A negative association between prevalence of diabetes and urban residential area greenness detected in nationwide assessment of urban Bangladesh

Jahidur Rahman Khan,Md Mazharul Islam,Amena Sultana,Raaj Kishore Biswas

doi:10.1038/s41598-021-98585-6

Jahidur Rahman Khan, Md Mazharul Islam + Show 2 more

Open Access

https://doi.org/10.1038/s41598-021-98585-6

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Abstract

Residential area greenness may influence diabetes, but limited studies have explored this relationship in developing countries. This study assessed the association between residential area greenness and diabetes among urban adults in Bangladesh. The mediation effect of the body mass index (BMI) was also assessed. A total of 2367 adults aged ≥ 35 years were extracted from a nationally representative survey. Diabetes was characterised as fasting plasma glucose level be ≥ 7.0 mmol/L or taking prescribed medications to reduce blood sugar level. Residential area greenness was estimated by enhanced vegetation index. Binary logistic regression models were employed to estimate the association between residential area greenness and diabetes adjusting for sociodemographic factors. Mediation analysis was performed to assess whether BMI mediated the association between greenness and diabetes. Greater area greenness was associated with lower odds of diabetes (adjusted odds ratio 0.805, 95% confidence interval 0.693–0.935, p = 0.0052). BMI significantly mediated 36.4% of the estimated association between greenness and diabetes. Presence of areas of greenness adjacent to living area tends to be associated with lower diabetes prevalence. Findings emphasised the importance of preserving the local environment to tackle the growing diabetes prevalence in Bangladesh.

Highlights

Population projections suggest that by 2050, there would be about 7.4 billion people living in urban areas globally[1]
As an indicator of residential area greenness, we considered survey cluster-level enhanced vegetation index (EVI) for the year 201041
This study focused on urban areas; a total of 2367 participants were selected from

Summary

Introduction

Population projections suggest that by 2050, there would be about 7.4 billion people living in urban areas globally[1]. Bangladesh had an estimated urban population of 53 million in 2014, projected to double by 2050 with an estimate of 112 m illion[1]. According to the national survey 2011 Bangladesh Demographic and health survey (BDHS), the diabetes prevalence among adults aged 35 + years was 11% (11.2% women and 10.7% men)[2,3]. These figures translated to 5 million people with diabetes which is projected to be 8 million by 20253. With a higher prevalence of diabetes among urban adults, preventive approaches based on a better understanding of the aetiology of diabetes might be more cost-effective with greater gains than treatment. In addition to interventions on individuals promoting healthy lifestyles, enhancing built-environmental features of the residential area can reduce diabetes[16]

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