches,
and salads, but they are often priced higher than what would be found in a traditional
grocery store," says Andrews.
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