Like the majority of New York City residents, I can attest to the physical activity required to live in a bustling city. Whether it's climbing up and down flights of underground subway stairs, lugging home 20 pounds of groceries or walking miles to get to and from each place, city living challenges my physical abilities on a daily basis. While I've considered the obvious health factors associated with this exertion, I've never stopped to think about how my neighborhood could affect my chances of developing diabetes.

The results of a new study, published in today's issue of Archives of Internal Medicine, suggest that living in an environment conducive to physical activity and nutrient-rich foods may be important elements in an individual's fight to curb the development of type 2 diabetes. "Better neighborhood resources, determined by a combined score for physical activity and healthy foods, were associated with a 38 percent lower incidence of type 2 diabetes," the journal reports.

According to the study authors, various environmental features promote a healthy lifestyle. When considering your neighborhood, ask yourself these questions:

• Does my neighborhood have safe sidewalks so I am not forced to drive?
• Does the public-transportation system allow me to rely less on my car?
• Does my neighborhood offer accessible parks or public green spaces?
• Do I have access to a farmer's market?
• Does my grocery store have a selection of fresh foods?

Those who live in large U.S. cities also may be interested in a report released earlier this year by the American College of Sports Medicine (ACSM), which ranks the state of health and fitness in America's 50 largest metropolitan areas. When determining which areas made the grade, ACSM considered factors such as healthy behaviors, levels of chronic disease conditions, health-care accessibility and physical-activity community resources.

Based on the report, here are the top five fittest cites:

1. Washington D.C.
2. Minneapolis-St. Paul
3. Denver
4. Boston
   
5. San Francisco

For more information on this study, read "Healthier Neighborhoods Help Keep Diabetes at Bay"

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