High Number of Fast Food Restaurants in Neighborhood Linked to Increased Risk of Diabetes

When you head out for a bite to eat in your neighborhood, you’re apt to have a mix of fast food joints, traditional restaurants, and supermarkets to choose from. A new study finds that whichever you see more may play a role in your risk of developing type 2 diabetes.

Researchers at NYU examined veteran populations across a variety of communities throughout the nation, looking at how the types of food establishments in their neighborhoods were linked with the development of diabetes. They found the more fast food restaurants that were in the vicinity, the higher the risk of developing diabetes. This was true despite the type of community where a person lived. The results were published in JAMA Network Open.


Rania Kanchi, the study’s lead author and researcher in the Department of Population Health at NYU Langone, says, “Most studies that examine the built food environment and its relationship to chronic diseases have been much smaller or conducted in localized areas. Our study design is national in scope and allowed us to identify the types of communities that people are living in, characterize their food environment, and observe what happens to them over time. The size of our cohort allows for geographic generalizability in a way that other studies do not.”

The size of their cohort was quite large, with more than 4 million veterans living in 98% of U.S. census tracts involved. This group, made up of veterans who did not have diabetes at the beginning of the study, was put together between 2008 and 2016. Their health was followed through 2018 or until they developed diabetes, died, or hadn’t had an appointment for more than two years. The median time they were followed was five and a half years.

The criteria for determining the proportion of fast food restaurants or supermarkets in a neighborhood consisted of a few measures: those that were within a one-mile walk in high-density urban areas, a two-mile drive in low-density urban neighborhoods, a six-mile drive in the suburbs, and a 10-mile drive in rural areas.


Throughout the study, 13.2% of the group was diagnosed with diabetes. When broken down into neighborhoods, those in high-density urban areas had the highest rate – 14.3%. The lowest rate of 12.6% was observed in the suburbs and rural areas.

The researchers say that the proportion of fast food restaurants to traditional restaurants was linked to an increased incidence of diabetes in all four types of neighborhoods. A 10% increase in the number of fast food businesses versus all restaurants was linked with a 1% increase in type 2 diabetes risk in high-density and low density urban areas, as well as rural communities. In the suburbs, that jumped to 2%. On the other end of the spectrum, a 10% increase in supermarket density compared with other food stores was linked with lower diabetes incidence in suburban and rural areas, but not in urban areas.

Dr. Lorna E. Thorpe, the study’s senior author and professor in the Department of Population Health at NYU Langone, says, “The more we learn about the relationship between the food environment and chronic diseases like type 2 diabetes, the more policymakers can act by improving the mix of healthy food options sold in restaurants and food outlets, or by creating better zoning laws that promote optimal food options for residents.”


The researchers did note some limitations of the study. One was that findings may not be as applicable to non-veteran populations. This is because veterans are typically male, have more health burdens and financial instability, and are at a greater risk of obesity and other chronic health conditions.

Going forward, the team wants to see if fast food availability impacts other groups in the same way. They’d like to see if there are differences between genders, races, ethnicities, and socioeconomic groups.

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