Use of green spaces and blood glucose in children; a population-based CASPIAN-V study

A limited but emerging body of evidence is suggestive for a beneficial association between contact with green spaces and glucose homeostasis in adults; however, such an evidence for children is scarce. We evaluated the association between time spent in green spaces and fasting blood glucose (FBG) levels and impaired fasting glucose (IFG, FBG≥110 mg/dL) in a population-based multicentric sample of 3844 Iranian schoolchildren aged 7-18 years (2015). Participants were instructed to report the average hours per week spent in green spaces separately during each season and in each type of green space (parks, woods/other natural green spaces, and private gardens/agricultural field) for a 12-month period preceding the interview. We developed linear and logistic mixed effects models with centre as random effect to evaluate the association of time spent in green spaces (separately for each type as well as all types together) with FBG and IFG, respectively, controlled for a wide range of covariates including household indicators of socioeconomic status. We observed inverse associations between time spent in green spaces, especially in natural green spaces, and FBG levels. Specifically, 1.83 h increase in the total time spent in green spaces was associated with -0.5 mg/dl (95% confidence intervals: -0.9, -0.1) change in FBG levels. We also observed reduced risk of IFG associated with time spent in green spaces; however, the association was statistically significant only for the time spent in natural green spaces. There were suggestions for stronger associations for those residing in urban areas and those from lower socioeconomic status groups; however, the interaction terms for socioeconomic status and urbanity were not statistically significant. Further longitudinal studies are required to replicate our findings in other settings with different climates and population susceptibilities.