Examining longitudinal associations between the recreational physical activity environment, change in body mass index, and obesity by age in 8864 Yorkshire Health Study participants

Residential Density Is Associated With BMI Trajectories in Children and Adolescents: Findings From the Moving to Health Study

Introduction

This study investigates the associations between built environment features and 3-year BMI trajectories in children and adolescents.

Methods

This retrospective cohort study utilized electronic health records of individuals aged 5-18 years living in King County, Washington, from 2005 to 2017. Built environment features such as residential density; counts of supermarkets, fast-food restaurants, and parks; and park area were measured using SmartMaps at 1,600-meter buffers. Linear mixed-effects models performed in 2022 tested whether built environment variables at baseline were associated with BMI change within age cohorts (5, 9, and 13 years), adjusting for sex, age, race/ethnicity, Medicaid, BMI, and residential property values (SES measure).

Results

At 3-year follow-up, higher residential density was associated with lower BMI increase for girls across all age cohorts and for boys in age cohorts of 5 and 13 years but not for the age cohort of 9 years. Presence of fast food was associated with higher BMI increase for boys in the age cohort of 5 years and for girls in the age cohort of 9 years. There were no significant associations between BMI change and counts of parks, and park area was only significantly associated with BMI change among boys in the age cohort of 5 years.

Conclusions

Higher residential density was associated with lower BMI increase in children and adolescents. The effect was small but may accumulate over the life course. Built environment factors have limited independent impact on 3-year BMI trajectories in children and adolescents.

The role of residential greenness levels, green land cover types and diversity in overweight/obesity among older adults: A cohort study

BACKGROUND

Few studies have investigated the effects of greenness exposure, green land cover types and diversity and their interaction with particulate matter (PM) to adiposity.

METHOD

Cohort data were collected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Baseline data on greenness levels, green land cover types and diversity were assessed by the Normalized Difference Vegetation Index (NDVI), three greenery types (trees, shrublands and grassland) and Shannon's diversity index, respectively. Body mass index (BMI) and waist circumference (WC) were separately used as dependent variables and represented for peripheral overweight/obesity and central obesity, respectively. The mixed Cox model with random intercept was used to estimate the effects of greenness levels, types and diversity on overweight/obesity using single and multiple exposure models. We also examined the interaction of PM and the aforementioned indicators on overweight/obesity on both additive and multiplicative scales.

RESULTS

Single exposure models showed that higher levels of residential greenness, tree coverage and ratio of trees to shrublands/grassland were inversely associated with peripheral overweight/obesity and central obesity. An increase in shrublands, grassland and diversity of green was related to lower odds of peripheral overweight/obesity. Multiple exposure models confirmed the association between greenness levels and peripheral overweight/obesity. Males, educated participants and elderly who lived in southern regions and areas with cleaner air environments acquired more benefits from greenspace exposure. Single and multiple exposure models indicated that an antagonistic effect of increasing PM and decreasing greenness levels on peripheral overweight/obesity and central obesity. Single exposure models showed the potential interaction of tree coverage, ratio of trees to grassland and PM_2.5 exposures on the risk of peripheral overweight/obesity.

CONCLUSION

Increasing residential greenness and diversity of green were associated with healthy weight status. The relationship between greenery and overweight/obesity varied, and the effects of greenspace exposure on overweight/obesity were associated with air pollution.

Investigating how researcher-defined buffers and self-drawn neighbourhoods capture adolescent availability to physical activity facilities and greenspaces: An exploratory study

BACKGROUND

Modifying the environment is considered an effective population-level approach for increasing healthy behaviours, but associations remain ambiguous. This exploratory study aims to compare researcher-defined buffers and self-drawn neighbourhoods (SDN) to objectively measured availability of physical activity (PA) facilities and greenspaces in adolescents.

METHODS

Seven consecutive days of GPS data were collected in an adolescent sample of 14-18 year olds (n = 69). Using Points of Interest and greenspace data, availability of PA opportunities within activity spaces were determined. We compared 30 different definitions of researcher-defined neighbourhoods and SDNs to objectively measured availability.

RESULTS

Findings showed low agreement for all researcher-defined buffers in measuring the availability of PA facilities in activity spaces. However, results were less clear for greenspace. SDNs also demonstrate low agreement for capturing availability to the PA environment.

CONCLUSION

This exploratory study highlights the inadequacy of researcher-defined buffers and SDNs to define availability to environmental features.

Associations between neighborhood built environment, residential property values, and adult BMI change: The Seattle Obesity Study III

Objective

To examine associations between neighborhood built environment (BE) variables, residential property values, and longitudinal 1- and 2-year changes in body mass index (BMI).

Methods

The Seattle Obesity Study III was a prospective cohort study of adults with geocoded residential addresses, conducted in King, Pierce, and Yakima Counties in Washington State. Measured heights and weights were obtained at baseline (n = 879), year 1 (n = 727), and year 2 (n = 679). Tax parcel residential property values served as proxies for individual socioeconomic status. Residential unit and road intersection density were captured using Euclidean-based SmartMaps at 800 m buffers. Counts of supermarket (0 versus. 1+) and fast-food restaurant availability (0, 1–3, 4+) were measured using network based SmartMaps at 1600 m buffers. Density measures and residential property values were categorized into tertiles. Linear mixed-effects models tested whether baseline BE variables and property values were associated with differential changes in BMI at year 1 or year 2, adjusting for age, gender, race/ethnicity, education, home ownership, and county of residence. These associations were then tested for potential disparities by age group, gender, race/ethnicity, and education.

Results

Road intersection density, access to food sources, and residential property values were inversely associated with BMI at baseline. At year 1, participants in the 3rd tertile of density metrics and with 4+ fast-food restaurants nearby showed less BMI gain compared to those in the 1st tertile or with 0 restaurants. At year 2, higher residential property values were predictive of lower BMI gain. There was evidence of differential associations by age group, gender, and education but not race/ethnicity.

Conclusion

Inverse associations between BE metrics and residential property values at baseline demonstrated mixed associations with 1- and 2-year BMI change. More work is needed to understand how individual-level sociodemographic factors moderate associations between the BE, property values, and BMI change.

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Strong, inverse cross-sectional relationships between the built environment, residential property values (a proxy for individual socioeconomic status), and measured BMI were observed.

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Measures of the built environment and residential property values showed modest and inconsistent associations with 1- and 2-year BMI change.

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There was suggestive evidence that age may moderate the association between urban density and 1- and 2-year BMI change while education may moderate the association between residential property values and 2-year BMI change.

Effects of Kindergarten, Family Environment, and Physical Activity on Children's Physical Fitness

To explore the relationship between kindergarten environmental factors, children's physical activity, and physical fitness, this study uses the stratified random sampling method to obtain 4,600 children in relevant kindergartens. The questionnaire survey and children's physical fitness test were completed with the help of parents and kindergarten staff. The exploratory (EFA) and confirmatory (CFA) factor analysis is used to process the obtained database and set the significance level of all indicators α = 0.05. The results show that kindergarten environmental factors significantly affect children's physical activity and healthy physical fitness. Children with large play areas in these kindergartens, more sports equipment items, who participate in more than three games per week, of no <40 min of each class, with an appropriate number of classes, and excellent teachers' teaching ability have better physical fitness. Family environmental factors significantly affect children's physical activity and fitness. Children with more family sports equipment items, more peers living nearby, safer playing places, more hands and feet, and parents who are good at sports have better performance in health fitness. Children's physical activity not only directly affects their performance of physical fitness, but also plays a dual intermediary role between kindergarten environment and physical fitness, family environment, and healthy physical fitness.

Benchmarking the driver acceleration impact on vehicle energy consumption and CO2 emissions

The study proposes a methodology for quantifying the impact of real-world heterogeneous driving behavior on vehicle energy consumption, linking instantaneous acceleration heterogeneity and CO₂ emissions. Data recorded from 20 different drivers under real driving are benchmarked against the Worldwide Harmonized Light Vehicle Test Cycle (WLTC), first by correlating the speed cycle with individual driver behavior and then by quantifying the CO₂ emissions and consumption. The vehicle-Independent Driving Style metric (IDS) is used to quantify acceleration dynamicity, introducing driving style stochasticity by means of probability distribution functions. Results show that the WLTC cycle assumes a relatively smooth acceleration style compared to the observed ones. The method successfully associates acceleration dynamicity to CO₂ emissions. We observe a 5% difference in the CO₂ emissions between the most favourable and the least favourable case. The intra-driver variance reached 3%, while the inter-driver variance is below 2%. The approach can be used for quantifying the driving style induced emissions divergence.

Association between residential greenness and overweight/obesity among rural adults in northwestern China

BACKGROUND

Living in greener areas may reduce adiposity, but epidemiological evidence on this topic is still inconsistence and limited, especially in rural areas.

METHODS

We performed a cross-sectional study among 4651 Uyghur adults in rural areas in Xinjiang province, northwestern China, from May to September 2016. We measured residential greenness levels using satellite-derived Normalized Difference Vegetation Index (NDVI) and Soil Adjusted Vegetation Index (SAVI) in 100 m, 300 m, 500 m, and 1000 m buffers around each home address. Body height, weight, and waist circumference were assessed according to recommended guidelines. Data on baseline characteristics and confounders were collected using a questionnaire. We used generalized linear mixed models to estimate the associations of residential greenness with overweight/obesity prevalence and obesity-related anthropometric indices.

RESULTS

Higher residential greenness levels were associated with lower waist circumference and body mass index levels, as well as with a lower odds ratio of peripheral overweight/obesity prevalence. No significant association was found for greenness and central obesity prevalence. The associations persisted in magnitude and direction across several sensitivity analyses we performed. Stratified analysis suggested that the associations were generally stronger in older adults than those in younger adults. Additionally, neither air pollutants nor physical activity significantly mediated the associations between greenness and obesity.

CONCLUSIONS

Our results suggest that higher residential greenness were associated with lower odds of overweight/obesity and lower obesity-related anthropometric indices among rural Uyghur adults in China, especially for older adults.

The Association between Fast Food Outlets and Overweight in Adolescents Is Confounded by Neighbourhood Deprivation: A Longitudinal Analysis of the Millennium Cohort Study

The aim of our study is to utilise longitudinal data to explore if the association between the retail fast food environment and overweight in adolescents is confounded by neighbourhood deprivation. Data from the Millennium Cohort Study for England were obtained for waves 5 (ages 11/12; 2011/12; n = 13,469) and 6 (ages 14/15; 2014/15; n = 11,884). Our outcome variable was overweight/obesity defined using age and sex-specific International Obesity Task Force cut points. Individuals were linked, based on their residential location, to data on the density of fast food outlets and neighbourhood deprivation. Structural Equation Models were used to model associations and test for observed confounding. A small positive association was initially detected between fast food outlets and overweight (e.g., at age 11/12, Odds Ratio (OR) = 1.0006, 95% Confidence Intervals (CI) = 1.0002–1.0009). Following adjusting for the confounding role of neighbourhood deprivation, this association was non-significant. Individuals who resided in the most deprived neighbourhoods had higher odds of overweight than individuals in the least deprived neighbourhoods (e.g., at age 11/12 OR = 1.95, 95% CIs = 1.64–2.32). Neighbourhood deprivation was also positively associated to the density of fast food outlets (at age 11/12 Incidence Rate Ratio = 3.03, 95% CIs = 2.80–3.28).

Systematic Review and Meta-Analysis of the Relationship between Actual Exercise Intensity and Rating of Perceived Exertion in the Overweight and Obese Population

The number of overweight (OW) and obese (OB) children, adolescents, and adults has increased globally. Exercise intensity, both actual and perceived, is a significant factor in a variety of health-related investigations and rehabilitation trainings. Despite this, literature on the connection between actual exercise intensity and the rating of perceived exertion (RPE) in overweight and obese populations is lacking. A systematic review, meta-analysis, combined analysis of variance (Brown-Forsythe ANOVA), and Spearman correlation were performed to fill this gap. After preliminary assessments, ten studies were classified as having a low risk of bias and a degree of heterogeneity (I² = 34%; p = 0.05). The RPE scores (F = 0.032; p = 0.859), physiological index (percentage of maximal heart rate (%HR_max) (F = 0.028; p = 0.869), and percentage of maximal oxygen uptake (%VO_2max) (F = 2.434; p = 0.136) demonstrated consistency without being significantly different between the normal weight (NW) and OW/OB groups. The RPE scores varied by age (NW (coefficient values) = 0.677 ***, OW = 0.585 **), as well as by indoor temperature (OW only, coefficient values = 0.422 *), body mass index (NW (coefficient values) = 0.516 **, OW = 0.580 **), and test time (NW only, coefficient values = 0.451 *). We conclude that RPE is appropriate for the following OW and OB people: (1) those who are older than 21.5 (the lowest age in the group of ≥18) years old and younger than 58.6 (the highest age in the group of ≥18) years old, without any other diseases, and (2) those who engage in low-intensity exercise while maintaining a standard indoor temperature. Future studies may address alternative techniques for increasing the reliability of longitudinal comparisons and gender comparisons, as well as investigate other possible confounding factors.

Differential associations of the built environment on weight gain by sex and race/ethnicity but not age

OBJECTIVE

To explore the built environment (BE) and weight change relationship by age, sex, and racial/ethnic subgroups in adults.

METHODS

Weight trajectories were estimated using electronic health records for 115,260 insured Kaiser Permanente Washington members age 18-64 years. Member home addresses were geocoded using ArcGIS. Population, residential, and road intersection densities and counts of area supermarkets and fast food restaurants were measured with SmartMaps (800 and 5000-meter buffers) and categorized into tertiles. Linear mixed-effect models tested whether associations between BE features and weight gain at 1, 3, and 5 years differed by age, sex, and race/ethnicity, adjusting for demographics, baseline weight, and residential property values.

RESULTS

Denser urban form and greater availability of supermarkets and fast food restaurants were associated with differential weight change across sex and race/ethnicity. At 5 years, the mean difference in weight change comparing the 3rd versus 1st tertile of residential density was significantly different between males (-0.49 kg, 95% CI: -0.68, -0.30) and females (-0.17 kg, 95% CI: -0.33, -0.01) (P-value for interaction = 0.011). Across race/ethnicity, the mean difference in weight change at 5 years for residential density was significantly different among non-Hispanic (NH) Whites (-0.47 kg, 95% CI: -0.61, -0.32), NH Blacks (-0.86 kg, 95% CI: -1.37, -0.36), Hispanics (0.10 kg, 95% CI: -0.46, 0.65), and NH Asians (0.44 kg, 95% CI: 0.10, 0.78) (P-value for interaction <0.001). These findings were consistent for other BE measures.

CONCLUSION

The relationship between the built environment and weight change differs across demographic groups. Careful consideration of demographic differences in associations of BE and weight trajectories is warranted for investigating etiological mechanisms and guiding intervention development.

Attributes of the food and physical activity built environments from the Southern Cone of Latin America

Previous studies have shown the influence of the physical and social environments on the development of obesity and non-communicable diseases (NCD). An obesogenic environment promotes higher dietary energy intakes and sedentary behaviors while limiting opportunities or incentives for active living. This paper presents a dataset with key attributes of the food and physical activity built environment, including green spaces, quality of streets and sidewalks, and different types of food retail outlets in four cities of the Southern Cone of Latin America. A total of 139 representative neighborhoods randomly selected from: Marcos Paz and Bariloche (Argentina), Temuco (Chile) and Canelones-Barros Blancos (Uruguay) were evaluated, where standardized community walks were conducted for direct observation of the built environment. This dataset will contribute valuable data to the evaluation of obesogenic environments in the region, and could be linked to additional ecological information about risk factors for NCDs and socio-economic features from other sources. Understanding environmental influences on cardiovascular risk factors and individual habits may help explain NCD outcomes and plan urban policies.

The water incident database (WAID) 2012 to 2019: a systematic evaluation of the documenting of UK drownings

Background

Death by drowning is a leading cause of accidental death in the United Kingdom (UK) and worldwide. The World Health Organization (WHO) states that effective documentation of drowning is required to describe drowning frequency and to underpin effective drowning prevention intervention, thus improving the quality of data describing drowning frequency represents a key initiative. The water incident database (WAID) has been used to document UK fatal and non-fatal water-based incidents since 2009. WAID has not undergone a systematic evaluation of its data or data collection procedures to establish if the database meets the WHO requirements. The present study investigated the characteristics of UK fatal drowning incidents and audited current WAID data capture procedures.

Methods

Data for the fatal drowning cases recorded between 2012 and 2019 were reviewed. Descriptive data were generated 1) to describe fatal drownings in the UK’s WAID in this period; 2) a sub-set of drownings were audited i) for completeness of data entry and, based on source documents, ii) for quality of data entry; 3) these processes were used to make recommendations for onward revisions to WAID.

Results

A total of 5051 fatalities were recorded between 2012 and 2019. Drowning was most frequent amongst males aged 35 to 60 years (n = 1346), whilst suspected accidents and suicides accounted for 44 and 35% of fatalities. Suicide by drowning was at a peak in the most recent year of data analysed (i.e., 2019; 279 cases) highlighting an urgent need for targeted intervention. Audit part 2i) indicated that 16% of all fields were incomplete, thus indicating potential redundancy, duplication, or the need for onward review. Audit part 2ii) indicated high levels of agreement (80 ± 12%) between audited cases and the ‘true’ WAID entries.

Conclusions

This study confirms WAID as a rigorous, transparent and effective means of documenting UK drownings thereby meeting WHO requirements for data quality; yet future improvements are recommended. Such findings allow researchers and policy makers to use WAID to further investigate UK drowning with a view to improving public safety measures and drowning prevention interventions. Observations alongside several expert recommendations have informed a revised version of WAID.

Relationship between Green and Blue Spaces with Mental and Physical Health: A Systematic Review of Longitudinal Observational Studies

There is growing interest in the ways natural environments influence the development and progression of long-term health conditions. Vegetation and water bodies, also known as green and blue spaces, have the potential to affect health and behaviour through the provision of aesthetic spaces for relaxation, socialisation and physical activity. While research has previously assessed how green and blue spaces affect mental and physical wellbeing, little is known about the relationship between these exposures and health outcomes over time. This systematic review summarised the published evidence from longitudinal observational studies on the relationship between exposure to green and blue space with mental and physical health in adults. Included health outcomes were common mental health conditions, severe mental health conditions and noncommunicable diseases (NCDs). An online bibliographic search of six databases was completed in July 2020. After title, abstract and full-text screening, 44 eligible studies were included in the analysis. Depression, diabetes and obesity were the health conditions most frequently studied in longitudinal relationships. The majority of exposures included indicators of green space availability and urban green space accessibility. Few studies addressed the relationship between blue space and health. The narrative synthesis pointed towards mixed evidence of a protective relationship between exposure to green space and health. There was high heterogeneity in exposure measures and adjustment for confounding between studies. Future policy and research should seek a standardised approach towards measuring green and blue space exposures and employ theoretical grounds for confounder adjustment.

Obesity and Natural Spaces in Adults and Older People: A Systematic Review

BACKGROUND

Obesity is an important public health issue that has increased globally in the last decade and continues to be one of the main causes of morbidity and premature mortality. An accumulating body of evidence suggests that contact with nature is a valuable resource for the promotion of a more active lifestyle and seems to have a central role in maintaining a healthy weight. The authors conducted a systematic review to summarize the findings of studies that investigated the relationship between natural spaces and obesity.

METHODS

Following Primary Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature search was conducted using 11 databases for studies fully available in English and published between 2010 and 2020, with adults (18-64 y) and/or older people (≥65 y).

RESULTS

Fifty studies were found that met all the inclusion criteria. The majority (68%) of papers found that higher availability and less distance to green and blue spaces are associated with lower levels of adiposity. These associations were positive, even after adjusting for the demographic and socioeconomic factors.

CONCLUSIONS

Exploring the characteristics of green and blue spaces seems to be a promising tool for urban planning and health policies. The authors suggest the implementation of exercise programs in contact with nature for future interventions.

Investigating the environmental, behavioural, and sociodemographic determinants of attendance at a city-wide public health physical activity intervention: Longitudinal evidence over one year from 185,245 visits

Understanding the determinants of attendance at public health interventions is critical for effective policy development. Most research focuses on individual-level determinants of attendance, while less is known about environmental-level determinants. Data were obtained from the Leeds Let's Get Active public health intervention in Leeds, England. Longitudinal data (April 2015-March 2016) on attendance were obtained for n = 25,745 individuals (n = 185,245 total visits) with baseline data on sociodemographic determinants and lifestyle practices obtained for n = 3621 individuals. This resulted in a total of n = 744,468 days of attendance and non-attendance. Random forests were used to explore the relative importance of the determinants on attendance, while generalised linear models were applied to examine specific associations (n = 3621). The probability that a person will attend more than once, the number of return visits, and the probability that a person will attend on a particular day were investigated. When considering if a person returned to the same leisure centre after one visit, the most influential determinant was the distance from their home. When considering number of return visits overall however, age group was the most influential. While distance to a leisure centre was less important for predicting the number of return visits, the difference between estimates for 300 m and 15,000 m was 7-10 visits per year. Finally, calendar month was the most important determinant of daily attendance. This longitudinal study highlights the importance of both individual and environmental determinants in predicting various aspects of attendance. It has implications for strategies aiming to increase attendance at public health interventions.

Greenspace with overweight and obesity: A systematic review and meta-analysis of epidemiological studies up to 2020

Several reviews have been conducted to assess the association between greenspace and overweight or obesity, but the conclusions were inconsistent. However, an updated comprehensive review and meta-analysis is warranted, because several high-quality papers have been published more recently. The objectives of this study are to systematically and quantitatively assess the evidence for a link between greenspace with overweight/obesity and to make specific recommendations for further research. We searched three English language databases, four Chinese language databases and the reference lists of previously published reviews for epidemiological studies on greenspace and overweight/obesity published before January 2020. We developed inclusion criteria, screened the literature and extracted key data from selected papers. We assessed methodological quality and risk of bias, and we graded the credibility of the pooled evidence. We also performed sensitivity analyses. Fifty-seven records met our inclusion criteria and were included in the study. Most studies were cross-sectional designs (81%) and were from developed nations (88%). More than half (55%) of the included studies found beneficial associations between greenspace and overweight/obesity in overall or subpopulations. Our meta-analytical results showed that greater normalized difference vegetation index was associated with lower odds of overweight/obesity in a statistically significant fashion (odds ratio [OR]: 0.88; 95% CI: 0.84, 0.91) but not residential proximity to greenspace (OR: 0.99; 95% CI: 0.99, 1.00), proportion of greenspace (OR: 0.96; 95% CI: 0.85, 1.08) or number of parks in an area (OR: 0.99; 95% CI: 0.97, 1.01). However, we detected high between-study heterogeneity in two of the four meta-analyses, which reduced the credibility of the pooled evidence. Current evidence indicates that there might be an association between greater access to greenspace and lower odds of overweight/obesity. However, additional high-quality studies are needed to more definitively assess the evidence for a causal association.

Adults' leisure-time physical activity and the neighborhood built environment: a contextual perspective

BACKGROUND

Context-free outcome measures, such as overall leisure-time physical activity (LTPA), are habitually applied to study the neighborhood built environment correlates of physical activity. This cross sectional study identifies and empirically tests potential methodological limitations related to the use of context-free measures and discusses how these may help in the interpretation of inconsistent associations between participation in moderate-to-vigorous LTPA and objectively measured neighborhood-level built environment attributes.

METHODS

We employ a public participation geographic information system (PPGIS), an advanced participatory mapping method, to study the spatial distribution of moderate-to-vigorous LTPA among adult urban Finnish residents (n 1322). Secondary sources of GIS land-use and sport facility data were used to disaggregate respondent-mapped LTPA by the behavioral context, such as indoor and outdoor sport facilities, green spaces, and other public open spaces. Associations between the use of the identified LTPA settings and a range of objectively measured neighborhood built environment attributes were studied with multilevel logistic regression models.

RESULTS

Disaggregated by behavioral context, we observed varied and partly opposite built environment correlates for LTPA. The use of indoor and outdoor sport facilities showed no significant associations with their neighborhood availability, but were significantly associated with personal-level attributes. By contrast, participation in LTPA in green and built public open space shared significant associations with access to and availability of neighborhood green space that persisted after controlling for personal-level covariates. Moreover, neighborhood distances up to 1600 m poorly captured participation in moderate-to-vigorous LTPA, as, on average, 40% of visits were located further from home. However, we found the immediate home environment to be an important LTPA setting for the least active participants.

CONCLUSIONS

This study demonstrates that LTPA can be a highly heterogeneous measure regarding both the spatial distribution and the environmental correlates of behavioral contexts. The results show that context-free LTPA outcome measures yield inconsistent associations with built environment exposure variables, challenging the applicability of such measures in designing neighborhood-level built environment interventions.

Associations between food environment typologies and body mass index: Evidence from Yorkshire, England

International research linking food outlets and body mass index (BMI) is largely cross-sectional, yielding inconsistent findings. However, addressing the exposure of food outlets is increasingly considered as an important adult obesity prevention strategy. Our study investigates associations between baseline food environment types and change in BMI over time. Survey data were used from the Yorkshire Health Study (n=8,864; wave one: 2010-2012, wave two: 2013-2015) for adults aged 18-86. BMI was calculated using self-reported height (cm) and weight (kg). Restaurants, cafés, fast-food, speciality, convenience and large supermarkets were identified from the Ordnance Survey Point of Interest database within 1600m radial buffer of home postcodes. K-means cluster analysis developed food environment typologies based on food outlets and population density. Large supermarkets, restaurants, cafés, fast-food, speciality and convenience food outlets all clustered together to some extent. Three neighbourhood typologies were identified. However, multilevel models revealed that relative to cluster one all were unrelated to change in BMI (cluster 2, b= -0.146 [-0.274, 0.566]; cluster 3, b= 0.065 [-0.224, 0.356]). There was also little evidence of gender-based differences in these associations when examined in a three-way interaction. Policymakers may need to begin to consider multiple types of food outlet clusters, while further research is needed to confirm how these relate to changed BMI.

Comparing Different Residential Neighborhood Definitions and the Association Between Density of Restaurants and Home Cooking Among Dutch Adults

The definition of neighborhoods as areas of exposure to the food environment is a challenge in food environment research. We aimed to test the association of density of restaurants with home cooking using four different definitions of residential neighborhoods. We also tested effect modification by age, length of residency, education, and income. This innovative cross-sectional study was conducted in the Netherlands (N = 1245 adults). We calculated geographic information system-based measures of restaurant density using residential administrative neighborhood boundaries, 800 m and 1600 m buffers around the home and respondents' self-defined boundaries (drawn by the respondents on a map of their residential area). We used adjusted Poisson regression to test associations of restaurant density (tertiles) and the outcome "weekly consumption of home-cooked meals" (six to seven as compared to five days per week (day/week) or fewer). Most respondents reported eating home-cooked meals for at least 6 day/week (74.2%). Regardless of the neighborhood definition used, no association between food environment and home cooking was observed. No effect modification was found. Although exposure in terms of density of restaurants was different according to the four different neighborhood definitions, we found no evidence that the area under study influences the association between density of restaurants and home cooking among Dutch adults.

Exploring the myth of the chubby gamer: A meta-analysis on sedentary video gaming and body mass

RATIONALE

High body mass and obesity are frequently linked to the use of sedentary media, like television (TV) or non-active video games. Empirical evidence regarding video gaming, however, has been mixed, and theoretical considerations explaining a relationship between general screen time and body mass may not generalize to non-active video gaming.

OBJECTIVE

The current meta-analysis had two main goals. First, we wanted to provide an estimate of the average effect size of the relationship between sedentary video gaming and body mass. In doing so we acknowledged several context variables to gauge the stability of the average effect. Second, to provide additional evidence on processes, we tested the displacement effect of physical activity by video gaming time with the help of a meta-analytic structural equation model (MASEM).

METHOD

Published and unpublished studies were identified through keyword searches in different databases and references in relevant reports were inspected for further studies. We present a random-effects, three-level meta-analysis based on 20 studies (total N = 38,097) with 32 effect sizes.

RESULTS

The analyses revealed a small positive relationship between non-active video game use and body mass, ρˆ=.09, 95% CI [0.03, 0.14], indicating that they shared less than 1% in variance. The studies showed significant heterogeneity, Q (31) = 593.03, p < .001, I² = 95.13. Moderator analyses revealed that the relationship was more pronounced for adults, ρˆ=.22, 95% CI [0.04, 0.40], as compared to adolescents, ρˆ=.01, 95% CI [-0.21, 0.23], or children, ρˆ=.09, 95% CI [-0.07, 0.25]. Meta-analytic structural equation modeling found little evidence for a displacement of physical activity through time spent on video gaming.

CONCLUSION

These results do not corroborate the assumption of a strong link between video gaming and body mass as respective associations are small and primarily observed among adults.

Would increasing access to recreational places promote healthier weights and a healthier nation?

Addressing gaps in evidence on causal associations, this study tested the hypothesis that better access to recreational places close to home helps people to maintain lower body mass index (BMI) using a retrospective longitudinal study design and up to 6 years of data for the same individuals (1,522,803 men and 183,618 women). Participants were military veterans aged 20-64 who received healthcare through the U.S. Department of Veterans Affairs in 2009-2014 and lived in a metropolitan area. Although there were cross-sectional associations, we found no longitudinal evidence that access to parks and fitness facilities was associated with BMI for either men or women in the full sample or in subgroups of residential movers and stayers. Our findings suggest that simply increasing the number of parks and fitness facilities may not be enough to achieve needed population-level reductions in weight.