# Effects of Walking in Greenspace and the Built Environment in Adults with Prediabetes: A Randomized Crossover Trial

> **NIH NIH R01** · UNIVERSITY OF MINNESOTA · 2024 · $627,289

## Abstract

PROJECT SUMMARY: Given the substantial adverse health and economic consequences of diabetes,
preventing progression of prediabetes (prevalence of 38% in U.S. adults) to type 2 diabetes (T2D) is a major
public health goal. The environment plays a critical role in determining risk for T2D. Urbanization has been
associated with increased psychosocial stress and adverse health outcomes. Stress responses cause hormonal
changes that lead to insulin resistance, hyperglycemia, inflammation, oxidative stress, and obesity. Increased
exposure to air pollution has been associated with higher risk of diabetes and cardiovascular disease.
‘Greenspace’ is defined as publicly accessible areas with predominant naturalistic elements (e.g., trees, grass,
water features, etc.). Previous studies in adults support the hypothesis that exposure to Greenspace (‘Green’)
may have several health benefits relative to urban built (‘Gray’) environments. These benefits may include better
autonomic functioning as assessed by improved heart rate variability (HRV), reductions in anxiety/stress, and
enhanced psychological restoration, with Greenspace also serving to buffer air pollution. Walking is the most
common form of moderate-intensity physical activity and has a beneficial influence on blood glucose control.
Preliminary studies have suggested walking and exposure to Greenspace may act together to improve health
outcomes. Yet, aside from our preliminary studies, rigorous experimental studies have not been conducted to
examine how regular walking may interact with exposure to urban Greenspace, compared to urban Grayspace,
to improve health. These studies are needed to investigate novel and highly generalizable strategies for “Green
exercise”, capable of being implemented at the population-level to reduce the burden of disease. Therefore, we
will conduct a mechanistic randomized crossover trial to compare differences in physiological, psychological, air
pollution, and cardiometabolic risk measures between walking interventions completed in urban Green and Gray
environments in adults with prediabetes. This multisite trial will include 180 individuals within metropolitan areas
of Minneapolis/St. Paul, MN and Chicago, IL. Walking interventions will be completed in urban Green and urban
Gray environments, with participants engaging in 150 minutes/week of walking for 6 weeks in each environment,
separated by a 5-week washout. Specific Aims: Aim 1: Measure and compare psychosocial stress between
Green and Gray walking. Aim 2: Measure and compare physiological stress over six weeks between Green and
Gray walking. Aim 3: Measure real-time individual exposure to ambient particulate matter using personal air
pollution monitors with GPS tracking while walking in Green and Gray environments. Aim 4: Measure individual
cardiometabolic disease risk scores (index of blood glucose, insulin, lipids, systolic blood pressure, and waist)
and inflammatory factors before and after 6 weeks of Green and ...

## Key facts

- **NIH application ID:** 10870116
- **Project number:** 5R01HL170504-02
- **Recipient organization:** UNIVERSITY OF MINNESOTA
- **Principal Investigator:** TERESA H HORTON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $627,289
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10870116

## Citation

> US National Institutes of Health, RePORTER application 10870116, Effects of Walking in Greenspace and the Built Environment in Adults with Prediabetes: A Randomized Crossover Trial (5R01HL170504-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10870116. Licensed CC0.

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