Preventive health and urban planning are inching closer together with more evidence that living in car-dependent suburbs can make you fat and sick.

Research to be presented Monday in Vancouver at the weeklong World Diabetes Congress concludes that residents of Metro Vancouver's most walkable neighbourhoods are 30 per cent less likely to be overweight or obese than their counterparts in the least walkable areas.

Obesity is a key risk factor for Type 2 diabetes, a condition in which the body can no longer adequately process sugar. Diabetes can contribute to a host of other serious health problems including heart disease, and nerve and kidney damage.

"What we want municipal planners to realize is that just as they will invest in community centres, green spaces and parks, they need to look at their sidewalks as physical activity resources for the community," says Jat Sandhu, the principal investigator for My Health My Community , an in-depth survey of Metro Vancouver residents in 2013-14 which provided the obesity statistics for his presentation. "Making it easier for people to walk has dividends in physical health in terms of obesity and long-term consequences like diabetes."

Pockets of high-density housing scattered along SkyTrain lines and in city centres throughout Metro Vancouver are examples of new walkable areas, he says.

While obesity isn't a surefire cause of Type 2 diabetes, it's known that about 80 per cent of people with the condition are overweight, Sandhu says.

The research team looked at self-reported height and weight for 22,499 respondents, used the two to determine the body mass index, or BMI, for those in the study, and then sorted them by neighbourhood.

The neighbourhoods were then rated using Walk Score , an online tool usually used by apartment-seekers that calculates how easy it is to do daily

tasks on foot like shopping and getting to work. Vancouver's West End gets a Walk Score rating of 94 out of 100, for example, while Langley Township comes in at 39.

Almost 57 per cent of respondents were overweight or obese (BMIs above 25 and 30, respectively), and seven per cent said they had been diagnosed with diabetes. People living in areas with a Walk Score over 90 were one-third less likely to be obese or overweight than those in cardependent communities with scores less than 49.

Researchers adjusted the figures to take into account income and health status, Sandhu said.

It's well known that people with higher incomes tend to be healthier, and some of the most walkable areas of Metro Vancouver are also the most expensive. Dr. Jan Hux, chief science officer for the Canadian Diabetes Association , says this work reinforces research in Metro Toronto that reached similar conclusions about the unhealthiness of its suburbs. A striking finding of the work, published in 2012, is that recent immigrants living in suburbs with poor public transit were 50 per cent more likely to develop diabetes.

"The suburbs are unhealthy," Hux said. "The fact that the findings still hold in Vancouver is important."

While far-flung municipalities are generally stuck with their originally designed roads and sidewalks, better public transit can make a difference by getting people to walk a few blocks to a bus stop rather than their garage, she said.

"Public transit is a more active lifestyle, and it can be introduced or improved in areas where rebuilding the existing infrastructure would be more challenging," Hux said.

The Canadian Diabetes Association is also releasing recommendations Monday afternoon on the issue.

About 8,000 delegates and 350 expert speakers are attending the World Diabetes Congress from Monday to Friday, organized by the International Diabetes Federation. Free public sessions on Friday from 1 p.m. to 4 p.m. at the Vancouver Convention Centre focus on the scope of diabetes in B.C. and how to manage the disease.

eellis@vancouversun.com