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Filgueiras MDS, Pessoa MC, Bressan J, Fogal Vegi AS, do Carmo AS, Albuquerque FMD, Gardone DS, Novaes JFD. Characteristics of the obesogenic environment around schools are associated with body fat and low-grade inflammation in Brazilian children. Public Health Nutr 2023; 26:2407-2417. [PMID: 37559196 DOI: 10.1017/s1368980023001696] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
OBJECTIVE To assess the association of obesogenic environmental characteristics around schools with body adiposity and adipokine concentrations in Brazilian children. DESIGN Cross-sectional study. Body adiposity was assessed using the dual-energy X-ray absorptiometry. Concentrations of leptin, adiponectin, retinol-binding protein 4 (RBP4) and chemerin were measured. Predominantly ultra-processed food (UPF) stores, public physical activity (PA) facilities, green spaces, walkability, traffic accidents and crime were evaluated. The neighbourhood unit was the 400 m (0·25 miles) road network buffer around schools. The association of environmental characteristics with body adiposity and adipokine concentrations was assessed by linear regression models using generalised estimating equations. SETTING Urban schools (n 24), Viçosa, Minas Gerais, Brazil. PARTICIPANTS Children aged 8 and 9 years (n 378). RESULTS A higher density of predominantly UPF stores and a lower percentage of green space were associated with higher total (β: 0·12; 95 % CI 0·06, 0·18 and β: -0·10; 95 % CI -0·16, -0·04, respectively) and android body fat (β: 0·28; 95 % CI 0·13, 0·43 and β: -0·18; 95 % CI -0·32, -0·04, respectively). In addition, the densities of PA facilities and crime were inversely associated with leptin concentrations. Traffic accidents density and percentage of green spaces around schools had, respectively, a positive and an inverse association with concentrations of adiponectin and RBP4. CONCLUSIONS Obesogenic environmental characteristics around schools were associated with total and android body fat, as well as with pro-inflammatory adipokine concentrations in Brazilian children from a medium-sized city.
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Affiliation(s)
- Mariana De Santis Filgueiras
- Department of Nutrition and Health, Universidade Federal de Viçosa, Av. P.H. Rolfs s/n, Centro de Ciências Biológicas II, Campus Universitário, Viçosa36570-900, Minas Gerais, Brazil
| | - Milene Cristine Pessoa
- Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte30130-100, Minas Gerais, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Av. P.H. Rolfs s/n, Centro de Ciências Biológicas II, Campus Universitário, Viçosa36570-900, Minas Gerais, Brazil
| | - Aline Siqueira Fogal Vegi
- Nutrition School, Universidade Federal de Ouro Preto, Rua Dois, Campus Morro do Cruzeiro, Ouro Preto35400-000, Minas Gerais, Brazil
| | - Ariene Silva do Carmo
- Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte30130-100, Minas Gerais, Brazil
| | - Fernanda Martins de Albuquerque
- Department of Nutrition and Health, Universidade Federal de Viçosa, Av. P.H. Rolfs s/n, Centro de Ciências Biológicas II, Campus Universitário, Viçosa36570-900, Minas Gerais, Brazil
| | - Danielle Soares Gardone
- Department of Nutrition, Nursing School, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte30130-100, Minas Gerais, Brazil
| | - Juliana Farias de Novaes
- Department of Nutrition and Health, Universidade Federal de Viçosa, Av. P.H. Rolfs s/n, Centro de Ciências Biológicas II, Campus Universitário, Viçosa36570-900, Minas Gerais, Brazil
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Jabeen A, Afzal MS, Pathan SA. A Review of the Role of Built Environment and Temperature in the Development of Childhood Obesity. Cureus 2023; 15:e49657. [PMID: 38161805 PMCID: PMC10756253 DOI: 10.7759/cureus.49657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
The burden of obesity is rising globally and is studied widely, yet the evidence for the association of environmental factors (both built and natural) with childhood obesity remains inconsistent. A relation with temperature as a proxy for natural environmental factors for obesity has not been reviewed previously. The purpose of this review was to assimilate updated evidence on environmental factors of childhood obesity. Three databases, MEDLINE (Medical Literature Analysis and Retrieval System Online), Web of Science, and Cochrane, were searched for articles related to the effect of built environment and temperature on childhood obesity in 6-12-year-olds published in the last five years. Twelve studies were identified: four longitudinal and eight cross-sectional. The studies were appraised using the National Institute of Health Quality (NIH) Assessment Tool. A review of included studies showed that built environmental features like higher residential and population density, higher intersection density, more playgrounds, and all park features like the presence or availability of parks, high number of parks, proximity to parks, and an increased park land area, showed a protective association against childhood obesity while land use mix showed a promoting association for the development of childhood obesity. Inconclusive evidence was observed for other built environmental features. The search strategy did not retrieve any literature published in the past five years studying the association between temperature and the development of childhood obesity. Standardization of definitions of exposure and outcome measures is recommended. Further research studying the relationship between environmental temperature and the development of childhood obesity is recommended.
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Affiliation(s)
- Atika Jabeen
- Public Health, London School of Hygiene & Tropical Medicine, University of London, London, GBR
- Emergency Department, Hamad Medical Corporation, Doha, QAT
| | | | - Sameer A Pathan
- Emergency Department, Hamad Medical Corporation, Doha, QAT
- Emergency Medicine, Blizard Institute, Queen Mary University of London, London, GBR
- Emergency Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, AUS
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Ye T, Yu P, Wen B, Yang Z, Huang W, Guo Y, Abramson MJ, Li S. Greenspace and health outcomes in children and adolescents: A systematic review. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 314:120193. [PMID: 36122655 DOI: 10.1016/j.envpol.2022.120193] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/04/2022] [Accepted: 09/13/2022] [Indexed: 06/15/2023]
Abstract
An increasing body of evidence has linked greenspace and various health outcomes in children and adolescents, but the conclusions were inconsistent. For this review, we comprehensively summarized the measurement methods of greenspace, resultant health outcomes, and potential mechanisms from epidemiological studies in children and adolescents (aged ≤19 years). We searched for studies published and indexed in MEDLINE and EMBASE (via Ovid) up to April 11, 2022. There were a total of 9,291 studies identified with 140 articles from 28 countries finally assessed and included in this systematic review. Over 70% of the studies were conducted in highly urbanised countries/regions, but very limited research has been done in low-and middle-income countries and none in Africa. Measures of greenspace varied. Various health outcomes were reported, including protective effects of greenspace exposure on aspects of obesity/overweight, myopia, lung health, circulatory health, cognitive function, and general health in children and adolescents. The associations between greenspace exposure and other health outcomes were inconsistent, especially for respiratory health studies. We pooled odds ratios (OR) using random-effects meta-analysis for health outcomes of asthma (OR = 0.94, 95%CI: 0.84 to 1.06), allergic rhinitis (OR = 0.95; 95% CI: 0.73 to 1.25), and obesity/overweight (OR = 0.91, 95%CI: 0.84 to 0.98) with per 0.1 unit increase in normalized difference in vegetation index (NDVI). These associations have important implications for the assessment and management of urban environment and health in children and adolescents.
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Affiliation(s)
- Tingting Ye
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Pei Yu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Bo Wen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Zhengyu Yang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Wenzhong Huang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Michael J Abramson
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
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Aris IM, Perng W, Dabelea D, Padula AM, Alshawabkeh A, Vélez-Vega CM, Aschner JL, Camargo CA, Sussman TJ, Dunlop AL, Elliott AJ, Ferrara A, Zhu Y, Joseph CLM, Singh AM, Hartert T, Cacho F, Karagas MR, North-Reid T, Lester BM, Kelly NR, Ganiban JM, Chu SH, O’Connor TG, Fry RC, Norman G, Trasande L, Restrepo B, James P, Oken E. Associations of Neighborhood Opportunity and Social Vulnerability With Trajectories of Childhood Body Mass Index and Obesity Among US Children. JAMA Netw Open 2022; 5:e2247957. [PMID: 36547983 PMCID: PMC9857328 DOI: 10.1001/jamanetworkopen.2022.47957] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/30/2022] [Indexed: 12/24/2022] Open
Abstract
Importance Physical and social neighborhood attributes may have implications for children's growth and development patterns. The extent to which these attributes are associated with body mass index (BMI) trajectories and obesity risk from childhood to adolescence remains understudied. Objective To examine associations of neighborhood-level measures of opportunity and social vulnerability with trajectories of BMI and obesity risk from birth to adolescence. Design, Setting, and Participants This cohort study used data from 54 cohorts (20 677 children) participating in the Environmental Influences on Child Health Outcomes (ECHO) program from January 1, 1995, to January 1, 2022. Participant inclusion required at least 1 geocoded residential address and anthropometric measure (taken at the same time or after the address date) from birth through adolescence. Data were analyzed from February 1 to June 30, 2022. Exposures Census tract-level Child Opportunity Index (COI) and Social Vulnerability Index (SVI) linked to geocoded residential addresses at birth and in infancy (age range, 0.5-1.5 years), early childhood (age range, 2.0-4.8 years), and mid-childhood (age range, 5.0-9.8 years). Main Outcomes and Measures BMI (calculated as weight in kilograms divided by length [if aged <2 years] or height in meters squared) and obesity (age- and sex-specific BMI ≥95th percentile). Based on nationwide distributions of the COI and SVI, Census tract rankings were grouped into 5 categories: very low (<20th percentile), low (20th percentile to <40th percentile), moderate (40th percentile to <60th percentile), high (60th percentile to <80th percentile), or very high (≥80th percentile) opportunity (COI) or vulnerability (SVI). Results Among 20 677 children, 10 747 (52.0%) were male; 12 463 of 20 105 (62.0%) were White, and 16 036 of 20 333 (78.9%) were non-Hispanic. (Some data for race and ethnicity were missing.) Overall, 29.9% of children in the ECHO program resided in areas with the most advantageous characteristics. For example, at birth, 26.7% of children lived in areas with very high COI, and 25.3% lived in areas with very low SVI; in mid-childhood, 30.6% lived in areas with very high COI and 28.4% lived in areas with very low SVI. Linear mixed-effects models revealed that at every life stage, children who resided in areas with higher COI (vs very low COI) had lower mean BMI trajectories and lower risk of obesity from childhood to adolescence, independent of family sociodemographic and prenatal characteristics. For example, among children with obesity at age 10 years, the risk ratio was 0.21 (95% CI, 0.12-0.34) for very high COI at birth, 0.31 (95% CI, 0.20-0.51) for high COI at birth, 0.46 (95% CI, 0.28-0.74) for moderate COI at birth, and 0.53 (95% CI, 0.32-0.86) for low COI at birth. Similar patterns of findings were observed for children who resided in areas with lower SVI (vs very high SVI). For example, among children with obesity at age 10 years, the risk ratio was 0.17 (95% CI, 0.10-0.30) for very low SVI at birth, 0.20 (95% CI, 0.11-0.35) for low SVI at birth, 0.42 (95% CI, 0.24-0.75) for moderate SVI at birth, and 0.43 (95% CI, 0.24-0.76) for high SVI at birth. For both indices, effect estimates for mean BMI difference and obesity risk were larger at an older age of outcome measurement. In addition, exposure to COI or SVI at birth was associated with the most substantial difference in subsequent mean BMI and risk of obesity compared with exposure at later life stages. Conclusions and Relevance In this cohort study, residing in higher-opportunity and lower-vulnerability neighborhoods in early life, especially at birth, was associated with a lower mean BMI trajectory and a lower risk of obesity from childhood to adolescence. Future research should clarify whether initiatives or policies that alter specific components of neighborhood environment would be beneficial in preventing excess weight in children.
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Affiliation(s)
- Izzuddin M. Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Wei Perng
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora
| | - Amy M. Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco
| | - Akram Alshawabkeh
- Department of Civil and Environmental Engineering, Northeastern University, Boston, Massachusetts
| | - Carmen M. Vélez-Vega
- UPR Medical Sciences Campus, University of Puerto Rico Graduate School of Public Health, San Juan
| | - Judy L. Aschner
- Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, New Jersey
- Department of Pediatrics, Albert Einstein College of Medicine, New York, New York
| | - Carlos A. Camargo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Emergency Medicine, Massachusetts General Hospital, Boston
| | - Tamara J. Sussman
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, New York
| | - Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia
| | - Amy J. Elliott
- Avera Research Institute, Sioux Falls, South Dakota
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland
| | | | - Anne Marie Singh
- Division of Allergy, Immunology and Rheumatology, University of Wisconsin–Madison, Madison
| | - Tina Hartert
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ferdinand Cacho
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Margaret R. Karagas
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Hanover, New Hampshire
| | - Tiffany North-Reid
- Department of Epidemiology, Dartmouth Geisel School of Medicine, Hanover, New Hampshire
| | - Barry M. Lester
- Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Nichole R. Kelly
- Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, Eugene
| | - Jody M. Ganiban
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia
| | - Su H. Chu
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Rebecca C. Fry
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Gwendolyn Norman
- Institute for Environmental Health Sciences, Wayne State University School of Medicine, Detroit, Michigan
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York
| | - Bibiana Restrepo
- Department of Pediatrics, University of California Davis School of Medicine, Sacramento
- MIND Institute, University of California Davis, Sacramento, California
| | - Peter James
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Mazzocchi A, De Cosmi V, Milani GP, Agostoni C. Health and Sustainable Nutritional Choices from Childhood: Dietary Pattern and Social Models. ANNALS OF NUTRITION AND METABOLISM 2022; 78 Suppl 2:21-27. [PMID: 35679841 DOI: 10.1159/000524860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/02/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND The role of diet in the pediatric age for optimal development, achievement, and maintenance of a healthy status is well recognized. Increasing attention is nowadays also paid to reducing the burden of human nutrition on the planet's health for present and future generations. SUMMARY Beyond environmental sustainability, the transition to diets rich in animal and processed foods contributes to an overall unhealthy nutritional status leading to an increased prevalence of obesity- and diet-related noncommunicable diseases. Childhood overweight and obesity are a growing public health crisis worldwide. The aim of this narrative review was to summarize evidence of the nutritional status and dietary habits in children and the link with environmental sustainability. KEY MESSAGE Optimizing nutrition in infancy and establishing healthy lifestyles from the preschool years might help to reduce the risk of overweight, and all the disorders related, respecting the sustainability dimension.
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Affiliation(s)
- Alessandra Mazzocchi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy,
| | - Valentina De Cosmi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gregorio P Milani
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Pediatric Unit, Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Pediatric Intermediate Care Unit, Milan, Italy
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Boechat JL, Delgado L, Paciência I. Social and Physical Environment Inequalities and Childhood Health. JAMA Pediatr 2022; 176:422-423. [PMID: 35157013 DOI: 10.1001/jamapediatrics.2021.6292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- José Laerte Boechat
- Allergy and Clinical Immunology Service, Faculty of Medicine, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Luis Delgado
- Basic & Clinical Immunology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Inês Paciência
- EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
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Fyfe-Johnson AL, Hazlehurst MF, Perrins SP, Bratman GN, Thomas R, Garrett KA, Hafferty KR, Cullaz TM, Marcuse EK, Tandon PS. Nature and Children's Health: A Systematic Review. Pediatrics 2021; 148:e2020049155. [PMID: 34588297 DOI: 10.1542/peds.2020-049155] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Daily outdoor play is encouraged by the American Academy of Pediatrics. Existing evidence is unclear on the independent effect of nature exposures on child health. OBJECTIVE We systematically evaluated evidence regarding the relationship between nature contact and children's health. DATA SOURCES The database search was conducted by using PubMed, Cumulative Index to Nursing and Allied Health Literature, PsychInfo, ERIC, Scopus, and Web of Science in February 2021. STUDY SELECTION We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In all searches, the first element included nature terms; the second included child health outcome terms. DATA EXTRACTION Of the 10 940 studies identified, 296 were included. Study quality and risk of bias were assessed. RESULTS The strongest evidence for type of nature exposure was residential green space studies (n = 147, 50%). The strongest evidence for the beneficial health effects of nature was for physical activity (n = 108, 32%) and cognitive, behavioral, or mental health (n = 85, 25%). Physical activity was objectively measured in 55% of studies, and 41% of the cognitive, behavioral, or mental health studies were experimental in design. LIMITATIONS Types of nature exposures and health outcomes and behaviors were heterogenous. Risk of selection bias was moderate to high for all studies. Most studies were cross-sectional (n = 204, 69%), limiting our ability to assess causality. CONCLUSIONS Current literature supports a positive relationship between nature contact and children's health, especially for physical activity and mental health, both public health priorities. The evidence supports pediatricians in advocating for equitable nature contact for children in places where they live, play, and learn.
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Affiliation(s)
- Amber L Fyfe-Johnson
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | | | | | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, Washington
| | - Rick Thomas
- National Academy of Sciences, Washington, District of Columbia
| | - Kimberly A Garrett
- Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington
| | - Kiana R Hafferty
- Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington
| | - Tess M Cullaz
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | | | - Pooja S Tandon
- Pediatrics
- Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington
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Nguyen TH, Götz S, Kreffter K, Lisak-Wahl S, Dragano N, Weyers S. Neighbourhood deprivation and obesity among 5656 pre-school children-findings from mandatory school enrollment examinations. Eur J Pediatr 2021; 180:1947-1954. [PMID: 33576893 PMCID: PMC8105223 DOI: 10.1007/s00431-021-03988-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/29/2021] [Accepted: 02/05/2021] [Indexed: 11/20/2022]
Abstract
The risk of child obesity is strongly related to socioeconomic factors such as individual socioeconomic position (SEP) and neighbourhood deprivation. The present study analyses whether the relationship between neighbourhood deprivation and child obesity differs by child's individual SEP. Data from 5656 children (5-7 years) from the mandatory school enrollment examinations of the pre-school cohorts 2017/2018 in Düsseldorf were analysed. Obesity was determined by the age- and gender-specific body mass index (BMI); neighbourhood deprivation by using the socio-spatial degree of deprivation of the children's residential addresses; and individual SEP by the level of parental education. Using Poisson regression, we estimated prevalence ratios (PR with 95% confidence interval (CI)) of child obesity by neighbourhood deprivation and parental education. Interactions between neighbourhood deprivation and parental education were tested. The prevalence of child obesity increases with the degree of neighbourhood deprivation. Compared to children living in low deprivation neighbourhoods, the proportion of obese children was twice as high in high deprivation neighbourhoods (PR=2.02; CI=1.46-2.78). Likewise, children from families with medium and low education have twice the risk for obesity compared to children with high parental education (PR=2.05; CI=1.46-2.78). The relationship between neighbourhood deprivation and child obesity was significantly moderated by parental education; it was stronger for higher parental education than for medium and low parental education (p<.001).Conclusion: Our findings suggest that children from deprived neighbourhoods and families with lower education have a higher risk for child obesity. The identification of particularly deprived neighbourhoods with structural interventions in combination with the strengthening of parental health literacy seems reasonable. What is Known: • Studies show that children from disadvantaged neighbourhoods are more frequently obese. What is New: • The relationship between neighbourhood deprivation and child obesity is significantly moderated by parental education. It is stronger for children with higher parental education than for children with medium and low parental education.
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Affiliation(s)
- Thuy Ha Nguyen
- grid.14778.3d0000 0000 8922 7789Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany
| | - Simon Götz
- grid.14778.3d0000 0000 8922 7789Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany
| | - Katharina Kreffter
- grid.14778.3d0000 0000 8922 7789Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany
| | | | - Nico Dragano
- grid.14778.3d0000 0000 8922 7789Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225 Duesseldorf, Germany
| | - Simone Weyers
- Faculty of Medicine, University Hospital Duesseldorf, Centre for Health and Society, Institute of Medical Sociology, Moorenstrasse 5, 40225, Duesseldorf, Germany.
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