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de Albuquerque FM, Pessoa MC, Filgueiras MDS, do Carmo AS, Vegi ASF, Ribeiro AQ, de Novaes JF. Obesogenic environment around schools is associated with atherogenic risk in Brazilian children. Am J Hum Biol 2023; 35:e23844. [PMID: 36469550 DOI: 10.1002/ajhb.23844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Cardiometabolic risk factors often emerge in childhood, increasing the risk of cardiovascular diseases in adulthood. The school environments represent an important active space in a child's routine and may influence their health status. METHODS In this cross-sectional study, we aimed to evaluate the clustering of cardiometabolic risk factors and its association with the obesogenic and leptogenic environment around schools. A total of 378 children (181 boys; 197 girls) aged 8 and 9 years, enrolled in all urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Concentrations of high-density lipoprotein-cholesterol (HDL-c) and triglycerides (TG), and the insulin resistance (HOMA-IR), waist circumference (WC), and mean arterial pressure (MAP) were measured. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure and/or physical activities, traffic accidents, crime and green spaces densities were assessed in 400 road network buffers around schools. To test association of the obesogenic and leptogenic environment around schools with cardiometabolic risk clustering, binary logistic regression models were performed with generalized estimating equations. RESULTS "Obesogenic school environments" had greater densities of ultra-processed food stores, crime and traffic accidents, and higher walkability. The "↓ Atherogenic risk" cluster consisted of higher HDL-c values. There was an inverse association between the obesogenic environment around schools and a child's "↓ atherogenic risk" clustering (OR = 0.63; p < 0.001). CONCLUSION We concluded that public policies aimed at modifying the environment around schools, by providing healthier food options and safe conditions for active mobility, are essential to prevent child's atherogenic risk.
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Affiliation(s)
- Fernanda Martins de Albuquerque
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Milene Cristine Pessoa
- Programa de Pós Graduação em Nutrição e Saúde, Departamento de Nutrição, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Mariana De Santis Filgueiras
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Ariene Silva do Carmo
- Programa de Pós Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline Siqueira Fogal Vegi
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Andréia Queiroz Ribeiro
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Juliana Farias de Novaes
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
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de Albuquerque FM, Pessoa MC, Filgueiras MDS, do Carmo AS, Vegi ASF, Ribeiro AQ, de Novaes JF. Neighborhood obesogenic environment and cardiometabolic risk in Brazilian children: The mediation role of the mother's body mass index. Am J Hum Biol 2023; 35:e23835. [PMID: 36394453 DOI: 10.1002/ajhb.23835] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE We aimed to evaluate the association of neighborhood obesogenic and leptogenic environments with cardiometabolic risk clustering among Brazilian schoolchildren, mediated by child's ultra-processed food consumption and the mother's body mass index (BMI). METHODS A total of 367 children aged 8-9 years, enrolled in urban schools of Viçosa, Minas Gerais, Brazil, were evaluated. Waist circumference, insulin resistance, blood pressure, high-density lipoprotein-cholesterol, and triglycerides concentrations were measured. The child's ultra-processed food consumption assessment was performed by applying three 24-hour dietary recall. The mother's weight and height values were used to calculate the BMI. The neighborhood income, walkability index, predominantly ultra-processed food stores, public spaces for leisure, and/or physical activities, traffic accidents, crime, and green spaces densities were assessed in four hundred road network buffers around households. From neighborhood and cardiometabolic risk variables, four latent variables were obtained from confirmatory factor analysis: neighborhood "obesogenic", and "leptogenic" environments; "high cardiometabolic risk," and "low atherogenic risk". A structural equation model was used to test the direct and indirect associations between neighborhood environment and cardiometabolic risk clusters. RESULTS The neighborhood obesogenic environment had a significant total association (Standardized Coefficient = 0.172, p = .011) and was indirectly associated with the child's "high cardiometabolic risk" cluster, mediated by the mother's body mass index (Standardized Coefficient = 0.066, p = .049). CONCLUSIONS Our results reinforce the role of the urban environment on maternal obesity and child's cardiometabolic risk and provide evidence for public health policies aimed to prevent such conditions.
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Affiliation(s)
- Fernanda Martins de Albuquerque
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Milene Cristine Pessoa
- Programa de Pós Graduação em Nutrição e Saúde, Departamento de Nutrição, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Mariana De Santis Filgueiras
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Ariene Silva do Carmo
- Programa de Pós Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline Siqueira Fogal Vegi
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Andréia Queiroz Ribeiro
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
| | - Juliana Farias de Novaes
- Programa de Pós Graduação em Ciência da Nutrição, Departamento de Nutrição e Saúde, Universidade Federal de Viçosa (UFV), Viçosa, Brazil
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Silva TPRD, Viana TGF, Pessoa MC, Felisbino-Mendes MS, Inácio MLC, Mendes LL, Velasquez-Melendez G, Martins EF, Matozinhos FP. Environmental and individual factors associated with gestational weight gain. BMC Public Health 2022; 22:540. [PMID: 35303846 PMCID: PMC8933974 DOI: 10.1186/s12889-022-12948-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 03/09/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Environmental factors have an impact on inappropriate food choices and sedentary lifestyle, and both individually and in combination these factors favour improper gestational weight gain (GWG) and consequent maternal and neonatal health problems. The objective of this study was to analyze the environmental and individual factors associated with GWG. METHODS Data were from "Born in Belo Horizonte: Survey on childbirth and birth", a hospital-based retrospective cohort of 506 pregnant women with deliveries in public and private maternity hospitals in Belo Horizonte, Minas Gerais. Data were collected via face-to-face interviews from November 2011 to March 2013. The outcome variable of this study was the GWG categorized based on the Institute of Medicine Guidelines. Explanatory environmental variables included the availability and access to food environment and places available for physical activity in the neighborhood. Explanatory individual variables included socioeconomic and demographic, obstetric and childbirth variables. Generalized estimating equations examined the association of environmental and individual factors with insufficient or excessive GWG. RESULTS The final sample consisted of 506 mothers. There was 36.4% pregnant women showing excessive GWG and 22.7% showing GWG below the recommended interval. Regarding excessive GWG, there was a positive association with the number of mixed food purchasing establishments close to the place of residence, pre-pregnancy body mass index in the categories of overweight and obesity, arterial hypertension and the private sector as the predominant place for prenatal consultations. CONCLUSION GWG outside of the recommended interval was associated with individual and environmental factors, and most pregnant women had insufficient or excessive gestational weight gain. Such results can complement previously published evidence, important for creating more effective strategies for the prevention of excessive and inadequate GWG and the consequent problems related to it during pregnancy.
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Affiliation(s)
- Thales Philipe Rodrigues da Silva
- Departamento de Enfermagem Materno Infantil E Saúde Pública, Postdoctoral Fellow, Ph.D in Health Sciences, Child and Adolescent Health, Universidade Federal de Minas Gerais. Escola de Enfermagem, Programa de Pós-Graduação Em Enfermagem, Belo Horizonte, MG, Brazil
| | | | - Milene Cristine Pessoa
- PhD. Professor, Departamento de Nutrição, Universidade Federal de Minas Gerais. Escola de Enfermagem, Belo Horizonte, MG, Brazil
| | - Mariana Santos Felisbino-Mendes
- PhD. Professor, Departamento de Enfermagem Materno Infantil E Saúde Pública, Universidade Federal de Minas Gerais. Escola de Enfermagem, Belo Horizonte, MG, Brazil
| | | | - Larissa Loures Mendes
- PhD. Professor, Departamento de Nutrição, Universidade Federal de Minas Gerais. Escola de Enfermagem, Belo Horizonte, MG, Brazil
| | - Gustavo Velasquez-Melendez
- PhD. Professor, Departamento de Enfermagem Materno Infantil E Saúde Pública, Universidade Federal de Minas Gerais. Escola de Enfermagem, Belo Horizonte, MG, Brazil
| | - Eunice Francisca Martins
- PhD. Professor, Departamento de Enfermagem Materno Infantil E Saúde Pública, Universidade Federal de Minas Gerais. Escola de Enfermagem, Belo Horizonte, MG, Brazil
| | - Fernanda Penido Matozinhos
- PhD. Professor, Departamento de Enfermagem Materno Infantil E Saúde Pública, Universidade Federal de Minas Gerais. Escola de Enfermagem, Belo Horizonte, MG, Brazil.
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Westbury S, Ghosh I, Jones HM, Mensah D, Samuel F, Irache A, Azhar N, Al-Khudairy L, Iqbal R, Oyebode O. The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries: a systematic review. BMJ Glob Health 2021; 6:e006358. [PMID: 34635553 PMCID: PMC8506857 DOI: 10.1136/bmjgh-2021-006358] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/17/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Diet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions. METHODS We conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of the food environment and a diet, nutrition or health outcome. Study selection was done independently in duplicate. Data extraction and quality appraisal using the National Heart Lung and Blood Institute checklists were completed based on published reports using a prepiloted form on Covidence. Data were synthesised narratively. RESULTS 74 studies met eligibility criteria. Consistent evidence reported an association between availability characteristics in the neighbourhood food environment and dietary behaviour (14 studies, 10 rated as good quality), while the balance of evidence suggested an association with health or nutrition outcomes (17 of 24 relevant studies). We also found a balance of evidence that accessibility to food in the neighbourhood environment was associated with diet (10 of 11 studies) although evidence of an association with health outcomes was contradictory. Evidence on other neighbourhood food environment characteristics was sparse and mixed. Availability in the school food environment was also found to be associated with relevant outcomes. Studies investigating our other primary outcomes in observational studies of the school food environment were sparse, but most interventional studies were situated in schools. We found very little evidence on how workplace and home food environments are associated with relevant outcomes. This is a substantial evidence gap. CONCLUSION 'Zoning' or 'healthy food cart' interventions to alter food availability may be appropriate in urban LMIC. PROSPERO REGISTRATION NUMBER CRD42020207475.
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Affiliation(s)
- Susannah Westbury
- School of Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - Iman Ghosh
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Daniel Mensah
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Folake Samuel
- Department of Human Nutrition and Dietetics, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Ana Irache
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Nida Azhar
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
| | | | - Romaina Iqbal
- Department of Community Health Sciences, The Aga Khan University, Karachi, Sindh, Pakistan
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