216 Participants Needed

Walking Environments for Prediabetes

Recruiting at 2 trial locations
SR
SR
Overseen BySarah Rydell, MPH
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine whether walking in nature (Green Walk) or in urban settings (Gray Walk) more effectively reduces stress and anxiety in people with prediabetes, a condition where blood sugar levels are higher than normal but not yet diabetes. Participants will walk for 150 minutes each week in both environments over different six-week periods. Individuals diagnosed with prediabetes in the past year, who are not very active, and have stable weight might be suitable for this study. As an unphased trial, the study offers a unique opportunity to explore personal health benefits from different walking environments.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it does exclude people who have changed medications affecting study outcomes in the last 3 months or plan to change them. If you are on medications for lipids, blood pressure, anxiety, or depression, they will be tracked closely.

What prior data suggests that these walking environments are safe for people with prediabetes?

Research has shown that walking in natural (green) or urban (gray) areas is generally safe for people with prediabetes. Studies have found that walking in these environments provides both mental and physical benefits without major negative effects, indicating it is well-tolerated.

Walking in nature can reduce stress and improve mood, which benefits overall health and usually doesn't cause any problems. Similarly, walking in urban areas offers advantages. The city environment can encourage physical activity, which is important for managing prediabetes.

In summary, evidence supports that walking, whether in nature or city settings, is a safe and effective way to improve health for those with prediabetes.12345

Why are researchers excited about this trial?

Researchers are excited about the Walking Environments for Prediabetes trial because it compares the impact of walking in nature-based environments to walking in commercial, built environments on prediabetes. Unlike traditional treatments for prediabetes that focus on medication and dietary changes, this trial explores how the setting of physical activity might influence health outcomes. The unique aspect here is the focus on the environment as a potential factor in managing prediabetes, which could open up new, accessible, and natural ways to improve health. The trial aims to uncover whether the calming effects of nature might enhance the benefits of exercise beyond what's achieved in urban settings.

What evidence suggests that this trial's walking environments could be effective for prediabetes?

Research shows that walking can greatly improve health for people with prediabetes. Studies have found that regular walking, especially brisk walking for at least 150 minutes a week, can lower the risk of developing diabetes by 58% over a few years. This trial will compare two walking environments: nature-based walking and built-environment/commercial walking. Walking in nature, such as parks or forests, can lift mood and reduce stress and anxiety more than walking in city areas. Participants who have walked regularly have seen lower blood sugar levels and a decrease in their HbA1c, a measure of blood sugar control, by an average of 0.50%. Overall, walking anywhere can be a simple and effective way to manage prediabetes and improve overall well-being.13678

Who Is on the Research Team?

MP

Mark Pereira, PhD

Principal Investigator

University of Minnesota

Are You a Good Fit for This Trial?

Adults aged 25-64 with prediabetes, classified as overweight or obese (BMI 20.0-39.9), who exercise less than 100 minutes per week and have stable weight for the last three months can join this trial. They must not be pregnant or breastfeeding, willing to keep their diet and exercise habits except for study requirements, own a smartphone, and pass a health questionnaire.

Inclusion Criteria

No exercise contraindications as assessed by the Physical Activity Readiness Questionnaire (PAR-Q)
Stable weight over the last 3 months (<10% change)
Willing to maintain current dietary and exercise habits as per the study exercise protocol
See 9 more

Exclusion Criteria

Currently engaged in more than 100 min/week of physical activity
Self-reported physical/mental disability that would prevent adherence to the intervention
My BMI is either below 20 or 40 and above.
See 15 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Baseline measurements of anxiety, mood, heart rate variability, and other biomarkers are taken

1 week
1 visit (in-person)

Treatment

Participants engage in walking sessions in both Green and Gray environments in a randomized crossover design

6 weeks
Multiple visits (in-person) for assessment walks

Follow-up

Participants are monitored for changes in anxiety, mood, heart rate variability, and other biomarkers

12 weeks
Follow-up visits at weeks 7, 12, and 18

What Are the Treatments Tested in This Trial?

Interventions

  • Gray Walk
  • Green Walk
Trial Overview The trial is testing the effects of walking in different environments on adults with prediabetes by comparing walks in urban green spaces ('Green Walk') versus built-up city areas ('Gray Walk'). It aims to see which setting might better reduce stress and improve health indicators like heart rate variability.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: Nature-based Walking then Built-environment/Commercial WalkingExperimental Treatment2 Interventions
Group II: Built-environment/Commercial Walking then Nature-based WalkingExperimental Treatment2 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Minnesota

Lead Sponsor

Trials
1,459
Recruited
1,623,000+

Northwestern University

Collaborator

Trials
1,674
Recruited
989,000+

Published Research Related to This Trial

Prediabetes, characterized by impaired fasting glucose or glucose tolerance, is linked to a higher risk of metabolic syndrome and cardiovascular issues, highlighting the importance of early intervention.
Effective management of prediabetes includes weight loss and regular physical activity, with certain medications also being recommended to help prevent the progression to Type 2 diabetes and cardiovascular diseases.
Prediabetes.Rosolová, H.[2022]
A systematic review of 47 studies involving over 8000 individuals with prediabetes or diabetes found that while there are some risks associated with increased physical activity, such as musculoskeletal injuries and hypoglycemia, the overall prevalence of severe adverse events is low.
The review supports that increased physical activity is generally safe for individuals with prediabetes and diabetes, and it led to the development of a new risk assessment algorithm to help guide safe exercise practices for these patients.
Evidence-based risk assessment and recommendations for physical activity clearance: diabetes mellitus and related comorbidities.Riddell, MC., Burr, J.[2022]
In a study of 50,593 participants, increased residential greenness was linked to a significant reduction in the risk of prediabetes and diabetes, with stronger effects observed in rural areas compared to urban areas.
The protective effects of greenness against diabetes were partly mediated by factors such as air pollution, physical activity, and body mass index, highlighting the importance of environmental factors in diabetes prevention.
Rural-urban disparities in the associations of residential greenness with diabetes and prediabetes among adults in southeastern China.Yu, W., Li, X., Zhong, W., et al.[2023]

Citations

NCT06365723 | Effects of Walking in Greenspace and the ...Nature-based Walking then Built-environment/Commercial Walking. People with prediabetes randomized to six weeks of nature-based walking followed by a five ...
Walking Green: Developing an Evidence Base for Nature ...We report psychological outcomes measured from thirty-eight participants before and after three conditions: a 50 min walk on a forest path, a 50 min walk along ...
Walking for subjects with type 2 diabetes: A systematic ...The results of this meta-analysis supported the conclusion that walking is effective in decreasing HbA1c, by an average of 0.50% (95% CI, 0.70–0.21%), in ...
Faculty Research Highlights Potential Benefits of Walking to ...The study, published in Diabetes Care open_in_new, found that three short post-meal walks were as effective at reducing blood sugar over 24 ...
Daily physical activity and type 2 diabetes: A review - PMCOutcome, results​​ The lifestyle intervention reduced the incidence of diabetes by 58% after a 2.8-year follow-up. Brisk walking for at least 150 min/wk was a ...
Green Space Exposure Association with Type 2 Diabetes ...This review aims to study the association between exposure to green spaces and outcomes such as diabetes, obesity, and physical activity in the general ...
Walking Green: The Effects of Walking in Forested andThis study records the psychological and physiological effects of green vs gray walks during a longitudinal crossover study on 41 participants. In accordance ...
The multifaceted benefits of walking for healthy agingWalking decreases the risk or severity of various health outcomes such as cardiovascular and cerebrovascular diseases, type 2 diabetes mellitus, cognitive ...
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