Is a hilly neighborhood environment associated with diabetes mellitus among older people? Results from the JAGES 2010 study

Fujiwara, Takeo; Takamoto, Iseki; Amemiya, Ayao; Hanazato, Masamichi; Suzuki, Norimichi; Nagamine, Yuiko; Sasaki, Y.; Tani, Yasuhiro; Yazawa, Aki; Inoue, Yosuke; Shirai, Kokoro; Shobugawa, Yugo; Kondo, Naoki; Kondo, Katsunori

doi:10.1016/j.socscimed.2017.04.008

Cited by 36 publications

(38 citation statements)

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“…It is not uncommon to see steep slopes (greater than 25 percent), even in central parts of Japanese cities ( Figure 1 ). Some previous studies have shown the positive effects of slope on type 2 diabetes, assumingly through vigorous physical activity [ 46 , 47 ]. However, slope (and subsequently stairs) has been identified as one of the barriers for the elderly to be physically active within their neighborhoods [ 48 , 49 , 50 ].…”

Section: Key Issues In Activity-friendly Built Environment Researcmentioning

confidence: 99%

Activity-Friendly Built Environments in a Super-Aged Society, Japan: Current Challenges and toward a Research Agenda

Koohsari

Nakaya

Oka

2018

IJERPH

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There is a growing recognition of the role of built environment attributes, such as streets, shops, greenways, parks, and public transportation stations, in supporting people’s active behaviors. In particular, surrounding built environments may have an important role in supporting healthy active aging. Nevertheless, little is known about how built environments may influence active lifestyles in “super-aged societies”. More robust evidence-based research is needed to identify how where people live influences their active behaviors, and how to build beneficial space in the context of super-aged societies. This evidence will also be informative for the broader international context, where having an aging society will be the inevitable future. This commentary sought to move this research agenda forward by identifying key research issues and challenges in examining the role of built environment attributes on active behaviors in Japan, which is experiencing the longest healthy life expectancy, but rapid “super-aging”, with the highest proportion of old adults among its population in the world.

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Section: Key Issues In Activity-friendly Built Environment Researcmentioning

confidence: 99%

Activity-Friendly Built Environments in a Super-Aged Society, Japan: Current Challenges and toward a Research Agenda

Koohsari

Nakaya

Oka

2018

IJERPH

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“…Previous studies have reported that a hilly environment was positively associated with hypertension13 and weight gain 14. By contrast, a hilly environment was reported to be negatively associated with diabetes 15 16. Results on health outcomes have been inconsistent.…”

Section: Introductionmentioning

confidence: 98%

Hilly environment and physical activity among community-dwelling older adults in Japan: a cross-sectional study

Abe

Okuyama

Hamano³

et al. 2020

BMJ Open

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ObjectivesWe investigated whether a moderate-to-vigorous physical activity (MVPA) level and walking time were associated with a hilly environment in rural Japanese older adults.DesignCross-sectional study.SettingUnnan city, Ohnan and Okinoshima towns in Shimane, Japan.ParticipantsData were collected from 1115 adults from the Shimane CoHRE study, who were aged 60 years and older and living in rural Japan in 2012.MeasuresWe measured the total time spent on MVPA and walking using a Japanese short version of the International Physical Activity Questionnaire. The land slope in 400 or 800 m network buffers was assessed using the geographic information system. A multivariable Poisson regression model examined the prevalence ratios (PR) and 95% CIs of walking time or MVPA levels meeting the WHO guideline (>150 min/week) in the land slope categories (low, middle and high), adjusted for confounders.ResultsEngaging in the recommended level of MVPA was significantly associated with middle land slope (PR=1.07; p=0.03) and high land slope (PR=1.06; p=0.07) compared with low land slope in the 400 m network buffer, as well as with middle land slope (PR=1.02; p=0.48) and high land slope (PR=1.04; p=0.25) compared with the low land slope in the 800 m network buffer. Walking time was significantly associated with middle land slope (PR=1.13; p=0.04) and high land slope (PR=1.17; p=0.01) compared with low land slope in the 400 m network buffer, and with middle land slope (PR=1.09; p=0.16) and high land slope (PR=1.17; p<0.01) compared with low land slope in the 800 m network buffer. The sensitivity analysis found only a positive association between walking time and land slope in the 400 and 800 m network buffers.ConclusionsThis study showed that a hilly environment was positively associated with walking time among older adults living in rural Japan.

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“…This study described the effect of subjective availability in the context of Japan’s considerably higher population density and higher density of food stores, compared with the previous study settings of the US, Australia, New Zealand, and Canada. In our study sites in Japan, a mean of 10.6 food stores were found to be within a 500-m radius of a participant’s residence, and the mean population density of inhabitable land [ 32 ] was 3674 people/km 2 . Our findings suggest that living in a neighborhood with many options for accessing fruits and vegetables, and having a perception of high food availability, may be important for healthy aging in Japan.…”

Section: Discussionmentioning

confidence: 99%

“…Although our subjective measure of availability asked respondents to indicate the number of stores within 1 km of their home, the perception of this 1-km radius could vary based on physical barriers in their area that are difficult to evaluate with GIS, including volume of street traffic or steep roads. We found that older adults who reported low subjective availability of food stores lived in hillier environments compared with those who reported high availability; the average land slope [ 32 ] was 4.5° in areas with the lowest food store availability and 2.5° in areas with the highest availability (Additional file 1 : Table S4). For these reasons, the subjective measure may be more capable than the objective measure of accurately describing access to food stores.…”

Section: Discussionmentioning

confidence: 99%

“…The population density of inhabitable land in participants’ residential school districts was calculated using the 2010 census and land-utilization tertiary mesh data (as of 2010) from the Ministry of Land, Infrastructure, Transport and Tourism’s National Land Numerical Information, based on a 1:25,000 topographic map of Japan. These calculations excluded non-developed areas (e.g., rivers, lakes, forests, and wasteland) [ 32 ]. Covariates with missing data were categorized as “missing.”…”

Section: Methodsmentioning

confidence: 99%

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Neighborhood food environment and mortality among older Japanese adults: results from the JAGES cohort study

Tani

Suzuki

Fujiwara

et al. 2018

Int J Behav Nutr Phys Act

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BackgroundPrevious research has linked lower availability of food stores selling fruits and vegetables to unhealthy diet. However, the longitudinal association between the availability of healthy food stores and mortality is unknown. This study examined the association between neighborhood availability of food stores and mortality by driving status among older adults.MethodsThis study drew upon a three-year follow up of participants in the Japan Gerontological Evaluation Study, a population-based cohort study of Japanese adults aged 65 years or older. Mortality from 2010 to 2013 was analyzed for 49,511 respondents. Neighborhood availability of food stores was defined as the number of food stores selling fruits and vegetables within a 500-m or 1-km radius of a person’s residence. Both subjective (participant-reported) and objective (geographic information system-based) measurements were used to assess this variable. Cox regression models were used to estimate hazard ratios (HR) for mortality.ResultsA total of 2049 deaths occurred during the follow up. Lower subjective availability of food stores was significantly associated with increased mortality. Compared with participants reporting the highest availability, the age- and sex-adjusted HR for those reporting the lowest availability was 1.28 (95% CI: 1.04–1.58; p = 0.02). The association remained significant after adjustment for sociodemographic (education, income, cohabitation, marital status, and employment status) and environmental (driving status, use of public transportation, and study site) status (HR = 1.24, 95% CI: 1.01–1.53, p = 0.04). This association was stronger among non-car users, among whom the HR for those reporting the lowest availability of food stores was 1.61 (95% CI: 1.08–2.41, p = 0.02). In contrast, no significant association was seen between objective availability and mortality.ConclusionsLower availability of healthy food stores measured subjectively, but not objectively, was associated with mortality, especially among non-car users. Considering the decline in mobility with age, living in a neighborhood with many options for procuring fruits and vegetables within walking distance may be important for healthy aging.Electronic supplementary materialThe online version of this article (10.1186/s12966-018-0732-y) contains supplementary material, which is available to authorized users.

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Is a hilly neighborhood environment associated with diabetes mellitus among older people? Results from the JAGES 2010 study

Cited by 36 publications

References 38 publications

Activity-Friendly Built Environments in a Super-Aged Society, Japan: Current Challenges and toward a Research Agenda

Activity-Friendly Built Environments in a Super-Aged Society, Japan: Current Challenges and toward a Research Agenda

Hilly environment and physical activity among community-dwelling older adults in Japan: a cross-sectional study

Neighborhood food environment and mortality among older Japanese adults: results from the JAGES cohort study

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