• Stephanie Hsieh, Ann C Klassen, Frank C Curriero, Laura E Caulfield, Lawrence J Cheskin, Jaimie N Davis, Michael I Goran, Marc J Weigensberg, and Donna Spruijt-Metz.
• Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. Electronic address: shsieh@jhsph.edu.
• Am J Prev Med. 2014 Apr 1; 46 (4): 378-87.

BackgroundEvidence of associations between the built environment and obesity risk has been steadily building, yet few studies have focused on the relationship between the built environment and aspects of metabolism related to obesity's most tightly linked comorbidity, type 2 diabetes.PurposeTo examine the relationship between aspects of the neighborhood built environment and insulin resistance using accurate laboratory measures to account for fat distribution and adiposity.MethodsData on 453 Hispanic youth (aged 8-18 years) from 2001 to 2011 were paired with neighborhood built environment and 2000 Census data. Analyses were conducted in 2011. Walking-distance buffers were built around participants' residential locations. Body composition and fat distribution were assessed using dual x-ray absorptiometry and waist circumference. Variables for park space, food access, walkability, and neighborhood sociocultural aspects were entered into a multivariate regression model predicting insulin resistance as determined by the homeostasis model assessment.ResultsIndependent of obesity measures, greater fast-food restaurant density was associated with higher insulin resistance. Increased park space and neighborhood linguistic isolation were associated with lower insulin resistance among boys. Among girls, park space was associated with lower insulin resistance, but greater neighborhood linguistic isolation was associated with higher insulin resistance. A significant interaction between waist circumference and neighborhood linguistic isolation indicated that the negative association between neighborhood linguistic isolation and insulin resistance diminished with increased waist circumference.ConclusionsReducing access to fast food and increasing public park space may be valuable to addressing insulin resistance and type 2 diabetes, but effects may vary by gender.Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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