1
|
Kershaw KN, Magnani JW, Diez Roux AV, Camacho-Rivera M, Jackson EA, Johnson AE, Magwood GS, Morgenstern LB, Salinas JJ, Sims M, Mujahid MS. Neighborhoods and Cardiovascular Health: A Scientific Statement From the American Heart Association. Circ Cardiovasc Qual Outcomes 2024; 17:e000124. [PMID: 38073532 DOI: 10.1161/hcq.0000000000000124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
The neighborhoods where individuals reside shape environmental exposures, access to resources, and opportunities. The inequitable distribution of resources and opportunities across neighborhoods perpetuates and exacerbates cardiovascular health inequities. Thus, interventions that address the neighborhood environment could reduce the inequitable burden of cardiovascular disease in disenfranchised populations. The objective of this scientific statement is to provide a roadmap illustrating how current knowledge regarding the effects of neighborhoods on cardiovascular disease can be used to develop and implement effective interventions to improve cardiovascular health at the population, health system, community, and individual levels. PubMed/Medline, CINAHL, Cochrane Library reviews, and ClinicalTrials.gov were used to identify observational studies and interventions examining or targeting neighborhood conditions in relation to cardiovascular health. The scientific statement summarizes how neighborhoods have been incorporated into the actions of health care systems, interventions in community settings, and policies and interventions that involve modifying the neighborhood environment. This scientific statement presents promising findings that can be expanded and implemented more broadly and identifies methodological challenges in designing studies to evaluate important neighborhood-related policies and interventions. Last, this scientific statement offers recommendations for areas that merit further research to promote a deeper understanding of the contributions of neighborhoods to cardiovascular health and health inequities and to stimulate the development of more effective interventions.
Collapse
|
2
|
Herreros-Irarrázabal D, Guzmán-Habinger J, Mahecha Matsudo S, Kovalskys I, Gómez G, Rigotti A, Cortés LY, Yépez García MC, Pareja RG, Herrera-Cuenca M, Farías-Valenzuela C, Marques A, Leme ACB, Fisberg M, Drenowatz C, Ferrari G. Association between Active Transportation and Public Transport with an Objectively Measured Meeting of Moderate-to-Vigorous Physical Activity and Daily Steps Guidelines in Adults by Sex from Eight Latin American Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11553. [PMID: 34770064 PMCID: PMC8583702 DOI: 10.3390/ijerph182111553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 01/23/2023]
Abstract
This study aimed to examine the associations between active transportation and public transport and the objectively measured meeting of moderate-to-vigorous physical activity (MVPA) and steps per day guidelines in adults by sex from eight Latin American countries. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants aged 18-65 years. MVPA and steps per day were evaluated using Actigraph GT3X accelerometers. The mode of transportation, its frequency and duration were collected using a self-reported questionnaire. The average time dedicated to active transportation was 12.8 min/day in men (IQR: 2.8-30.0) and 12.9 min/day in women (IQR: 4.3-25.7). A logistic regression analysis was conducted, showing that active transportation (≥10 min) was associated with higher odds of meeting MVPA guidelines (men: OR: 2.01; 95%CI: 1.58-2.54; women: OR: 1.57; 95%CI: 1.25-1.96). These results show a greater association when considering active transportation plus public transport (men: OR: 2.98; 95%CI: 2.31-3.91; women: OR: 1.82; 95%CI: 1.45-2.29). Active transportation plus public transport was positively associated with meeting steps per day guidelines only in men (OR: 1.55; 95%CI: 1.15-2.10). This study supports the suggestion that active transportation plus public transport is significantly associated with meeting the MVPA and daily steps recommendations.
Collapse
Affiliation(s)
- Diego Herreros-Irarrázabal
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago 8580745, Chile; (D.H.-I.); (J.G.-H.); (S.M.M.)
| | - Juan Guzmán-Habinger
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago 8580745, Chile; (D.H.-I.); (J.G.-H.); (S.M.M.)
| | - Sandra Mahecha Matsudo
- Sports Medicine and Physical Activity Specialty, Science Faculty, Universidad Mayor, Santiago 8580745, Chile; (D.H.-I.); (J.G.-H.); (S.M.M.)
- Centro de Investigación en Medicina Deporte Ejercicio y Salud—Clínica MEDS, Santiago 7550000, Chile
| | - Irina Kovalskys
- Nutrition Career, Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires C1107AAZ, Argentina;
| | - Georgina Gómez
- Department of Biochemistry, School of Medicine, Universidad de Costa Rica, San José 11501-2060, Costa Rica;
| | - Attilio Rigotti
- Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica, Santiago 8330024, Chile;
| | - Lilia Yadira Cortés
- Department of Nutrition and Biochemistry, Pontificia Universidad Javeriana, Bogotá 110231, Colombia;
| | | | | | - Marianella Herrera-Cuenca
- Centro de Estudios del Desarrollo, Universidad Central de Venezuela (CENDES-UCV)/Fundación Bengoa, Caracas 1053, Venezuela;
| | - Claudio Farías-Valenzuela
- Instituto del Deporte, Universidad de las Américas, Santiago 9170022, Chile;
- Department of Didactics of Musical, Plastic and Corporal Expression, Faculty of Education, University of Granada, 18071 Granada, Spain
| | - Adilson Marques
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisbon, Portugal;
- ISAMB, Universidade de Lisboa, 1649-028 Lisbon, Portugal
| | - Ana Carolina B. Leme
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil; (A.C.B.L.); (M.F.)
- Family Relations and Applied Nutrition, University of Guelph, Guelph, ON N1G 2W1, Canada
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
| | - Mauro Fisberg
- Centro de Excelencia em Nutrição e Dificuldades Alimentaes (CENDA), Instituto Pensi, Fundação José Luiz Egydio Setubal, Hospital Infantil Sabará, São Paulo 01228-200, Brazil; (A.C.B.L.); (M.F.)
- Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo 04023-061, Brazil
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, 4020 Linz, Austria;
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago 7500618, Chile
| |
Collapse
|
3
|
Cohen DA, Williamson S, Han B. Gender Differences in Physical Activity Associated with Urban Neighborhood Parks: Findings from the National Study of Neighborhood Parks. Womens Health Issues 2021; 31:236-244. [PMID: 33358644 PMCID: PMC8154653 DOI: 10.1016/j.whi.2020.11.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 10/12/2020] [Accepted: 11/20/2020] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Urban neighborhood parks are designed to provide easy access to recreation and physical activity. We analyzed data from the first National Study of Neighborhood Parks, which assessed the characteristics and use of a representative sample of U.S. urban neighborhood parks. This article compares factors associated with active commuting (e.g., walking) to parks among men and women and park characteristics associated with observed moderate-to-vigorous physical activity (MVPA) within neighborhood parks. METHODS We used systematic direct observation to quantify parks visitors of all ages in 162 U.S. neighborhood parks in 25 cities in 2016 and surveyed a sample of adult visitors (877 women and 793 men). We used descriptive statistics to identify park facilities, amenities, and park management practices associated with park use. We also conducted multivariate regressions to identify factors most closely associated with observed park-based MVPA among all age groups and with self-reported levels of active commuting to parks among adults. RESULTS Reasons to visit parks varied by gender, with women more likely than men to bring children (59% vs 42% for men; p < .001), and men more likely than women to go to parks to relax (38% vs 29%; p = .01). Bringing children to parks was associated with more motorized transport among women, but not among men. Active commuting to parks was associated with living closer to parks (β = -0.92; p < .0001), a greater frequency of park use (β = 0.99; p < .0001), and the park having a working drinking fountain (β = 0.62; p = .01), with no significant differences between men and women. Men and boys used park facilities very differently than women and girls. Men and boys engaged in the most MVPA in soccer fields, gyms, and skate parks, whereas for women and girls the top three sites were pools, playgrounds, and walking paths. CONCLUSIONS Significant gender differences in why men and women visit parks and how parks are used likely reflect cultural determinants of gender roles. Our findings suggest that park management practices should be adjusted to mitigate the lower use of parks and lower levels of park-based MVPA among women and girls compared with men and boys.
Collapse
Affiliation(s)
- Deborah A Cohen
- RAND Corporation, Santa Monica, California; Kaiser Permanente, Research and Evaluation, Pasadena, California.
| | | | - Bing Han
- RAND Corporation, Santa Monica, California
| |
Collapse
|
4
|
Herrador-Colmenero M, Segura-Jiménez V, Álvarez-Gallardo IC, Soriano-Maldonado A, Camiletti-Moirón D, Delgado-Fernández M, Chillón P. Is active commuting associated with sedentary behaviour and physical activity in women with fibromyalgia? The al-Ándalus project. Disabil Rehabil 2021; 44:4602-4610. [PMID: 33645371 DOI: 10.1080/09638288.2021.1884758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE This study aimed to examine the association between active commuting and sedentary time (ST) and physical activity (PA) in women with fibromyalgia. MATERIALS AND METHODS This cross-sectional study included 420 women with fibromyalgia (aged 30 to 74 years old) from Spain. The participants wore an accelerometer during seven days to record ST and PA. They also self-reported patterns of active commuting. Linear regression analyses were conducted to examine the relationships between commuting and accelerometer outcomes. Age, pressure pain threshold, and accelerometer wear time were used as confounders. RESULTS There was a negative association between active commuting and ST whereas active commuting was positively associated with moderate PA, moderate-to-vigorous PA, total PA, and step count (all p ≤ 0.01). No associations were observed in the older group. CONCLUSION Younger women with fibromyalgia who were active commuters spent less ST and were involved in greater PA than passive commuters. This study highlights the importance of promoting active commuting to increase PA among young women with fibromyalgia, while other sources of PA might be recommended for older patients if levels of active commuting are not increased.Implications for rehabilitationActive commuting is a source to increase PA in women with fibromyalgia.Active commuting alone does not seem to be enough to increase PA levels in older women with fibromyalgia and additional PA strategies should be implemented.Promotion of active commuting in young women with fibromyalgia is recommended.
Collapse
Affiliation(s)
- Manuel Herrador-Colmenero
- La Inmaculada Teacher Training Centre, University of Granada, Granada, Spain.,PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Víctor Segura-Jiménez
- GALENO Research Group, Department of Physical Education, Faculty of Education, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | - Inmaculada C Álvarez-Gallardo
- GALENO Research Group, Department of Physical Education, Faculty of Education, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.,SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Daniel Camiletti-Moirón
- GALENO Research Group, Department of Physical Education, Faculty of Education, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | - Manuel Delgado-Fernández
- PA-HELP 'PA-HELP: Physical Activity for HEaLth Promotion' research group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Palma Chillón
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| |
Collapse
|
5
|
Lorenzo E, Szeszulski J, Shin CN, Todd M, Lee RE. Relationship between walking for active transportation and cardiometabolic health among adults: A systematic review. JOURNAL OF TRANSPORT & HEALTH 2020; 19:100927. [PMID: 34676154 PMCID: PMC8525782 DOI: 10.1016/j.jth.2020.100927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Elizabeth Lorenzo
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3 St., Phoenix, Arizona, 85004, United States
| | - Jacob Szeszulski
- Center for Health Promotion and Prevention Research, Michael Susan Dell Center for Healthy Living, University of Texas Health Science Center at 7000 Fannin St. #2528 Houston, Texas, United States
| | - Cha-Nam Shin
- Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3 St., Phoenix, Arizona, 85004, United States
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3 St., Phoenix, Arizona, 85004, United States
| | - Rebecca E. Lee
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3 St., Phoenix, Arizona, 85004, United States
| |
Collapse
|
6
|
Hajna S, White T, Panter J, Brage S, Wijndaele K, Woodcock J, Ogilvie D, Imamura F, Griffin SJ. Driving status, travel modes and accelerometer-assessed physical activity in younger, middle-aged and older adults: a prospective study of 90 810 UK Biobank participants. Int J Epidemiol 2020; 48:1175-1186. [PMID: 31004155 PMCID: PMC6693808 DOI: 10.1093/ije/dyz065] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2019] [Indexed: 01/24/2023] Open
Abstract
Background Associations between driving and physical-activity (PA) intensities are unclear, particularly among older adults. We estimated prospective associations of travel modes with total PA, sedentary time (ST), light-intensity PA (LPA), and moderate-to-vigorous intensity PA (MVPA) among adults aged 39–70 years. Methods We studied 90 810 UK Biobank participants (56.1 ± 7.8 years). Driving status, specific travel modes (non-work travel; commuting to/from work) and covariates were assessed by questionnaire (2006–10). PA was assessed over 7 days by wrist-worn accelerometers (2013–15). We estimated associations using overall and age-stratified multivariable linear-regression models. Results Drivers accumulated 1.4% more total PA (95% confidence interval: 0.9, 1.9), 11.2 min/day less ST (–12.9, –9.5), 12.2 min/day more LPA (11.0, 13.3) and 0.9 min/day less MVPA (–1.6, –0.2) than non-drivers. Compared with car/motor-vehicle users, cyclists and walkers had the most optimal activity profiles followed by mixed-mode users (e.g. for non-work travel, cyclists: 10.7% more total PA, 9.0, 12.4; 20.5 min/day less ST, –26.0, –15.0; 14.5 min/day more MVPA, 12.0, 17.2; walkers: 4.2% more total PA, 3.5, 5.0; 7.5 min/day less ST –10.2, –4.9; 10.1 min/day more MVPA, 8.9, 11.3; mixed-mode users: 2.3% more total PA, 1.9, 2.7; 3.4 min/day less ST –4.8, –2.1; 4.9 min/day more MVPA, 4.3, 5.5). Some associations varied by age (p interaction < 0.05), but these differences appeared small. Conclusions Assessing specific travel modes rather than driving status alone may better capture variations in activity. Walking, cycling and, to a lesser degree, mixed-mode use are associated with more optimal activity profiles in adults of all ages.
Collapse
Affiliation(s)
- Samantha Hajna
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.,UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Tom White
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Jenna Panter
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.,UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Søren Brage
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - James Woodcock
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.,UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - David Ogilvie
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.,UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Fumiaki Imamura
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| | - Simon J Griffin
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.,UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK.,Primary Care Unit, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
| |
Collapse
|
7
|
Active and Fit Communities. Associations between Neighborhood Walkability and Health-Related Fitness in Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041131. [PMID: 32053915 PMCID: PMC7068275 DOI: 10.3390/ijerph17041131] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/07/2020] [Accepted: 02/08/2020] [Indexed: 12/16/2022]
Abstract
There are many health benefits of regular physical activity and improving physical fitness levels can reduce the risk of chronic disease. Accumulating evidence suggests the neighborhood built environment is important for supporting physical activity; however, few studies have investigated the contribution of the neighborhood built environment to fitness levels. We examined the associations between objectively-determined and self-reported neighborhood walkability and overall and specific components of perceived health-related fitness (cardiorespiratory, muscular strength, and flexibility) in a random sample of 592 adults from two areas of Calgary (Canada). Participants provided complete data to an online questionnaire capturing perceived cardiorespiratory fitness (CRF), muscular strength (MST), flexibility, moderate-to-vigorous intensity physical activity (MVPA), resistance training, and sociodemographic characteristics. The questionnaire also captured participant’s perceptions of their neighborhood’s walkability (Physical Activity Neighborhood Environment Scale; PANES) and the physical activity supportiveness of neighborhood parks (Park Perceptions Index; PPI). Objectively-measured neighborhood walkability was estimated using Walk Score®. The average (SD) age of participants was 46.6 (14.8) years and 67.2% were female. Participants, on average, participated in at least 30-minutes of MVPA on 3.4 (2.1) days/week and undertook resistance training 2.0 (1.8) days/week. Adjusting for covariates, Walk Score® was not associated with any fitness outcomes. Adjusting for covariates, the PANES index was positively associated (p < 0.05) with CRF, MST, flexibility, and overall fitness and the PPI was positively associated (p < 0.05) with all fitness outcomes except MST. Our findings provide novel preliminary evidence suggesting the neighborhood built environment may be important for supporting higher health-related fitness levels in adults.
Collapse
|
8
|
Whitaker KM, Xiao Q, Pettee Gabriel K, Gordon Larsen P, Jacobs DR, Sidney S, Reis JP, Barone Gibbs B, Sternfeld B, Kershaw K. Perceived and objective characteristics of the neighborhood environment are associated with accelerometer-measured sedentary time and physical activity, the CARDIA Study. Prev Med 2019; 123:242-249. [PMID: 30940573 PMCID: PMC9036921 DOI: 10.1016/j.ypmed.2019.03.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 03/20/2019] [Accepted: 03/28/2019] [Indexed: 11/24/2022]
Abstract
We investigated cross-sectional and longitudinal associations of neighborhood environment characteristics with accelerometer-measured sedentary time (SED), light-intensity physical activity (LPA), and moderate-to-vigorous intensity physical activity (MVPA). Participants were 2120 men and women in the year 20 (2005-2006) and year 30 CARDIA exams (2015-2016). Year 20 neighborhood characteristics included neighborhood cohesion, resources for physical activity, poverty, and racial residential segregation. Physical activity was measured by accelerometer at years 20 and 30. Multivariable linear regression models examined associations of standardized neighborhood measures at year 20 with SED, LPA, and MVPA assessed that year, and with 10-year changes in SED, LPA, and MVPA. Cross-sectionally, a one standard deviation (SD) increase in cohesion was associated with 4.06 less SED min/day (95% CI: -7.98, -0.15), and 4.46 more LPA min/day (95% CI: 0.88, 8.03). Each one SD increase in resources was associated with 1.19 more MVPA min/day (95% CI: 0.06, 2.31). A one SD increase in poverty was associated with 11.18 less SED min/day (95% CI: -21.16, -1.18) and 10.60 more LPA min/day (95% CI: 1.79, 19.41) among black men. No neighborhood characteristic was associated with 10-year changes in physical activity in the full sample; however, a one SD increase in cohesion was associated with a 10-year decrease of 25.44 SED min/day (95% CI: -46.73, -4.14) and an increase of 19.0 LPA min/day (95% CI, 1.89, 36.10) in black men. Characteristics of the neighborhood environment are associated with accelerometer-measured physical activity. Differences were observed by race and sex, with more robust findings observed in black men.
Collapse
Affiliation(s)
- Kara M Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, United States of America; Department of Epidemiology, University of Iowa, Iowa City, IA, United States of America.
| | - Qian Xiao
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, United States of America; Department of Epidemiology, University of Iowa, Iowa City, IA, United States of America
| | - Kelley Pettee Gabriel
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health - Austin Campus, University of Texas Health Science Center at Houston, Austin, TX, United States of America; The University of Texas at Austin, Dell Medical School, Department of Women's Health, Austin, TX, United States of America
| | - Penny Gordon Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Jared P Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America
| | - Bethany Barone Gibbs
- Department of Health and Physical Activity, School of Education, University of Pittsburgh., United States of America
| | - Barbara Sternfeld
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Kiarri Kershaw
- Preventive Medicine, Northwestern University, Chicago, IL, United States of America
| |
Collapse
|
9
|
Nordengen S, Andersen LB, Solbraa AK, Riiser A. Cycling and cardiovascular disease risk factors including body composition, blood lipids and cardiorespiratory fitness analysed as continuous variables: Part 2—systematic review with meta-analysis. Br J Sports Med 2019; 53:879-885. [DOI: 10.1136/bjsports-2018-099778] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2018] [Indexed: 01/19/2023]
Abstract
ObjectivesWe aimed to examine the relationship between cycling (particularly commuter cycling) and risk factors associated with cardiovascular diseases (CVDs) including body composition, blood lipids and cardiorespiratory fitness. This study differed from our recent (Part 1) systematic review in that risk factors for CVD were analysed as continuous variables rather than being present or absent.DesignSystematic review and meta-analysis.Eligibility criteriaWe searched four databases (Web of Science, MEDLINE, SPORTDiscus and Scopus). All quantitative studies, published until August 2017, were included when a general population was investigated, cycling was assessed either in total or as a transportation mode, and CVD risk factors were reported.MethodsWe analysed body composition, physical activity (PA), cardiorespiratory fitness (CRF), blood lipids and blood pressure (BP). Skinfold, waist circumference and body mass index were analysed and prioritised in that order when more than one measure were available. PA included measures of counts per minutes, moderate-to-vigorous PA or minutes per week. CRF included results of maximal tests with or without expired air or submaximal test. For blood lipids and BP, separate analyses were run for low-density and high-density lipoprotein, triglycerides, total cholesterol, systolic BP and diastolic BP. Studies were excluded when reporting dichotomous outcomes or when cycling and walking were combined. Heterogeneity was investigated using I2.ResultsFifteen studies were included; the majority reported commuter cycling. In total, we included 5775 cyclists and 39 273 non-cyclists. Cyclists had more favourable risk factor levels in body composition −0.08 (95% CI −0.13 to −0.04), PA 0.13 (95% CI 0.06 to 0.20), CRF 0.28 (95% CI 0.22 to 0.35) and blood lipids compared with non-cyclists. There was no sex difference in risk reduction.Conclusion/implicationCycling mitigated the risk factor profile for CVD. A strength of this systematic review is that all the risk factors were analysed as continuous variables. These data provide evidence for practitioners, stakeholders, policy-makers and city planners to accommodate and promote cycling.Systematic review registrationPROSPERO CRD42016052421.
Collapse
|
10
|
Zwald ML, Fakhouri THI, Fryar CD, Whitfield G, Akinbami LJ. Trends in active transportation and associations with cardiovascular disease risk factors among U.S. adults, 2007-2016. Prev Med 2018; 116:150-156. [PMID: 30227156 PMCID: PMC7216826 DOI: 10.1016/j.ypmed.2018.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/06/2018] [Accepted: 09/11/2018] [Indexed: 11/27/2022]
Abstract
Active transportation (AT), or walking or bicycling for transportation, represents one way individuals can achieve recommended physical activity (PA) levels. This study describes AT prevalence and temporal trends, and examines associations between AT levels and measured CVD risk factors (hypertension, hypercholesterolemia, low high-density [HDL] cholesterol, diabetes, and obesity) among U.S. adults. National Health and Nutrition Examination Survey (NHANES) 2007-2016 data (analyzed in 2017) were used to conduct overall trend analyses of reported AT in a typical week [none (0-9 min/week); low (10-149 min/week); or high (≥150 min/week)]. Logistic regression was used to examine associations between AT level and each CVD risk factor from NHANES 2011-2016 (n = 13,943). Covariates included age, sex, race/Hispanic origin, education, income, smoking, survey cycle, non-transportation PA, and urbanization level. U.S. adults who engaged in high AT levels increased from 13.1% in 2007-2008 to 17.9% in 2011-2012, and then decreased to 10.6% in 2015-2016 (p for quadratic trend = 0.004). Over the same period, the quadratic trend for low AT was not significant. During 2011-2016, 14.3% of adults engaged in high AT, 11.4% in low AT, and 74.4% in no AT. High AT levels were associated with decreased odds of each CVD risk factor assessed, compared to no AT. Low AT (versus no AT) was associated with decreased odds of hypertension (aOR = 0.77, 95% CI 0.64, 0.91) and diabetes (aOR = 0.68, 95% CI 0.54, 0.85). AT prevalence among adults has fluctuated from 2007 to 2016. Despite favorable associations between AT and CVD risk factors, most U.S. adults do not engage in any AT.
Collapse
Affiliation(s)
- Marissa L Zwald
- Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Nutrition Examination and Health Surveys, United States of America; Centers for Disease Control and Prevention, Epidemic Intelligence Service, United States of America; United States Public Health Service, United States of America.
| | - Tala H I Fakhouri
- Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Nutrition Examination and Health Surveys, United States of America
| | - Cheryl D Fryar
- Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Nutrition Examination and Health Surveys, United States of America
| | - Geoffrey Whitfield
- Centers for Disease Control and Prevention, National Center for Chronic Disease and Health Promotion, Division of Nutrition, Physical Activity and Obesity, United States of America
| | - Lara J Akinbami
- Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Nutrition Examination and Health Surveys, United States of America; United States Public Health Service, United States of America
| |
Collapse
|
11
|
Whitaker KM, Jacobs DR, Kershaw KN, Demmer RT, Booth JN, Carson AP, Lewis CE, Goff DC, Lloyd-Jones DM, Gordon-Larsen P, Kiefe CI. Racial Disparities in Cardiovascular Health Behaviors: The Coronary Artery Risk Development in Young Adults Study. Am J Prev Med 2018; 55:63-71. [PMID: 29776780 PMCID: PMC6014889 DOI: 10.1016/j.amepre.2018.03.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/16/2018] [Accepted: 03/21/2018] [Indexed: 10/14/2022]
Abstract
INTRODUCTION There are known racial differences in cardiovascular health behaviors, including smoking, physical activity, and diet quality. A better understanding of these differences may help identify intervention targets for reducing cardiovascular disease disparities. This study examined whether socioeconomic, psychosocial, and neighborhood environmental factors, in isolation or together, mediate racial differences in health behaviors. METHODS Participants were 3,081 men and women from the Coronary Artery Risk Development in Young Adults study who were enrolled in 1985-1986 (Year 0) and completed a follow-up examination in 2015-2016 (Year 30). A health behavior score was created at Years 0, 7, 20, and 30 using smoking, physical activity, and diet assessed that year. The race difference in health behavior score was estimated using linear regression in serial cross-sectional analyses. Mediation analyses computed the proportion of the race and health behavior score association attributable to socioeconomic, psychosocial, and neighborhood factors. RESULTS Data analysis conducted in 2016-2017 found that blacks had significantly lower health behavior scores than whites across 30 years of follow-up. Individual socioeconomic factors mediated 48.9%-70.1% of the association between race and health behavior score, psychosocial factors 20.3%-30.0%, and neighborhood factors 22.1%-41.4% (p<0.01 for all). CONCLUSIONS Racial differences in health behavior scores appear to be mediated predominately by correspondingly large differences in socioeconomic factors. This study highlights the profound impact of socioeconomic factors, which are mostly not under an individual's control, on health behaviors. Policy action targeting socioeconomic factors may help reduce disparities in health behaviors.
Collapse
Affiliation(s)
- Kara M Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa.
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | | | - Ryan T Demmer
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - John N Booth
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - April P Carson
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Cora E Lewis
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - David C Goff
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | | | - Penny Gordon-Larsen
- Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina
| | - Catarina I Kiefe
- Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| |
Collapse
|
12
|
Yang L, Hu L, Hipp JA, Imm KR, Schutte R, Stubbs B, Colditz GA, Smith L. Cross-sectional associations of active transport, employment status and objectively measured physical activity: analyses from the National Health and Nutrition Examination Survey. J Epidemiol Community Health 2018; 72:764-769. [PMID: 29730607 PMCID: PMC6086741 DOI: 10.1136/jech-2017-210265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 03/16/2018] [Accepted: 04/19/2018] [Indexed: 11/20/2022]
Abstract
Background To investigate associations between active transport, employment status and objectively measured moderate-to-vigorous physical activity (MVPA) in a representative sample of US adults. Methods Cross-sectional analyses of data from the National Health and Nutrition Examination Survey. A total of 5180 adults (50.2 years old, 49.0% men) were classified by levels of active transportation and employment status. Outcome measure was weekly time spent in MVPA as recorded by the Actigraph accelerometer. Associations between active transport, employment status and objectively measured MVPA were examined using multivariable linear regression models adjusted for age, BMI, race and ethnicity, education level, marital status, smoking status, working hour duration (among the employed only), and self-reported leisure time physical activity. Results Patterns of active transport were similar between the employed (n=2,897) and unemployed (n=2,283), such that 76.0% employed and 77.5% unemployed engaged in no active transport. For employed adults, those engaging in high levels of active transport (≥90 min/week) had higher amount of MVPA than those who did not engage in active transport. This translated to 40.8 (95% CI: 15.7, 65.9) additional minutes MVPA per week in men and 57.9 (95% CI: 32.1, 83.7) additional minutes MVPA per week in women. Among the unemployed adults, higher levels of active transport were associated with more MVPA among men (44.8 min/week MVPA, 95% CI: 9.2, 80.5), only. Conclusions Findings from the present study support interventions to promote active transport to increase population level physical activity. Additional strategies are likely required to promote physical activity among unemployed women.
Collapse
Affiliation(s)
- Lin Yang
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria.,Division of Public Health Sciences, School of Medicine, Washington University, Saint Louis, Missouri, USA
| | - Liang Hu
- Department of Sport Science, Zhejiang University College of Education, Hangzhou, China
| | - J Aaron Hipp
- Center for Geospatial Analytics, Department of Parks, Recreation and Tourism Management, North Carolina State University, Raleigh, North Carolina, USA
| | - Kellie R Imm
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Rudolph Schutte
- Department of Medical Science and Public Health, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
| | - Graham A Colditz
- Division of Public Health Sciences, School of Medicine, Washington University, Saint Louis, Missouri, USA
| | - Lee Smith
- Faculty of Science and Technology, Sports and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| |
Collapse
|
13
|
Neighbourhood Built Environment Influences on Physical Activity among Adults: A Systematized Review of Qualitative Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050897. [PMID: 29724048 PMCID: PMC5981936 DOI: 10.3390/ijerph15050897] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 04/19/2018] [Accepted: 04/21/2018] [Indexed: 11/17/2022]
Abstract
Qualitative studies can provide important information about how and why the built environment impacts physical activity decision-making—information that is important for informing local urban policies. We undertook a systematized literature review to synthesize findings from qualitative studies exploring how the built environment influences physical activity in adults. Our review included 36 peer-reviewed qualitative studies published from 1998 onwards. Our findings complemented existing quantitative evidence and provided additional insight into how functional, aesthetic, destination, and safety built characteristics influence physical activity decision-making. Sociodemographic characteristics (age, sex, ethnicity, and socioeconomic status) also impacted the BE’s influence on physical activity. Our review findings reinforce the need for synergy between transportation planning, urban design, landscape architecture, road engineering, parks and recreation, bylaw enforcement, and public health to be involved in creating neighbourhood environments that support physical activity. Our findings support a need for local neighbourhood citizens and associations with representation from individuals and groups with different sociodemographic backgrounds to have input into neighbourhood environment planning process.
Collapse
|
14
|
The Effect of Sharrows, Painted Bicycle Lanes and Physically Protected Paths on the Severity of Bicycle Injuries Caused by Motor Vehicles. SAFETY 2016; 2. [PMID: 29564357 PMCID: PMC5858726 DOI: 10.3390/safety2040026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We conducted individual and ecologic analyses of prospectively collected data from 839 injured bicyclists who collided with motorized vehicles and presented to Bellevue Hospital, an urban Level-1 trauma center in New York City, from December 2008 to August 2014. Variables included demographics, scene information, rider behaviors, bicycle route availability, and whether the collision occurred before the road segment was converted to a bicycle route. We used negative binomial modeling to assess the risk of injury occurrence following bicycle path or lane implementation. We dichotomized U.S. National Trauma Data Bank Injury Severity Scores (ISS) into none/mild (0-8) versus moderate, severe, or critical (>8) and used adjusted multivariable logistic regression to model the association of ISS with collision proximity to sharrows (i.e., bicycle lanes designated for sharing with cars), painted bicycle lanes, or physically protected paths. Negative binomial modeling of monthly counts, while adjusting for pedestrian activity, revealed that physically protected paths were associated with 23% fewer injuries. Painted bicycle lanes reduced injury risk by nearly 90% (IDR 0.09, 95% CI 0.02-0.33). Holding all else equal, compared to no bicycle route, a bicycle injury nearby sharrows was nearly twice as likely to be moderate, severe, or critical (adjusted odds ratio 1.94; 95% confidence interval (CI) 0.91-4.15). Painted bicycle lanes and physically protected paths were 1.52 (95% CI 0.85-2.71) and 1.66 (95% CI 0.85-3.22) times as likely to be associated with more than mild injury respectively.
Collapse
|
15
|
Brown BB, Tharp D, Tribby CP, Smith KR, Miller HJ, Werner CM. Changes in bicycling over time associated with a new bike lane: relations with kilocalories energy expenditure and body mass index. JOURNAL OF TRANSPORT & HEALTH 2016; 3:357-365. [PMID: 27672561 PMCID: PMC5034937 DOI: 10.1016/j.jth.2016.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Although bicycling has been related to positive health indicators, few studies examine health-related measures associated with non-competitive community cycling before and after cycling infrastructure improvements. This study examined cycling changes in a neighborhood receiving a bike lane, light rail, and other "complete street" improvements. Participants wore accelerometers and global positioning system (GPS) data loggers for one week in both 2012 and 2013, pre- and post- construction completion. Participants sampled within 2 km of the complete street improvements had the following patterns of cycling: never cyclists (n=434), continuing cyclists (n= 29), former cyclists (n=33, who bicycled in 2012 but not 2013), and new cyclists (n=40, who bicycled in 2013 but not 2012). Results show that all three cycling groups, as identified by GPS/accelerometry data, expended more estimated kilocalories (kcal) of energy per minute during the monitoring week than those who were never detected cycling, net of control variables. Similar but attenuated results emerged when cycling self-report measures were used. BMI was not related to cycling group but those who cycled longer on the new path had lower BMI. Although cyclists burn more calories than non-cyclists across the week, among cyclists, their cycling days involved more calories expended than their non-cycling days. The new cyclists account for 39% of the cyclists identified in this study and former cyclists account for 32% of cyclists. These results suggest that cycling is healthy, but that sustaining rates of cycling will be an important goal for future policy and research.
Collapse
Affiliation(s)
- Barbara B. Brown
- Department of Family and Consumer Studies; Cancer Control and Population Sciences, Huntsman Cancer Institute, 225 S 1400 E RM 228, University of Utah, Salt Lake City, UT, USA
| | - Douglas Tharp
- Department of Family & Consumer Studies, 225 S 1400 E RM 228, University of Utah, Salt Lake City, UT, USA
| | - Calvin P. Tribby
- Department of Geography; Ohio State University, 1036 Derby Hall, 154 N. Oval Mall, The Ohio State University, Columbus, OH, USA
| | - Ken R. Smith
- Department of Family and Consumer Studies; Cancer Control and Population Sciences, Huntsman Cancer Institute, 225 S 1400 E RM 228, University of Utah, Salt Lake City, UT, USA
| | - Harvey J. Miller
- Department of Geography; Ohio State University, 1036 Derby Hall, 154 N. Oval Mall, The Ohio State University, Columbus, OH, USA
| | - Carol M. Werner
- Department of Psychology, 380 S. 1530 E., RM 502 BSB, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
16
|
Slater ME, Kelly AS, Sadak KT, Ross JA. Active transportation in adult survivors of childhood cancer and neighborhood controls. J Cancer Surviv 2016; 10:11-20. [PMID: 25809159 PMCID: PMC4583837 DOI: 10.1007/s11764-015-0447-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 03/12/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE Childhood cancer survivors (CCS) are at high risk of treatment-related late effects, including cardiovascular disease and diabetes, which can be exacerbated by inadequate physical activity (PA). Previous PA interventions targeting CCS have focused on the domain of leisure-time/recreational PA. Active transportation, another domain of PA, has not been described in CCS. Therefore, this study aimed to identify active transportation behaviors, barriers, and correlates in adult CCS. METHODS We recruited 158 adult CCS and 153 controls matched on age, sex, and neighborhood for a survey regarding active transportation behaviors and perceptions. Linear and logistic regression models accounting for correlation among matched participants were used. RESULTS Adult CCS engaged in similar levels of active transportation as controls (2.72 vs. 2.32 h/week, P = 0.40) despite perceiving greater health-related barriers (1.88 vs. 1.65 (measured on four-point Likert scale), P = 0.01). Marital/relationship status (odds ratio (OR) = 0.30, 95 % confidence interval (CI) = 0.11-0.81), planning/psychosocial barriers (OR = 0.15, 95 % CI = 0.04-0.53), and perceived neighborhood walkability (OR = 2.55, 95 % CI = 1.14-5.66) were correlates of active transportation among adult CCS, while objective neighborhood walkability (OR = 1.03, 95 % CI = 1.01-1.05) was a correlate among controls. CONCLUSIONS Results suggest adult CCS and controls utilize active transportation at approximately equal levels. Factors other than health, including perceived neighborhood walkability, are related to active transportation behaviors to a greater degree in adult CCS. IMPLICATIONS FOR CANCER SURVIVORS Interventions might consider promoting active transportation as a way to incorporate more PA into the daily lives of adult CCS. Such interventions will not be likely successful, however, without existing or improved neighborhood walkability/bikeability.
Collapse
Affiliation(s)
- Megan E Slater
- Division of Epidemiology and Clinical Research, Division of Pediatric Hematology/Oncology, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Aaron S Kelly
- Division of Epidemiology and Clinical Research, Division of Pediatric Hematology/Oncology, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Karim T Sadak
- Division of Epidemiology and Clinical Research, Division of Pediatric Hematology/Oncology, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Julie A Ross
- Division of Epidemiology and Clinical Research, Division of Pediatric Hematology/Oncology, Department of Pediatrics, Masonic Cancer Center, University of Minnesota, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| |
Collapse
|
17
|
Evenson KR, Wen F, Hillier A, Cohen DA. Assessing the contribution of parks to physical activity using global positioning system and accelerometry. Med Sci Sports Exerc 2013; 45:1981-7. [PMID: 23531716 PMCID: PMC3778115 DOI: 10.1249/mss.0b013e318293330e] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Parks offer a free option for physical activity in many communities. How much time people spend using parks and the contribution that parks makes to their physical activity is not known. This study describes patterns of park use and physical activity among a diverse adult sample. METHODS From five US states, 248 adults enrolled in or near 31 study parks. Participants wore a global positioning system (GPS) monitor (Qstarz BT-Q1000X) and an ActiGraph accelerometer (GT1M) concurrently for 3 wk. Parks were mapped from local and national park shape files. Park visits and travel to and from the parks were derived from the objective data. RESULTS Participants visited parks a median of 2.3 times per week, and park visits lasted a median of 42.0 min. Overall, participants engaged in a median of 21.7 min·d-1 of moderate activity and 0.1 min·d-1 of vigorous activity, with an average of 8.2% of all moderate and 9.4% of all vigorous activity occurring within the parks. Among those with at least one park visit (n = 218), counts per minute, moderate, moderate-to-vigorous physical activity (MVPA), number and time in MVPA bouts per day, and sedentary behavior were all higher on days when a park was visited compared with days when a park was not visited. Considering several definitions of active travel, walking or bicycling to and from the park added an additional 3.7-6.6 mean minutes of MVPA per park visit. CONCLUSIONS Parks contributed as a place and destination for physical activity but were underused. One of the next steps in this line of inquiry is to understand characteristics of parks used more often as a place and destination for physical activity.
Collapse
Affiliation(s)
- Kelly R. Evenson
- University of North Carolina - Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC, USA
- University of North Carolina - Chapel Hill, Center for Health Promotion and Disease Prevention, Chapel Hill, NC, USA
| | - Fang Wen
- University of North Carolina - Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC, USA
| | - Amy Hillier
- University of Pennsylvania, Department of City and Regional Planning, Philadelphia, PA, USA
| | | |
Collapse
|
18
|
Freeman L, Neckerman K, Schwartz-Soicher O, Quinn J, Richards C, Bader MDM, Lovasi G, Jack D, Weiss C, Konty K, Arno P, Viola D, Kerker B, Rundle AG. Neighborhood walkability and active travel (walking and cycling) in New York City. J Urban Health 2013; 90:575-85. [PMID: 22941058 PMCID: PMC3732693 DOI: 10.1007/s11524-012-9758-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Urban planners have suggested that built environment characteristics can support active travel (walking and cycling) and reduce sedentary behavior. This study assessed whether engagement in active travel is associated with neighborhood walkability measured for zip codes in New York City. Data were analyzed on engagement in active travel and the frequency of walking or biking ten blocks or more in the past month, from 8,064 respondents to the New York City 2003 Community Health Survey (CHS). A neighborhood walkability scale that measures: residential, intersection, and subway stop density; land use mix; and the ratio of retail building floor area to retail land area was calculated for each zip code. Data were analyzed using zero-inflated negative binomial regression incorporating survey sample weights and adjusting for respondents' sociodemographic characteristics. Overall, 44 % of respondents reported no episodes of active travel and among those who reported any episode, the mean number was 43.2 episodes per month. Comparing the 75th to the 25th percentile of zip code walkability, the odds ratio for reporting zero episodes of active travel was 0.71 (95 % CI 0.61, 0.83) and the exponentiated beta coefficient for the count of episodes of active travel was 1.13 (95 % CI 1.06, 1.21). Associations between lower walkability and reporting zero episodes of active travel were significantly stronger for non-Hispanic Whites as compared to non-Hispanic Blacks and to Hispanics and for those living in higher income zip codes. The results suggest that neighborhood walkability is associated with higher engagement in active travel.
Collapse
Affiliation(s)
- Lance Freeman
- Graduate School of Architecture, Planning and Preservation, Columbia University, New York, NY, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Sahlqvist S, Goodman A, Cooper AR, Ogilvie D. Change in active travel and changes in recreational and total physical activity in adults: longitudinal findings from the iConnect study. Int J Behav Nutr Phys Act 2013; 10:28. [PMID: 23445724 PMCID: PMC3598920 DOI: 10.1186/1479-5868-10-28] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 02/20/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To better understand the health benefits of promoting active travel, it is important to understand the relationship between a change in active travel and changes in recreational and total physical activity. METHODS These analyses, carried out in April 2012, use longitudinal data from 1628 adult respondents (mean age 54 years; 47% male) in the UK-based iConnect study. Travel and recreational physical activity were measured using detailed seven-day recall instruments. Adjusted linear regression models were fitted with change in active travel defined as 'decreased' (<-15 min/week), 'maintained' (± 15 min/week) or 'increased' (>15 min/week) as the primary exposure variable and changes in (a) recreational and (b) total physical activity (min/week) as the primary outcome variables. RESULTS Active travel increased in 32% (n=529), was maintained in 33% (n=534) and decreased in 35% (n=565) of respondents. Recreational physical activity decreased in all groups but this decrease was not greater in those whose active travel increased. Conversely, changes in active travel were associated with commensurate changes in total physical activity. Compared with those whose active travel remained unchanged, total physical activity decreased by 176.9 min/week in those whose active travel had decreased (adjusted regression coefficient -154.9, 95% CI -195.3 to -114.5) and was 112.2 min/week greater among those whose active travel had increased (adjusted regression coefficient 135.1, 95% CI 94.3 to 175.9). CONCLUSION An increase in active travel was associated with a commensurate increase in total physical activity and not a decrease in recreational physical activity.
Collapse
Affiliation(s)
- Shannon Sahlqvist
- Centre for Physical Activity and Nutrition Research (C-PAN) School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Medical Research Council Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, Cambridge, UK
| | - Anna Goodman
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ashley R Cooper
- Centre for Exercise, Nutrition and Health Sciences, School of Policy Studies, University of Bristol, Bristol, UK
| | - David Ogilvie
- Medical Research Council Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, Cambridge, UK
| |
Collapse
|
20
|
Abstract
Technology linked with reduced physical activity (PA) in occupational work, home/domestic work, and travel and increased sedentary activities, especially television viewing, dominates the globe. Using detailed historical data on time allocation, occupational distributions, energy expenditures data by activity, and time-varying measures of metabolic equivalents of task (MET) for activities when available, we measure historical and current MET by four major PA domains (occupation, home production, travel and active leisure) and sedentary time among adults (>18 years). Trends by domain for the United States (1965-2009), the United Kingdom (1961-2005), Brazil (2002-2007), China (1991-2009) and India (2000-2005) are presented. We also project changes in energy expenditure by domain and sedentary time (excluding sleep and personal care) to 2020 and 2030 for each of these countries. The use of previously unexplored detailed time allocation and energy expenditures and other datasets represents a useful addition to our ability to document activity and inactivity globally, but highlights the need for concerted efforts to monitor PA in a consistent manner globally, increase global PA and decrease sedentary behavior. Given the potential impact on weight gain and other cardiometabolic health risks, the differential declines in MET of activity and increases in sedentary time across the globe represent a major threat to global health.
Collapse
Affiliation(s)
- S W Ng
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA.
| | | |
Collapse
|
21
|
Wanner M, Götschi T, Martin-Diener E, Kahlmeier S, Martin BW. Active transport, physical activity, and body weight in adults: a systematic review. Am J Prev Med 2012; 42:493-502. [PMID: 22516490 DOI: 10.1016/j.amepre.2012.01.030] [Citation(s) in RCA: 165] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 11/11/2011] [Accepted: 01/06/2012] [Indexed: 11/16/2022]
Abstract
CONTEXT Physical activity has various health benefits. Active transport can contribute to total physical activity and thus affect body weight because of increased energy expenditure. This review summarizes published evidence on associations of active transport, general physical activity, and body weight in adults. EVIDENCE ACQUISITION A systematic review of the literature was conducted in October 2010 using eight databases. A total of 14,216 references were screened; full texts were retrieved for 95 articles. Forty-six articles (36 unique studies) were included: 20 (17) from Europe; 18 (13) from North America, Australia, and New Zealand; and eight (six) from other countries. Analyses of the retrieved papers were carried out between November 2010 and March 2011. EVIDENCE SYNTHESIS Of 15 studies assessing active transport and physical activity, five found associations in the expected direction (more active transport associated with more physical activity) for all or most variables studied, nine found some associations, and one reported no associations. Of 30 studies assessing active transport and body weight, 13 reported associations in the expected direction (more active transport associated with lower body weight) for all or most variables studied, 12 found some associations, two presented some associations in the expected and some in the opposite direction, and three reported no associations. CONCLUSIONS There is limited evidence that active transport is associated with more physical activity as well as lower body weight in adults. However, study heterogeneity, predominantly cross-sectional designs, and crude measures for active transport and physical activity impede quantitative conclusions.
Collapse
Affiliation(s)
- Miriam Wanner
- Physical Activity and Health Unit, Institute of Social and Preventive Medicine, University of Zurich, Switzerland.
| | | | | | | | | |
Collapse
|