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Wayas FA, Smith JA, Lambert EV, Guthrie-Dixon N, Wasnyo Y, West S, Oni T, Foley L. Association of Perceived Neighbourhood Walkability with Self-Reported Physical Activity and Body Mass Index in South African Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2449. [PMID: 36767815 PMCID: PMC9916213 DOI: 10.3390/ijerph20032449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Adolescence is a life stage critical to the establishment of healthy behaviours, including physical activity (PA). Factors associated with the built environment have been shown to impact PA across the life course. We examined the sociodemographic differences in, and associations between, perceived neighbourhood walkability, PA, and body mass index (BMI) in South African adolescents. We recruited a convenience sample (n = 143; 13-18 years; 65% female) of students from three high schools (middle/high and low-income areas). Participants completed a PA questionnaire and the Neighbourhood Environment Walkability Scale (NEWS)-Africa and anthropometry measurements. Multivariable linear regression was used to examine various relationships. We found that, compared with adolescents living in middle/high income neighbourhoods, those living in low-income neighbourhoods had lower perceived walkability and PA with higher BMI percentiles. The associations between neighbourhood walkability and PA were inconsistent. In the adjusted models, land use diversity and personal safety were associated with club sports participation, street connectivity was positively associated with school sports PA, and more favourable perceived walkability was negatively associated with active transport. Overall, our findings suggest that the perceived walkability of lower income neighbourhoods is worse in comparison with higher income neighbourhoods, though the association with PA and BMI is unclear.
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Affiliation(s)
- Feyisayo A. Wayas
- Research Centre for Health through Physical Activity, Lifestyle and Sport (HPALS), Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Joanne A. Smith
- Caribbean Institute for Health Research, Epidemiology Research Unit, The University of the West Indies, Mona, Kingston 7, Jamaica
| | - Estelle V. Lambert
- Research Centre for Health through Physical Activity, Lifestyle and Sport (HPALS), Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | - Natalie Guthrie-Dixon
- Caribbean Institute for Health Research, Epidemiology Research Unit, The University of the West Indies, Mona, Kingston 7, Jamaica
| | - Yves Wasnyo
- Health of Populations in Transition (HoPiT), Research Group, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé P.O. Box 8046, Cameroon
| | - Sacha West
- Department of Sport Management, Cape Peninsula University of Technology, Cape Town 7705, South Africa
| | - Tolu Oni
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
- Research Initiative for Cities Health and Equity (RICHE), School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa
| | - Louise Foley
- Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge CB2 0QQ, UK
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Treister-Goltzman Y, Peleg R. Adolescent Obesity and Type Two Diabetes in Young Adults in the Minority Muslim Bedouin Population in Southern Israel. J Community Health 2022; 48:420-429. [DOI: 10.1007/s10900-022-01178-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
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Malacarne D, Handakas E, Robinson O, Pineda E, Saez M, Chatzi L, Fecht D. The built environment as determinant of childhood obesity: A systematic literature review. Obes Rev 2022; 23 Suppl 1:e13385. [PMID: 34859950 DOI: 10.1111/obr.13385] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 01/19/2023]
Abstract
We evaluated the epidemiological evidence on the built environment and its link to childhood obesity, focusing on environmental factors such as traffic noise and air pollution, as well as physical factors potentially driving obesity-related behaviors, such as neighborhood walkability and availability and accessibility of parks and playgrounds. Eligible studies were (i) conducted on human children below the age of 18 years, (ii) focused on body size measurements in childhood, (iii) examined at least one built environment characteristic, (iv) reported effect sizes and associated confidence intervals, and (v) were published in English language. A z test, as alternative to the meta-analysis, was used to quantify associations due to heterogeneity in exposure and outcome definition. We found strong evidence for an association of traffic-related air pollution (nitrogen dioxide and nitrogen oxides exposure, p < 0.001) and built environment characteristics supportive of walking (street intersection density, p < 0.01 and access to parks, p < 0.001) with childhood obesity. We identified a lack of studies that account for interactions between different built environment exposures or verify the role and mechanism of important effect modifiers such as age.
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Affiliation(s)
- Diego Malacarne
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Evangelos Handakas
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Oliver Robinson
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Elisa Pineda
- Centre for Health Economics & Policy Innovation (CHEPI), Imperial College Business School, and School of Public Health, Imperial College London, London, UK
| | - Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Leda Chatzi
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
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Cain KL, Salmon J, Conway TL, Cerin E, Hinckson E, Mitáš J, Schipperijn J, Frank LD, Anjana RM, Barnett A, Dygrýn J, Islam MZ, Molina-García J, Moran M, Wan Muda WAM, Oyeyemi AL, Reis R, Santos MP, Schmidt T, Schofield GM, Timperio A, Van Dyck D, Sallis JF. International Physical Activity and Built Environment Study of adolescents: IPEN Adolescent design, protocol and measures. BMJ Open 2021; 11:e046636. [PMID: 33462102 PMCID: PMC7813342 DOI: 10.1136/bmjopen-2020-046636] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Only international studies can provide the full variability of built environments and accurately estimate effect sizes of relations between contrasting environments and health-related outcomes. The aims of the International Physical Activity and Environment Study of Adolescents (IPEN Adolescent) are to estimate the strength, shape and generalisability of associations of the community environment (geographic information systems (GIS)-based and self-reported) with physical activity and sedentary behaviour (accelerometer-measured and self-reported) and weight status (normal/overweight/obese). METHODS AND ANALYSIS The IPEN Adolescent observational, cross-sectional, multicountry study involves recruiting adolescent participants (ages 11-19 years) and one parent/guardian from neighbourhoods selected to ensure wide variations in walkability and socioeconomic status using common protocols and measures. Fifteen geographically, economically and culturally diverse countries, from six continents, participated: Australia, Bangladesh, Belgium, Brazil, Czech Republic, Denmark, Hong Kong SAR, India, Israel, Malaysia, New Zealand, Nigeria, Portugal, Spain and USA. Countries provided survey and accelerometer data (15 countries), GIS data (11), global positioning system data (10), and pedestrian environment audit data (8). A sample of n=6950 (52.6% female; mean age=14.5, SD=1.7) adolescents provided survey data, n=4852 had 4 or more 8+ hours valid days of accelerometer data, and n=5473 had GIS measures. Physical activity and sedentary behaviour were measured by waist-worn ActiGraph accelerometers and self-reports, and body mass index was used to categorise weight status. ETHICS AND DISSEMINATION Ethical approval was received from each study site's Institutional Review Board for their in-country studies. Informed assent by adolescents and consent by parents was obtained for all participants. No personally identifiable information was transferred to the IPEN coordinating centre for pooled datasets. Results will be communicated through standard scientific channels and findings used to advance the science of environmental correlates of physical activity, sedentary behaviour and weight status, with the ultimate goal to stimulate and guide actions to create more activity-supportive environments internationally.
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Affiliation(s)
- Kelli L Cain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Jo Salmon
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Terry L Conway
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, University of Hong Kong, Hong Kong
| | - Erica Hinckson
- School of Sport & Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Josef Mitáš
- Institute of Active Lifestyle, Palacky University Olomouc, Olomouc, Olomoucký, Czech Republic
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lawrence D Frank
- Urban Design 4 Health, Seattle, Washington, USA
- Department of Urban Studies and Planning, University of California San Diego, La Jolla, California, USA
| | | | - Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Jan Dygrýn
- Institute of Active Lifestyle, Palacky University Olomouc, Olomouc, Olomoucký, Czech Republic
| | - Mohammed Zakiul Islam
- Department of Architecture, Bangladesh University of Engineering and Technology, Dhaka, Dhaka District, Bangladesh
| | - Javier Molina-García
- AFIPS research group, Department of Musical, Visual and Corporal Expression Teaching, University of Valencia, Valencia, Spain
| | - Mika Moran
- Institute of Urban and Regional Development, University of California Berkeley, Berkeley, California, USA
- School of Public Health, University of Haifa, Haifa, Israel
| | | | - Adewale L Oyeyemi
- Department of Physiotherapy, University of Maiduguri, Maiduguri, Borno, Nigeria
| | - Rodrigo Reis
- Prevention Research Center, Brown School at Washington University in St Louis, St Louis, Missouri, USA
- Graduate Program in Urban Management, Pontifical Catholic University of Parana, Curitiba, Paraná, Brazil
| | - Maria Paula Santos
- Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
| | - Tanja Schmidt
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Grant M Schofield
- School of Sport & Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Anna Timperio
- Institute of Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Delfien Van Dyck
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - James F Sallis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
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Sun Y, He C, Zhang X, Zhu W. Association of Built Environment with Physical Activity and Physical Fitness in Men and Women Living inside the City Wall of Xi'an, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144940. [PMID: 32659921 PMCID: PMC7400164 DOI: 10.3390/ijerph17144940] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/01/2020] [Accepted: 07/04/2020] [Indexed: 12/20/2022]
Abstract
This study was to investigate the association of built environment (BE) with physical activity (PA) and physical fitness of residents inside the city wall of Xi'an, one of the most historic cities in China. The cross-sectional study was conducted among 728 adults in this area. BE and PA were measured by Neighborhood Environment Walkability Scale and International Physical Activity Questionnaire, respectively. Body mass index (BMI), body fat percentage, blood pressure (BP), lung capacity, curl up, sit and reach, reaction time, balance, and grip strength were also measured. The results showed, for men, aesthetics was positively associated with total and leisure-time PA, and curl-up tests, respectively. Walking/cycling facilities were positively associated with leisure-time PA. Street connectivity was negatively associated with leisure-time PA and BMI. Residential density was positively correlated with BMI. Access to service was positively associated with lung capacity. Crime safety was negatively correlated with reaction time. For women, residential density was negatively associated with transportation PA and BP. Street connectivity was positively associated with curl-up test. The results suggest some BE attributes are positively related to PA and physical fitness in this population. Creating more PA-supportive BEs is recommended in this historic area along with urban conservation.
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Affiliation(s)
- Yuliang Sun
- Department of Exercise Science, School of Physical Education, Shaanxi Normal University, Xi’an 710119, China; (Y.S.); (X.Z.)
| | - Chunzhen He
- Department of Physical Education, Shanghai Ganxiang School, Shanghai 201515, China;
| | - Xinxin Zhang
- Department of Exercise Science, School of Physical Education, Shaanxi Normal University, Xi’an 710119, China; (Y.S.); (X.Z.)
| | - Wenfei Zhu
- Department of Exercise Science, School of Physical Education, Shaanxi Normal University, Xi’an 710119, China; (Y.S.); (X.Z.)
- Correspondence: ; Tel.: +86-17792321530
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Overview of the Pathogenesis, Genetic, and Non-Invasive Clinical, Biochemical, and Scoring Methods in the Assessment of NAFLD. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193570. [PMID: 31554274 PMCID: PMC6801903 DOI: 10.3390/ijerph16193570] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/16/2019] [Accepted: 09/20/2019] [Indexed: 02/06/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide. It represents a range of disorders, including simple steatosis, nonalcoholic steatohepatitis (NASH), and liver cirrhosis, and its prevalence continues to rise. In some cases, hepatocellular carcinoma (HCC) may develop. The develop;ment of non-invasive diagnostic and screening tools is needed, in order to reduce the frequency of liver biopsies. The most promising methods are those able to exclude advanced fibrosis and quantify steatosis. In this study, new perspective markers for inflammation, oxidative stress, apoptosis, and fibrogenesis; emerging scoring models for detecting hepatic steatosis and fibrosis; and new genetic, epigenetic, and multiomic studies are discussed. As isolated biochemical parameters are not specific or sensitive enough to predict the presence of NASH and fibrosis, there is a tendency to use various markers and combine them into mathematical algorithms. Several predictive models and scoring systems have been developed. Current data suggests that panels of markers (NAFLD fibrosis score, Fib-4 score, BARD score, and others) are useful diagnostic modalities to minimize the number of liver biopsies. The review unveils pathophysiological aspects related to new trends in current non-invasive biochemical, genetic, and scoring methods, and provides insight into their diagnostic accuracies and suitability in clinical practice.
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Sousa CM, Santana E, Lopes MV, Lima G, Azoubel L, Carneiro É, Barros AK, Pires N. Development of a Computational Model to Predict Excess Body Fat in Adolescents through Low Cost Variables. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2962. [PMID: 31426509 PMCID: PMC6720279 DOI: 10.3390/ijerph16162962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/03/2019] [Accepted: 08/14/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Excess body fat has been growing alarmingly among adolescents, especially in low income and middle income countries where access to health services is scarce. Currently, the main method for assessing overweight in adolescents is the body mass index, but its use is criticized for its low sensitivity and high specificity, which may lead to a late diagnosis of comorbidities associated with excess body fat, such as cardiovascular diseases. Thus, the aim of this study was to develop a computational model using linear regression to predict obesity in adolescents and compare it with commonly used anthropometric methods. To improve the performance of our model, we estimated the percentage of fat and then classified the nutritional status of these adolescents. METHODS The model was developed using easily measurable socio-demographic and clinical variables from a database of 772 adolescents of both genders, aged 10-19 years. The predictive performance was evaluated by the following metrics: accuracy, sensitivity, specificity, and area under ROC curve. The performance of the method was compared to the anthropometric parameters: body mass index and waist-to-height ratio. RESULTS Our model showed a high correlation (R = 0.80) with the body fat percentage value obtained through bioimpedance. In addition, regarding discrimination, our model obtained better results compared to BMI and WHtR: AUROC = 0.80, 0.64, and 0.55, respectively. It also presented a high sensitivity of 92% and low false negative rate (6%), while BMI and WHtR showed low sensitivity (27% and 9.9%) and a high false negative rate (65% and 53%), respectively. CONCLUSIONS The computational model of this study obtained a better performance in the evaluation of excess body fat in adolescents, compared to the usual anthropometric indicators presenting itself as a low cost alternative for screening obesity in adolescents living in Brazilian regions where financial resources are scarce.
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Affiliation(s)
- Carlos Magno Sousa
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
| | - Ewaldo Santana
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil.
- Laboratory of Signals Acquisition and Processing, LAPS, State University of Maranhão, Campus Paulo VI, São Luís 65700000, MA, Brazil.
| | - Marcus Vinicius Lopes
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
| | - Guilherme Lima
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
| | - Luana Azoubel
- Centro de Prevenção de Doenças Renais, University Hospital of Maranhão, São Luís 65080805, MA, Brazil
| | - Érika Carneiro
- Centro de Prevenção de Doenças Renais, University Hospital of Maranhão, São Luís 65080805, MA, Brazil
| | - Allan Kardec Barros
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
| | - Nilviane Pires
- Department of Electrical Engineering, Biological Information Processing Lab, Federal University of Maranhão, São Luis 65085680, MA, Brazil
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Kim J, Kim YM, Jang HB, Lee HJ, Park SI, Park KH, Lim H. Evidence-based Nutritional Intervention Protocol for Korean Moderate-Severe Obese Children and Adolescents. Clin Nutr Res 2019; 8:184-195. [PMID: 31384597 PMCID: PMC6675960 DOI: 10.7762/cnr.2019.8.3.184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 07/23/2019] [Accepted: 07/24/2019] [Indexed: 12/30/2022] Open
Abstract
Diet-related behavioral modification for healthy eating and lifestyle is required to improve childhood obesity. The present study aimed to develop customized nutritional intervention protocol and education program to find barriers to adhere healthy diet and lifestyle for moderate to severe obese children and adolescents and their families. Theoretical framework approaches can be used to change behavior and achieve goals. Previous studies that described the relationship between behavioral modification and nutrition education theory were reviewed. The social cognitive theory and transtheoretical model were employed with behavioral changes to target a healthful diet and lifestyle. The nutrition care process (NCP) model was adopted to customize nutrition care for the participants. Customized nutritional intervention protocol was developed following as the four steps of the NCP. Firstly, nutrition status of the participants was assessed by the nutrition expert. Nutrition problems were described as "inadequate energy intake," "overweight/obesity," or "food and nutrition-related knowledge deficit." All nutrition sessions were designed for nutrition intervention to give nutritional knowledge and a practical mission in real life for individual goal setting and self-control. Meal planning, portion control, healthy snack selection and cooking with fruits and vegetables were consisted of five components of the nutrition education session. During each session, the participants and their families were interviewed by a nutrition expert for monitoring and evaluating diet-related goal setting and achievement. A theoretical and evidence-based nutritional intervention was developed for the secondary to tertiary prevention of childhood obesity. This nutrition intervention protocol and program might be helpful for the further research on childhood obesity. Trial Registration Clinical Research Information Service Identifier: KCT0002111.
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Affiliation(s)
- Jieun Kim
- Department of Medical Nutrition, Kyung Hee University, Yongin 17104, Korea.,Research Institute of Medical Nutrition, Kyung Hee University, Seoul 02447, Korea
| | - Yoon Myung Kim
- Department of Sports Industry Studies, Yonsei University International Campus, Incheon 21983, Korea
| | - Han Byul Jang
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju 28159, Korea
| | - Hye-Ja Lee
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju 28159, Korea
| | - Sang Ick Park
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju 28159, Korea
| | - Kyung-Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Kyung Hee University, Yongin 17104, Korea.,Research Institute of Medical Nutrition, Kyung Hee University, Seoul 02447, Korea
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