Access to ready-to-eat outlets that sell food for instant consumption is associated with greater risk for type 2 diabetes, according to study results published in The Lancet Planetary Health.

With this cross-sectional study of 347,551 individuals (average age, 56 years) living across 21 cities in the United Kingdom, researchers used logistic regression models to determine the association between access to ready-to-eat food environments and type 2 diabetes. Participants were enrolled from the baseline phase of the UK Biobank cohort, and the researchers adjusted for individual covariates such as sociodemographic and lifestyle variables, physical activity, and television screen time. A total of 10,678 (3.1%) of included participants had type 2 diabetes.

Ready-to-eat environments were objectively measured within 1-km catchment areas of the participants’ residential streets and were expressed as measures of density and proximity to their homes. Nearly 20% of participants were exposed to environments that ranked within the highest category of density for ready-to-eat food environment (>10.70 units/km2). Compared with individuals with no exposure to restaurants and cafeterias, those with the highest exposure (>4.76 units/km2) had significantly higher odds for type 2 diabetes developing (odds ratio, 1.13; P =.0007).

The researchers also reported that distance to these food options was an important factor. Compared with those in the group who had to travel farthest to reach ready-to-eat food, individuals who had the least distance to travel were 10% more likely to have type 2 diabetes.

Overall, effect sizes were slightly larger among participants who were female, middle-income, and overweight, although a significant interaction was observed only for participants with a higher body mass index (P =.03).

Several limitations were noted for this study, including its cross-sectional nature and potential for multiple biases, including data incompleteness and temporal mismatch of food environments.

Despite these and other limitations, the researchers said their results “have important public health implications and make the case for a shift from an exclusively corporate-driven economic model to a public health-driven health economic model of urban food access and consumption.”

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Sarkar C, Webster C, Gallacher J. Are exposures to ready-to-eat food environments associated with type 2 diabetes? A cross-sectional study of 347 551 UK Biobank adult participants. Lancet Planet Health. 2018;2:e438-e450.

This article originally appeared on Endocrinology Advisor