Physical activity and perceived environmental attributes in a sample of Portuguese adults: results from the Azorean Physical Activity and Health study

Influence of parental perceived environment on physical activity, TV viewing, active play and Body Mass Index among Portuguese children: A mediation analysis

OBJECTIVES

The environment is believed to be key in obesity prevention, yet it is unclear how factors in the neighborhood influence weight-related behaviors. The present study aimed to investigate the influence of parental perceived environment on physical activity (PA), television (TV) time, active play and Body Mass Index (BMI) z score, and the mediating role of these weight-related behaviors on the relationship between neighborhood characteristics and children's BMI.

METHODS

Data of 8472 Portuguese preschool (aged 3-6, n = 3819) and school-aged children (aged 7-11 years, n = 4653) were collected during 2016/2017. Structural equation modeling was used to estimate the associations between parents perceived neighborhood characteristics (latent variables: unsafety and built/physical environment) and child's BMI z score, PA and TV time.

RESULTS

Among preschoolers, the latent variables of the perceived environment were not associated with the BMI, TV time, extracurricular PA, and active play. Among schoolchildren, the unsafety environment was positively associated with both the BMI (SC = 0.050, P = .008) and the time spent watching TV (SC = 0.052, P = .031) and negatively associated with extracurricular PA (SC = -0.125, P < .001). The latent variable Favorable Built Environment for PA (ie, environmental facilitating elements) was positively associated with active play (SC = 0.041, P = .031). Moreover, the TV time was a marginally significant mediator of the relationship between the perceived unsafe environment and the BMI of school-aged children (B = 0.002, P = .096).

CONCLUSIONS

In conclusion, changes in the environment to targeting parental perception of neighborhood safety could have positive effects on the promotion of healthy weight and the adoption of a healthy lifestyle in school-aged children.

The neighborhood social environment and physical activity: a systematic scoping review

BACKGROUND

Investigating the association of the neighborhood social environment on physical activity is complex. A systematic scoping review was performed to (1) provide an inventory of studies assessing the influence of the neighborhood social environment on physical activity since 2006; (2) describe methodologies employed; and (3) formulate recommendations for the field.

METHODS

Two databases were searched using terms related to 'physical activity,' 'neighborhood,' and 'social environment' in January 2017. Eligibility criteria included: 1) physical activity as an outcome; 2) neighborhood social environment as a predictor; 3) healthy population (without diagnosed clinical condition or special population); 4) observational or experimental design. Of 1352 studies identified, 181 were included. Textual data relevant to the social environment measurement and analysis were extracted from each article into qualitative software (MAXQDA) and coded to identify social environmental constructs, measurement methods, level of measurement (individual vs. aggregated to neighborhood), and whether authors explicitly recognized the construct as the social environment. The following measures were generated for each construct: number of unique measurements; % of times measured at an aggregate level; % of times authors referred to the construct as the social environment. Social environmental constructs were then grouped into larger descriptive dimensions.

RESULTS/FINDINGS

Fifty-nine social environmental constructs were identified and grouped into 9 dimensions: Crime & Safety (n = 133 studies; included in 73% of studies); Economic & Social Disadvantage (n = 55, 33%); Social Cohesion & Capital (n = 47, 26%); Social Relationships (n = 22, 12%); Social Environment (n = 16, 9%); Disorder & Incivilities (n = 15, 8%); Sense of Place/Belonging (n = 8, 4%); Discrimination/Segregation (n = 3, 2%); Civic Participation & Engagement (n = 2, 1%). Across all articles, the social environment was measured using 176 different methods, was measured at an aggregate-level 38% of the time, and referred to as the social environment 23% of the time.

CONCLUSIONS

Inconsistent terminology, definitions, and measurement of the social environment and the lack of explicit language identifying constructs as the social environment make it challenging to compare results across studies and draw conclusions. Improvements are needed to increase our understanding of social environmental correlates and/or determinants of physical activity and facilitate cross-disciplinary conversations necessary to effectively intervene to promote physical activity.

TRIAL REGISTRATION

PROSPERO CRD42017059580.

The Pleasure of Walking: An Innovative Methodology to Assess Appropriate Walkable Performance in Urban Areas to Support Transport Planning

The Walking Suitability Index of the Territory–T-WSI is an innovative methodology to assess walkability. Unlike other methods and tools in this field designed to evaluate walkability on given origin-destination paths, T-WSI is conceived for area-wide assessments, typically at the neighborhood level. This can be achieved by visual surveys to collect data, which are easy to perform at street level, their further process via an algorithm, and their aggregation to assess the walking performance levels of the test area. The paper describes such methodology, which includes the development of 12 indicators associated with four main evaluation categories (Practicability, Safety, Urbanity and Appeal), and its application to a case study in a medium-size town in central Italy. Results are described and elaborated to highlight T-WSI’s contribution to help decision makers in the urban governance process, typically in the fields of land use, mobility management and maintenance, coherently with the research objective to enlarge the potential of walkability methodologies thus far available up to area-level assessment.

Perceptions of activity-supportive environment and motorcycle use among urban Taiwanese adults

Background

Although research has shown that numerous perceived environmental factors are supportive of physical activity, little is known about their associations with sedentary transport in motorcycle-oriented countries. This study examined the association between perceptions of Taiwan’s environmental factors and urban adults’ motorcycle use.

Methods

Cross-sectional data from 1003 Taiwanese adults aged 20–64 years from three urban cities were collected through telephonic surveys in 2015. Data on motorcycle use, sociodemographic variables, and perceived environmental attributes were obtained. Logistic regression analyses were performed.

Results

In Model 1, adults who perceived favorable access to public transport and destinations, presence of sidewalks, and safety from crimes at night were less likely to use motorcycles. In Model 2, in which potential covariates were additionally adjusted for, the same four environmental attributes (perceived favorable access to public transport and destinations, presence of sidewalks, and safety from crimes at night; odds ratio [OR] = 0.46, 0.65, 0.63, 0.64, respectively) were significantly associated with motorcycle use.

Conclusion

The investigated perceived environmental factors, which have previously been associated with facilitating active transportation, discourage sedentary modes of transport, such as motorized vehicles.

Gender differences in the associations between perceived environment and walking for recreation in Taiwanese adults

This study examined gender differences in the associations between perceived environmental factors and walking for recreation in Taiwanese adults. In 2014, a telephone-based, cross-sectional survey targeting Taiwanese adults (20-64 years) was conducted. Data on nine items about environmental perception, time spent in walking for recreation, and socio-demographic variables were obtained from 1,065 adults using the International Physical Activity Questionnaire-long version and its environmental module. Adults who perceived good aesthetics (adjusted odds ratio [AOR] = 1.74; 95% confidence interval [CI]: 1.36-2.23) and reported seeing people being active (AOR = 1.58; 95% CI: 1.21-2.06) were more likely to perform 150 minutes of recreational walking per week. Furthermore, significant interactions regarding walking for recreation were observed between gender and five environmental correlates: access to shops (p = .046), the presence of sidewalks (p < .001), access to recreational facilities (p = .02), seeing people being active (p = .001), and aesthetics (p < .001). These five perceived environmental factors were positively associated with recreational walking in women but not in men. Gender is a potential modifier between perceived environment and walking for recreation in adults. Perceived environmental factors appear to be more critical for women in performing health-enhancing levels of recreational walking than they are for men.

Association of Sociodemographic and Perceived Environmental Factors with Public Bicycle Use among Taiwanese Urban Adults

Background: This study examined the sociodemographic and perceived environmental factors associated with public bicycle use among Taiwanese urban adults. Methods: A random-digit-dialing telephone-based cross-sectional survey was administered to Taiwanese urban adults aged 20–64 years in 2015. Data on sociodemographic variables, perceived environmental factors (for attributes identified in the International Physical Activity Questionnaire-Environmental Module), and public bicycle use were obtained from 1002 adults in three cities. Adjusted logistic regression was used. Results: After adjustment for potential confounders, the results showed that adults aged 20–29 years (odds ratio (OR) = 4.42) with a university degree or higher (OR = 2.03) were more likely to use public bicycles. In addition, adults living in Kaohsiung City were less likely to use public bicycles (OR = 0.24). Adults who saw people being active (OR = 1.76; 95% CI: 1.05–2.86) and had positive aesthetic experiences of their environment (OR = 1.69) were more likely to use public bicycles. Conclusions: Our findings suggest that seeing physically active people and positive aesthetic perceptions of the environment are key factors for developing transportation policies and intervention strategies for promoting public bicycle use among Taiwanese urban adults.

European Code against Cancer 4th Edition: Physical activity and cancer

Physical activity is a complex, multidimensional behavior, the precise measurement of which is challenging in free-living individuals. Nonetheless, representative survey data show that 35% of the European adult population is physically inactive. Inadequate levels of physical activity are disconcerting given substantial epidemiologic evidence showing that physical activity is associated with decreased risks of colon, endometrial, and breast cancers. For example, insufficient physical activity levels are thought to cause 9% of breast cancer cases and 10% of colon cancer cases in Europe. By comparison, the evidence for a beneficial effect of physical activity is less consistent for cancers of the lung, pancreas, ovary, prostate, kidney, and stomach. The biologic pathways underlying the association between physical activity and cancer risk are incompletely defined, but potential etiologic pathways include insulin resistance, growth factors, adipocytokines, steroid hormones, and immune function. In recent years, sedentary behavior has emerged as a potential independent determinant of cancer risk. In cancer survivors, physical activity has shown positive effects on body composition, physical fitness, quality of life, anxiety, and self-esteem. Physical activity may also carry benefits regarding cancer survival, but more evidence linking increased physical activity to prolonged cancer survival is needed. Future studies using new technologies - such as accelerometers and e-tools - will contribute to improved assessments of physical activity. Such advancements in physical activity measurement will help clarify the relationship between physical activity and cancer risk and survival. Taking the overall existing evidence into account, the fourth edition of the European Code against Cancer recommends that people be physically active in everyday life and limit the time spent sitting.

Perceived environmental and personal factors associated with walking and cycling for transportation in Taiwanese adults

This study examined perceived environmental and personal factors associated with walking and cycling as means of transportation for Taiwanese adults. A random-digit-dialing telephone-based cross-sectional survey was conducted with Taiwanese adults aged 20 to 64 years. Data on time spent walking and cycling for transportation and perceptions of neighborhood environment and personal characteristics were obtained from 1065 adults by using the International Physical Activity Questionnaire-long version and its environmental module. Adjusted binary logistic regression was performed. The results showed that, after adjusting potential confounders, common and different personal and perceived environmental factors were associated with walking and cycling for transportation. For common personal factors, adults who had employment were less likely to engage in 150 min of walking per week (odds ratio [OR] = 0.41; 95% confidence interval (CI): 0.27-0.62) and to use cycling as a means of transportation (OR = 0.51; 95% CI: 0.32-0.79). For common perceived environmental factors, adults who perceived good connectivity of streets were more likely to walk (OR = 1.95; 95% CI: 1.20-3.16) and cycle (OR = 2.02; 95% CI: 1.16-3.54) for transportation. Targeting employed adults and improving the connectivity of streets should be a priority for developing transport policies and intervention strategies to promote active transportation.

Neighborhood environment perceptions and the likelihood of smoking and alcohol use

Neighborhood characteristics are important correlates for a variety of health outcomes. Among several health risk behaviors, smoking and alcohol use have significant consequences. Perceptions of neighborhood problems are associated with depressive symptoms, lower physical activity, and lower quality of life. However, it is unclear which perceived aspects of neighborhoods might be related to smoking and drinking. We examined whether perceived neighborhood characteristics were associated with smoking and drinking patterns using data from US metropolitan Midwestern area adults. Participants completed surveys including sociodemographic characteristics, neighborhood perceptions, behavioral and psychological health. For men, negative perceptions of neighborhood infrastructures were significant predictors for smoking and binge drinking. Among women, no perceived environmental factors were associated with smoking or drinking. However, education was a significant negative predictor for smoking. As age increased, the likelihood of using cigarettes, heavy and binge drinking in women decreased significantly. Depression was a positive predictor for smoking and heavy drinking in men and women, respectively. These findings indicate that the perceived neighborhood infrastructure was predictive of health behaviors among men, even after adjusting for key confounders. Closer attention may need to be paid to the role of neighborhood environmental characteristics along with individual-level characteristics in influencing unhealthy behaviors.

Environments perceived as obesogenic have lower residential property values

BACKGROUND

Studies have tried to link obesity rates and physical activity with multiple aspects of the built environment.

PURPOSE

To determine the relation between residential property values and multiple perceived (self-reported) measures of the obesogenic environment.

METHODS

The Seattle Obesity Study (SOS) used a telephone survey of a representative, geographically distributed sample of 2,001 King County adults, collected in 2008-2009 and analyzed in 2012-2013. Home addresses were geocoded. Residential property values at the tax parcel level were obtained from the King County tax assessor. Mean residential property values within a 10-minute walk (833-m buffer) were calculated for each respondent. Data on multiple perceived measures of the obesogenic environment were collected by self-report. Correlations and multivariable linear regression analyses, stratified by residential density, were used to examine the associations among perceived environmental measures, property values, and BMI.

RESULTS

Perceived measures of the environment such as crime, heavy traffic, and proximity to bars, liquor stores, and fast food were all associated with lower property values. By contrast, living in neighborhoods that were perceived as safe, quiet, clean, and attractive was associated with higher property values. Higher property values were associated, in turn, with lower BMIs among women. The observed associations between perceived environment measures and BMI were largely attenuated after accounting for residential property values.

CONCLUSIONS

Environments perceived as obesogenic are associated with lower property values. Studies in additional locations need to explore to what extent other perceived environment measures can be reflected in residential property values.

Gender-specific associations of objective and perceived neighborhood characteristics with body mass index and waist circumference among older adults in the English longitudinal study of ageing

OBJECTIVES

We sought to determine whether objective and perceived neighborhood characteristics are independently associated with obesity indicators among older adults and whether associations differ by gender.

METHODS

Linear regression was used to examine mutually adjusted associations of objective area-level neighborhood deprivation and perceived individual-level neighborhood disorder in 2002-2003 with body mass index (BMI) and waist circumference (WC) 2 years later among 6297 community-dwelling older adults in the English Longitudinal Study of Ageing.

RESULTS

Associations between neighborhood characteristics and obesity indicators were evident for women only. Being in the most deprived quintile of neighborhood deprivation was associated with a BMI that was 1.18 kilograms per meters squared higher (95% confidence interval [CI] = 0.54, 1.83) and a WC that was 2.42 centimeters higher (95% CI = 0.90, 3.94) at follow-up in women after adjustment for baseline health status, socioeconomic factors, and neighborhood disorder. Neighborhood disorder was not independently associated with BMI or WC.

CONCLUSIONS

Among women, greater objective neighborhood deprivation was independently associated with higher BMI and WC after 2 years. Public efforts to reduce obesity among community-dwelling older women may benefit most from addressing objective residential characteristics, over and above subjective perceptions.

Fatores demográficos e hábitos de vida relacionados com a inatividade física de lazer entre gêneros

OBJETIVO: Analisar a associação entre variáveis sociodemográficas e hábitos de vida com Inatividade Física de Lazer, entre os sexos, em população de baixa renda. MÉTODOS: Estudo transversal de base populacional, em Duque de Caxias, Rio de Janeiro (2005). A coleta de dados constou de visita domiciliar e amostra de 1 113 adultos. Foram avaliados alguns dados sobre Atividade Física de Lazer, informações sociodemográficas, hábitos de vida (hábito de fumar, consumo de refrigerantes) e medidas antropométricas. Na análise de dados foi empregado o modelo hierárquico, utilizando a regressão de Poisson e a Inatividade Física de Lazer (indivíduos que responderam não praticar nenhum tipo de Atividade Física de Lazer) como desfecho. O primeiro nível do modelo considerou variáveis sociodemográficas e o segundo, o estado nutricional (índice de massa corporal em kg/m² (baixo peso <18,5; eutrófico ≥18,5 e <25,0; sobrepeso ≥25,0 e <30,0; e obeso ≥30,0), hábitos de vida e consumo alimentar. RESULTADOS: A prevalência de Inatividade Física de Lazer foi de 33,0% (IC95%: 28,6-37,6) para os homens, e 67,0% (IC95%: 62,3-71,3) para as mulheres. No modelo final, entre os homens, a Inatividade Física de Lazer foi associada com excesso de peso (sobrepeso: RP=1,50, obesidade: RP=1,50, p-valor=0,004) e cor de pele (pretos/pardos: RP=0,71, p-valor=0,003). Entre mulheres, a Inatividade Física de Lazer foi associada com escolaridade (RP=1,15, p-valor=0,019), perímetro de cintura (RP=0,87, p-valor=0,042), hábito de fumar (RP=1,17, p-valor=0,003) e maior ingestão de refrigerantes (RP=1,22, p-valor=0,015). CONCLUSÃO: Os fatores associados com a Inatividade Física de Lazer diferiram entre os gêneros. As mulheres possuíam estilos de vida não saudáveis, ou seja, fumavam, consumiam mais refrigerantes, e eram mais inativas fisicamente.

Individual and environmental factors associated for overweight in urban population of Brazil

BACKGROUND

Obesity is a significant global public health problem and the main cause of many chronic diseases in both developed and developing countries. The increase in obesity in different populations worldwide cannot be explained solely by metabolic and genetic factors; environmental and social factors also have a strong association with obesity. Thus, it is believed that the current obesity epidemic is the result of a complex combination of genetic factors and an obesogenic environment .The purpose of this study was to evaluate individual variables and variables within the built and social environment for their potential association with overweight and obesity in an urban Brazilian population.

METHODS

Cross-sectional study was carried out in a sample of 3404 adults living in the urban area of the city. Information from the surveillance system for chronic diseases of Brazilian Ministry of Health was used and individual data was collected by telephone interviews. The database was geocoded using the Brazilian System of Postal Codes for participant residences. An updated, existing list based on the current addresses of supermarkets and hypermarkets in the city was used as an indicator variable of the availability and access to food. Georeferenced information on parks, public squares, places for practicing physical activity and the population density were also used to create data on the built environment. To characterize the social environment, we used the health vulnerability index (HVI) and georeferenced data for homicide locations.

RESULTS

The prevalence was 44% for overweight, poisson regression was used to create the final model. The environment variables that independently associated with overweight were the highest population density, very high health vulnerability index and the homicide rate adjusted for individuals variables. The results of the current study illustrate and confirm some important associations between individual and environmental variables and overweight in a representative sample of adults in the Brazilian urban context.

CONCLUSIONS

The social environment variables relating to the socioeconomic deprivation of the neighborhood and the built environment variables relating to higher walkability were significantly associated with overweight and obesity in Belo Horizonte.

Behavioral Mediators of the Association between Neighborhood Environment and Weight Status in Nigerian Adults

Purpose.

Neighborhood built environments are related to obesity and physical activity (PA), but inconsistently to sedentary behaviors. This study investigated the mediating effects of PA and sedentary time on the associations of neighborhood environmental factors and body mass index (BMI) among Nigerian adults.

Design.

The study design was cross-sectional.

Setting.

The study setting was metropolitan Maiduguri, Nigeria.

Subjects.

Nigerian adults (n = 1411) were randomly selected from diverse neighborhoods and had complete data (43.1% women, 33.8% overweight or obese).

Measures.

PA, sedentary time, and 16 perceived neighborhood environmental factors were measured using Nigerian adaptations of validated international questionnaires. Outcomes were measured BMI and interviewer-led self-reports of moderate to vigorous PA, walking, total PA, and sitting time.

Analysis.

The product-of-coefficient test using generalized linear models was used to assess the mediating effects of outcomes on the associations between environmental factors and BMI.

Results.

Walking and total PA significantly mediated the association between BMI and perception of higher residential density (αβ = –.025 and –.037, respectively), absence of garbage (αβ = –.046 and –.076, respectively), and more safety from crime at night (αβ = –.044 and –.083, respectively). In addition, walking, moderate to vigorous PA, and total PA significantly mediated the association between BMI and perception of better aesthetics (αβ = –.035, –.022, and –.071, respectively). Sedentary time was not a significant mediator of any associations between environmental factors and BMI.

Conclusion.

The association of several neighborhood environmental variables with BMI was partially mediated by PA in Nigerian adults. Including questions on specific types of sedentary behaviors in future prospective studies may improve understanding of the relative influence of sedentary behavior and physical activity on obesity control and prevention among sub-Saharan African adults.

Association between physical activity and neighborhood environment among middle-aged adults in Shanghai

Objective. To determine the perceived neighborhood environment (NE) variables that are associated with physical activity (PA) in urban areas in China. Methods. Parents of students at two junior high schools in Shanghai, one downtown and the other in the suburbs, were recruited to participate in the study. They completed an International Physical Activity Questionnaire (IPAQ) and Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A) survey. Participant physical activity was also objectively measured using accelerometers. Results. Participants from downtown areas were more positively associated with transportation PA and leisure-time PA than respondents living in the suburbs. Residential density was found to be a significant positive predictor of recreational or leisure-based PA. Street connectivity was negatively associated with leisure time PA for respondents. Moderate-vigorous PA was found to be negatively associated with traffic safety. There were no significant associations between environmental factors and transportation PA. Women had higher levels of moderate-vigorous PA than men. Conclusions. The results of this study demonstrate that residential density, street connectivity, and traffic safety have a significant impact on Chinese middle-aged adults' PA, suggesting urban planning strategies for promoting positive public health outcomes.

Association between parental perceptions of residential neighbourhood environments and childhood obesity in Porto, Portugal

BACKGROUND

Portugal has one of the highest rates of childhood obesity in Europe. Few studies have explored the relationship between parents' perceptions of their residential neighbourhood (safety concerns and amenities of the built environment) and their children's weight status. This study aims to examine the associations between parents' perceptions of their residential neighbourhood and overweight/obesity among their children.

METHODS

Anthropometric measures of height and weight were taken for 2690 children in preschools and elementary schools in Porto. Body mass index (kg/m(2)) was calculated, and the International Obesity Taskforce (IOTF) cut-offs were used. Parents completed the 'Environmental Module' standard questionnaire of the International Physical Activity Prevalence Study. Chi-square tests and the logistic regression model adjusted for age, gender, maternal education and school cluster were used to examine the associations between parents' perceptions of their residential neighbourhood and overweight/obesity among their children.

RESULTS

In this sample, 31.8% of the children were overweight (including obese). Significant associations were found between child obesity and the following residential environmental characteristics: the odds of children being obese were lower if their parents believed that it was safe (low/no crime rate) to walk/cycle at night (OR = 0.65, 95% CI = 0.54-0.79) and during the day (OR = 0.70, 95% CI = 0.55-0.86) and that it was easy and pleasant (pedestrian safety) to walk in their neighbourhoods (OR = 0.73, 95% CI = 0.58-0.90) and when local sidewalks were well maintained and unobstructed (OR = 1.18, 95% CI = 1.01-1.40).

CONCLUSION

Parental perceptions of neighbourhood safety and the quality of local sidewalks are significantly associated with obesity values.

Relationship between the physical environment and different domains of physical activity in European adults: a systematic review

BACKGROUND

In the past decade, various reviews described the relationship between the physical environment and different physical activity (PA) domains. Yet, the majority of the current review evidence relies on North American/Australian studies, while only a small proportion of findings refer to European studies. Given some clear environmental differences across continents, this raises questions about the applicability of those results in European settings. This systematic review aimed at summarizing Europe-specific evidence on the relationship between the physical environment and different PA domains in adults.

METHODS

Seventy eligible papers were identified through systematic searches across six electronic databases. Included papers were observational studies assessing the relationship between several aspects of the physical environment and PA in European adults (18-65y). Summary scores were calculated to express the strength of the relationship between each environmental factor and different PA domains.

RESULTS

Convincing evidence on positive relationships with several PA domains was found for following environmental factors: walkability, access to shops/services/work and the composite factor environmental quality. Convincing evidence considering urbanization degree showed contradictory results, dependent on the observed PA domain. Transportation PA was more frequently related to the physical environment than recreational PA. Possible evidence for a positive relationship with transportation PA emerged for walking/cycling facilities, while a negative relationship was found for hilliness. Some environmental factors, such as access to recreational facilities, aesthetics, traffic- and crime-related safety were unrelated to different PA domains in Europe.

CONCLUSIONS

Generally, findings from this review of European studies are in accordance with results from North American/Australian reviews and may contribute to a generalization of the relationship between the physical environment and PA. Nevertheless, the lack of associations found regarding access to recreational facilities, aesthetics and different forms of safety are likely to be Europe-specific findings and need to be considered when appropriate interventions are developed. More research assessing domain-specific relationships with several understudied environmental attributes (e.g., residential density) is needed.

Associations of physical activity with neighborhood environments and transportation modes in older Japanese adults

OBJECTIVE

We investigated associations of walking and other leisure-time physical activity (LTPA) with environmental characteristics and transportation modes in older Japanese adults.

METHODS

This cross-sectional study in 2010-2011 used data from 421 community-dwelling older adults aged 65-85 years living in Kasama City, rural Japan. We used the Physical Activity Scale for the Elderly to assess walking and other LTPAs, and the International Physical Activity Questionnaire Environment Module for neighborhood environments.

RESULTS

After adjusting for confounders, we found that good traffic safety and aesthetics were positively associated with high levels of walking (ORs=1.64-2.12); whereas, good access to public transportation was negatively associated with walking (OR=0.64, 95% CI=0.42-0.98). Good access to recreational facilities, presence of sidewalks, absence of hills, seeing people exercise, and aesthetically pleasing surroundings were positively associated with high levels of LTPA except walking (ORs=1.61-2.13). Individuals who rode bicycles more than once per week were more likely to engage in a LTPA except walking (1-3 days: OR=1.72, 95% CI=1.03-2.87; ≥4 days: OR=2.90, 95% CI=1.71-4.93).

CONCLUSION

This study adds information on correlates of physical activity among older Japanese adults; the positive association between LTPA except walking and the frequency of bicycle travel is an especially new and intriguing finding.

Contribution of individual and environmental factors to physical activity level among Spanish adults

Background

Lack of physical activity (PA) is a major risk for chronic disease and obesity. The main aims of the present study were to identify individual and environmental factors independently associated with PA and examine the relative contribution of these factors to PA level in Spanish adults.

Methodology/Principal Findings

A population-based cross-sectional sample of 3,000 adults (18–75 years old) from Gran Canaria (Spain) was selected using a multistage stratified random sampling method. The participants were interviewed at home using a validated questionnaire to assess PA as well as individual and environmental factors. The data were analyzed using bivariate and multivariate logistic regression. One demographic variable (education), two cognitive (self-efficacy and perceived barriers), and one social environmental (organized format) were independently associated with PA in both genders. Odds ratios ranged between 1.76–2.07 in men and 1.35–2.50 in women (both p<0.05). Individual and environmental factors explained about one-third of the variance in PA level.

Conclusions/Significance

Self-efficacy and perceived barriers were the most significant factors to meet an adequate level of PA. The risk of insufficient PA was twofold greater in men with primary or lesser studies and who are employed. In women, living in rural environments increased the risk of insufficient PA. The promotion of organized PA may be an efficient way to increase the level of PA in the general population. Improvement in the access to sport facilities and places for PA is a prerequisite that may be insufficient and should be combined with strategies to improve self-efficacy and overcome perceived barriers in adulthood.

Identifying built environmental patterns using cluster analysis and GIS: relationships with walking, cycling and body mass index in French adults

Background

Socio-ecological models suggest that both individual and neighborhood characteristics contribute to facilitating health-enhancing behaviors such as physical activity. Few European studies have explored relationships between local built environmental characteristics, recreational walking and cycling and weight status in adults. The aim of this study was to identify built environmental patterns in a French urban context and to assess associations with recreational walking and cycling behaviors as performed by middle-aged adult residents.

Methods

We used a two-step procedure based on cluster analysis to identify built environmental patterns in the region surrounding Paris, France, using measures derived from Geographic Information Systems databases on green spaces, proximity facilities (destinations) and cycle paths. Individual data were obtained from participants in the SU.VI.MAX cohort; 1,309 participants residing in the Ile-de-France in 2007 were included in this analysis. Associations between built environment patterns, leisure walking/cycling data (h/week) and measured weight status were assessed using multinomial logistic regression with adjustment for individual and neighborhood characteristics.

Results

Based on accessibility to green spaces, proximity facilities and availability of cycle paths, seven built environmental patterns were identified. The geographic distribution of built environmental patterns in the Ile-de-France showed that a pattern characterized by poor spatial accessibility to green spaces and proximity facilities and an absence of cycle paths was found only in neighborhoods in the outer suburbs, whereas patterns characterized by better spatial accessibility to green spaces, proximity facilities and cycle paths were more evenly distributed across the region. Compared to the reference pattern (poor accessibility to green areas and facilities, absence of cycle paths), subjects residing in neighborhoods characterized by high accessibility to green areas and local facilities and by a high density of cycle paths were more likely to walk/cycle, after adjustment for individual and neighborhood sociodemographic characteristics (OR = 2.5 95%CI 1.4-4.6). Body mass index did not differ across patterns.

Conclusions

Built environmental patterns were associated with walking and cycling among French adults. These analyses may be useful in determining urban and public health policies aimed at promoting a healthy lifestyle.

Association of self-reported physical activity patterns and socio-demographic factors among normal-weight and overweight Japanese men

Background

It is still not known whether overweight men have different patterns and socio-demographic correlates of self-reported physical activity (PA) compared with normal-weight men. Thus, this study examined the perceived PA patterns and associated socio-demographic factors among normal-weight and overweight Japanese men.

Methods

Data were analyzed for 1,420 men (aged 44.48.3years) who responded to an Internet-based cross-sectional survey relating to socio-demographic variables, BMI status, and a short version of the International Physical Activity Questionnaire. Mann-Whitney, chi-square, and binary logistic regression analyses were employed.

Results

Normal-weight men were significantly more likely to attain 150 minutes per week of moderate-to-vigorous PA than overweight men (26.6% vs. 21.3%; p=0.035), whereas there were no significant proportional differences in total PA and walking between the two BMI subgroups. With PA, a significant interaction was observed between BMI status and household income (p=0.004 for total PA; p=0.02 for walking). In the subgroup analyses, having a lower household income (odds ratio, 0.63; 95% confidence interval, 0.41-0.96) was negatively associated with attaining 150 minutes of walking per week among normal-weight men. No significant associations between household income and attaining 150 minutes per week of total PA and walking were found among overweight men.

Conclusions

The results revealed that patterns and socio-demographic correlates of self-reported PA in overweight men are different from those in normal-weight men. This finding suggests the necessity of developing specific strategies for PA intervention among overweight men. Socio-demographic correlates of PA may be more important for normal-weight than overweight men.

Behavioral intervention in the overweight and obese employee: the challenge of promoting weight loss and physical activity

Effects of gender and employment situation on weight loss and lifestyle modification were assessed in a 3-month intervention study done for overweight and obesity. A total of 384 individuals in Izumo City Japan, participated from 2000 to 2006. Lifestyle modifications were quantitatively evaluated by calculating calories of energy intake and expenditure. Eleven men and 15 women failed to complete the intervention; they were significantly younger in both genders, and the women had a higher rate of employment than the completing group (91 men and 267 women). Intervention induced a weight loss of 1.9 kg for men and 1.6 kg for women, with no significant differences by gender. Significant differences were found in changes in energy intake and expenditure in both genders, but these disappeared after adjusting for weight. There were significant decreases in weight (1.6 kg in unemployed, 2.5 kg in employed) in men. Increases in walking and exercise for the employed were smaller than those for the unemployed. The relationship between changes in weight and energy balance by employment status was independently significant using multiple regression analysis. Employment is associated with difficulty in losing weight due to limited exercise time in behavioral intervention.

[Factors associated with global and leisure-time physical activity in the elderly: a health survey in São Paulo (ISA-SP), Brazil]

The purpose of this study was to measure the prevalence of global and leisure-time physical activity and associated factors in the elderly. This was a population-based cross-sectional study covering a multiple-stage sample of 1,950 subjects 60 years or older living in areas of São Paulo State, Brazil. Prevalence of global physical activity (assessed through the short version of the International Physical Activity Questionnaire - IPAQ) was 73.9%, and prevalence of leisure-time physical activity was 28.4%. The results highlight the differences between factors associated with global and leisure-time physical activities. The social groups most prone to overall sedentary lifestyle and especially to lack of leisure-time physical activity should be the main targets of health policies aimed at promoting healthier lifestyles.

Metabolic risk factors, physical activity and physical fitness in Azorean adolescents: a cross-sectional study

Background

The prevalence of metabolic syndrome has increased over the last few decades in adolescents and has become an important health challenge worldwide. This study analyzed the relationships between metabolic risk factors (MRF) and physical activity (PA) and physical fitness (PF) in a sample of Azorean adolescents.

Methods

A cross-sectional school-based study was conducted on 417 adolescents (243 girls) aged 15-18 from the Azorean Islands, Portugal. Height, weight, waist circumference, fasting glucose, HDL-cholesterol, triglycerides, and blood pressure were measured. A sum of MRF was computed, and adolescents were classified into three groups: no MRF, one MRF and two or more MRF. PA was assessed by a sealed pedometer. PF was assessed using five tests from the Fitnessgram Test Battery. Dietary intake was obtained using a semi-quantitative food frequency questionnaire.

Results

Mean daily steps for girls and boys were 7427 ± 2725 and 7916 ± 3936, respectively. Fifty-nine percent of the adolescents showed at least one MRF and 57.6% were under the healthy zone in the 20 m Shuttle Run Test. Ordinal logistic regression analysis showed that after adjusting for sex, body mass index, socio-economic status and adherence to a Mediterranean diet, adolescents who were in the highest quartile of the pedometer step/counts (≥9423 steps/day) and those who achieved the healthy zone in five tests were less likely to have one or more MRF (OR = 0.56;95%CI:0.33-0.95; OR = 0.55;95%CI:0.31-0.98, respectively).

Conclusions

Daily step counts and PF levels were negatively associated with having one or more MRF among Azorean adolescents. Our findings emphasize the importance of promoting and increasing regular PA and PF to reduce the public health burden of chronic diseases associated with a sedentary lifestyle.

Perceived environmental factors associated with physical activity among normal-weight and overweight Japanese men

Although it is crucial to examine the environmental correlates of physical activity (PA) for developing more effective interventions for overweight populations, limited studies have investigated differences in the environmental correlates on body mass index (BMI). The purpose of the present study was to examine the perceived environmental correlates of PA among normal-weight and overweight Japanese men. Data were analyzed for 1,420 men (aged 44.4 ± 8.3 years), who responded to an internet-based cross-sectional survey of answering the short version of the International Physical Activity Questionnaire and its Environment Module. Binary logistic regression analyses were utilized to examine the environmental factors associated with meeting the PA recommendation (150 minutes/week) between the normal-weight and overweight men. After adjusting for socio-demographic variables, common and different environmental correlates of PA were observed among normal-weight and overweight men. Furthermore, significant interactions regarding PA were observed between BMI status and two environmental correlates: access to public transportation (P = 0.03) and crime safety during the day (P = 0.01). The results indicated that BMI status is a potential moderator between perceived environmental factors and PA and suggested that different environmental intervention approaches should be developed for overweight populations.

Deprivation and the development of obesity a multilevel, longitudinal study in England

BACKGROUND

Evidence indicates that the rising trend in overweight and obesity may be stronger for people from more socioeconomically advantaged backgrounds.

PURPOSE

This study used longitudinal, multilevel data to describe trajectories of BMI for people living in more- versus less-deprived neighborhoods.

METHODS

Data from 2501 women and 5650 men in the Whitehall II study who were followed for up to 13 years from 1991 to 2004 were analyzed in 2009. BMI was measured on up to three occasions by a trained nurse. The Townsend index of multiple deprivation at census-ward level from the 1991 U.K. census captured neighborhood deprivation. Growth curves summarized change in BMI for men and women according to level of neighborhood deprivation, adjusted for age, individual socioeconomic position (captured by civil service employment grade), smoking status, alcohol intake, and physical activity level.

RESULTS

Women who remained in the most-deprived neighborhoods between 1991 and 2004 had higher initial BMI and greater weight gain. Compared to those in the least-deprived neighborhoods, weight gain for a woman of average height in one of the most-deprived neighborhoods was 1.0 kg more over 10 years. Neither BMI nor change in BMI in men was associated with neighborhood deprivation.

CONCLUSIONS

Whitehall II provides longitudinal evidence of socioeconomic differences in weight gain among middle-aged women, indicating that the neighborhood environment makes a contribution to the development of overweight and obesity.

Sitting time and body mass index, in a Portuguese sample of men: results from the Azorean Physical Activity and Health Study (APAHS)

The aim of this study was to verify the relation between body mass index (BMI) and sitting time in a sample of 4,091 Azorean men. BMI was calculated from self-reported weight and height. Total physical activity (PA) time and total sitting time were assessed with the IPAQ (short version). Linear Regression analysis showed that total sitting time (hours/day) was positively associated with BMI (B = 0.078; p < 0.001) after adjustments for age, meal frequency, alcohol and tobacco consumptions, island of residence, education level and total PA time. Although the cross sectional design precludes us from establishing causality, our findings emphasize the importance of reducing sedentary behavior to decrease the risk of obesity.

Neighborhood SES and walkability are related to physical activity behavior in Belgian adults

OBJECTIVE

To investigate whether neighborhood walkability (higher residential density, land use mix, street connectivity) is positively associated with physical activity in Belgian adults and whether this association is moderated by neighborhood SES.

METHODS

The Belgian Environmental Physical Activity Study (BEPAS) was conducted in Ghent, Belgium. Data were collected between May 2007 and September 2008. Twenty-four neighborhoods were selected, stratified on GIS-based walkability and neighborhood SES. In total, 1200 adults (aged 20-65 years; 50 per neighborhood) completed the International Physical Activity Questionnaire and wore an accelerometer for seven days. After omitting participants with missing accelerometer data, the final sample consisted of 1166 adults.

RESULTS

Living in a high-walkable neighborhood was associated with more accelerometer-based minutes of moderate-to-vigorous physical activity (38.6 vs. 31.8 min/day, p<0.001), transportational walking and cycling, recreational walking, and less motorized transport (all p<0.05). Low neighborhood SES was related to more cycling for transport and less motorized transport (all p<0.05). No interactions between walkability and neighborhood SES were found.

CONCLUSIONS

The BEPAS results generally confirmed the findings from Australia and the US showing that, in Europe, walkability is also positively related to physical activity. As neighborhood SES was not a significant moderator, walkability appears beneficial for all economic strata.

"Do you see what I see?" - correlates of multidimensional measures of neighborhood types and perceived physical activity-related neighborhood barriers and facilitators for urban youth

OBJECTIVES

To classify types of neighborhood environment and to examine the gender-specific cross-sectional associations between these neighborhood types and adolescents' perceptions of physical activity-related neighborhood barriers and facilitators.

METHODS

This cross-sectional study was conducted with a sample of 350 high school students in Baltimore, Maryland, in 2006. Participants completed the Neighborhood Environment Walkability Scale (NEWS). Objectively GIS-measured attributes of urban form came from various sources. Classification of built environment/neighborhood types was achieved by factor analysis and cluster analysis.

RESULTS

Four neighborhood types were identified: (1) arterial development; (2) inner-city area; (3) suburban residential; and (4) central business district. Girls who lived in suburban residential areas were less likely than their central business district counterparts to perceive the protective effects of crosswalks and pedestrian traffic signals. Girls living in inner-city neighborhoods were more likely than their central business district counterparts to perceive the traffic as being slow. Boys' perceptions of their neighborhood did not vary by neighborhood pattern.

CONCLUSIONS

Girls appear to be more sensitive to their environment and perceive more physical activity-related built environment barriers compared to boys. Efforts to overcome physical activity barriers salient for adolescent girls should be tailored to the type of neighborhood.

Environmental correlates of physical activity in driving and non-driving rural Japanese women

OBJECTIVE

This study examined the relationship between physical activity and the environment among rural Japanese women, and whether that relationship varied with driving status.

METHODS

434 women aged 40-64 years in Unnan City, rural Japan, were surveyed in 2006 about physical activity and their neighborhood environments. The proximity and frequency of public transport were measured using geographic information systems software.

RESULTS

Perceived good access to public transport and recreational facilities, presence of bike lanes, and good aesthetics were among factors positively associated with being physically active. The interaction between the convenience of bus service and driving status was statistically significant (P=0.023). Non-drivers residing in areas where bus service was moderately convenient were more likely to be active than those who were without it.

CONCLUSION

These findings suggested that driving status is a potential modifier of the relationship between physical activity and the convenience of bus service and that convenient bus service is important for promoting physical activity especially in non-drivers.

Socio-demographic and perceived environmental correlates of walking in Portuguese adults--a multilevel analysis

Several studies have identified associations between walking levels and socio-demographic and environmental variables. The aim of the present study was to describe walking patterns and examine associations between socio-demographic characteristics and perceived environmental attributes with walking among adults living in the Azorean Archipelago (Portugal). In all, 7330 adult participants (4104 women), aged 38.1 +/- 9.3 years, of the 2004 Azorean Physical Activity and Health Study answered the Environmental Module and the short version of the International Physical Activity Questionnaire. Among the Azoreans, the environmental dimension "infrastructures, access to destinations, social environment and aesthetics" and moderate to vigorous physical activity were positively associated with walking levels; and smoking, sitting time and being married were negatively related, regardless of gender, age or education level. Through the cross-sectional nature of this study, our results suggest that targeted programs for Azoreans aimed to increase walking levels should consider that infrastructures, access to destinations, social environment and aesthetics seem to act synergistically and associate positively with walking behaviour.

Individual, social, environmental, and physical environmental correlates with physical activity among Canadians: a cross-sectional study

Background

The identification of various individual, social and physical environmental factors affecting physical activity (PA) behavior in Canada can help in the development of more tailored intervention strategies for promoting higher PA levels in Canada. This study examined the influences of various individual, social and physical environmental factors on PA participation by gender, age and socioeconomic status, using data from the 2002 nationwide survey of the Physical Activity Monitor.

Methods

In 2002, 5,167 Canadians aged 15–79 years, selected by random-digit dialling from household-based telephone exchanges, completed a telephone survey. The short version of the International Physical Activity Questionnaire was used to collect information on total physical activity. The effects of socio-economical status, self-rated health, self-efficacy, intention, perceived barriers to PA, health benefits of PA, social support, and facility availability on PA level were examined by multiple logistic regression analyses.

Results

Self-efficacy and intention were the strongest correlates and had the greatest effect on PA. Family income, self-rated health and perceived barriers were also consistently associated with PA. The effects of the perceived health benefits, education and family income were more salient to older people, whereas the influence of education was more important to women and the influence of perceived barriers was more salient to women and younger people. Facility availability was more strongly associated with PA among people with a university degree than among people with a lower education level. However, social support was not significantly related to PA in any subgroup.

Conclusion

This study suggests that PA promotion strategies should be tailored to enhance people's confidence to engage in PA, motivate people to be more active, educate people on PA's health benefits and reduce barriers, as well as target different factors for men and women and for differing socio-economic and demographic groups.