Work

Association between residential greenness and diabesity among adults in southwestern China: The role of physical activity and ambient air pollutants

Year: 2025

Type: article

Abstract: Background While green space exposure has been associated with reduced risks of diabetes and obesity separately, its relationship with diabesity remains unclear. This large-scale cross-sectional study examined the relationship between residential greenness and diabesity among 76,545 adults from the China Multi-Ethnic Cohort, while assessing potential mediation by air pollution (PM₁, PM 2.5 , PM₁₀, NO₂) and physical activity (PA). Methods Residential greenness was assessed using satellite-derived Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) within 250 m, 500 m, and 1000 m buffers. Diabesity was defined as coexisting diabetes (fasting glucose ≥126 mg/dL or HbA1c ≥6.5 %) and obesity (BMI ≥28 kg/m²). Mediation and interaction analyses evaluated the roles of PA and air pollutants (PM₁, PM 2.5 , PM₁₀, and NO₂). Results Logistic regression models adjusted for sociodemographic, lifestyle, and environmental covariates revealed that higher residential greenness (per IQR increase in NDVI-500m and EVI-500m) was associated with 23 % (OR = 0.77, 95 % CI: 0.71–0.85) and 21 % (OR = 0.79, 95 % CI: 0.73–0.87) lower diabesity risk, respectively. Notably, stronger protective effects were observed among minorities, rural residents, and less-educated individuals. Mediation analysis indicated that PM 2.5 , PM₁₀, and PA accounted for 16–52 % of the protective effect. While significant antagonistic interactions between greenness and air pollutants were detected (all P < 0.001), no interaction was observed with PA. Conclusions These findings suggest that residential greenness is inversely associated with diabesity risk, partially mediated by reduced air pollution and increased PA. Targeted green space interventions may mitigate diabesity, particularly in vulnerable subgroups.

Source: Ecotoxicology and Environmental Safety

DOI: 10.1016/j.ecoenv.2025.118948

Authors: Yajie Li, Jianbo Li, Li Yin, Qucuo Nima, Xianzhi Li

Institutions: Panzhihua Central Hospital, Dali University

Language: English

Topic: Urban Green Space and Health

Subfield: Health, Toxicology and Mutagenesis

Field: Environmental Science

Domain: Physical Sciences

SDGs: Good health and well-being, Sustainable cities and communities

Open Access status: gold

Estimated APC paid: $3,650