Can mindful eating buffer against the influence of neighbourhood fast food exposure on unhealthy food intake?

A food-abundant environment is associated with unhealthy food intake, but not everyone is affected to the same degree. Mindful eating, which is eating with attention and awareness, has been associated with less external eating and less food cravings, and could act as a protective factor against influences from the food environment. The current study aimed to investigate whether the association between exposure to fast-food around the home and unhealthy food intake was moderated by mindful eating. The study was conducted in 1086 Dutch adults of 55 years and older of the Longitudinal Aging Study Amsterdam study. The mindful eating domains (Mindful Eating Behavior Scale) were tested as moderating variables in the linear regression models with absolute and relative density of fast-food outlets in the neighbourhood (400, 800 and 1600m) as independent variables and unhealthy food intake (snacks (g/d)) and saturated fat as a percentage of total energy intake (en%)) as dependent variable. Bootstrapping with 5000 samples using the pick-a-point approach showed that after adjustments, only two out of 48 interactions terms were statistically significant: Eating with Awareness (EwA) and Eating without Distraction (EwD) moderated the positive association between the relative density of fast-food outlets and saturated fat (en%) respectively in a buffer of 800m (interaction EwA: B = -0.84, 95% CI [-1.46; -0.22]) and in a buffer of 1600m (interaction EwD: B = -0.82, 95% CI [-1.61; -0.04]). The results of the current study indicate that mindful eating cannot buffer against the influence of the fast-food abundant environment on unhealthy food intake. Future research is needed to confirm these findings, for example in younger populations.

Ethnic and socioeconomic inequalities in relation to air pollution exposure in the Netherlands

Background

Air pollution (AP) contributes to a large disease burden and some populations are disproportionately exposed. It is unclear to what extent AP exposure differs across ethnic groups in the Netherlands and how this intersects with socioeconomic position (SEP). First, we identified differences in AP exposures between ethnic groups in the Netherlands. Second, we examined the interrelationships between ethnicity and SEP in relation to AP exposures.

Methods

We assessed AP exposures for residents of the Netherlands in 2019 (N = 17,251,511). Home address AP levels were estimated by dispersion models of the National Institute of Public Health and the Environment (RIVM). We linked exposure estimations of particulate matter <10 or < 2.5 μm (PM10, PM2.5), nitrogen dioxide (NO2), and elemental carbon (EC) to demographic data gathered by Statistics Netherlands. Absolute and relative differences in AP levels across ethnic groups were assessed. We conducted multivariable linear regression analyses and estimated marginal mean exposures to evaluate differences by ethnicity, SEP, age and sex within urban and rural areas. We tested for interactions and stratified accordingly.

Results

For the 40 largest minority ethnic groups (N > 18,314 per group), exposure to all pollutants was higher than for ethnic Dutch, with up to 1.5-fold differences for NO2. After stratification for urbanity and SEP, ethnic exposure inequalities persisted. For ethnic Dutch and some migrant groups, we found the lowest AP exposures in the middle SEP group (i.e. U-shaped trends), while we found linear patterns in other large migrant groups, with higher exposures at lower SEP.

Conclusions

Exposure to PM10, PM2.5, NO2, and EC was consistently higher in minority ethnic groups compared to ethnic Dutch. The association between SEP and AP levels showed different patterns between the majority ethnic Dutch and some of the largest minority ethnic groups. Further research is needed to define the equity and health implications.

Key messages

• Minority ethnic groups in the Netherlands are consistently exposed to higher levels of air pollution (PM10, PM2.5, NO2, and EC) than the ethnic Dutch population.

• Depending on the ethnic group, the association between SEP and air pollution exposure was either linear (i.e. lower exposures at higher SEP) or U-shaped (i.e. lower exposures in the middle SEP group).

Social environment and cardiometabolic health outcomes: systematic review and meta-analysis

 

A number of studies investigated the relationship between the social environment (SE) (i.e., the social relationships and social context in which groups of people live and interact) and lifestyle behaviours. However, to what extent this relation extends to cardiometabolic disease (CMD) outcomes is unknown. This systematic review and meta-analysis summarizes the available evidence. We systematically searched PubMed (Medline), Scopus, and Web of Science from inception to 16 February 2021. Outcomes of were type 2 diabetes mellitus and cardiovascular diseases and determinants were SE factors. We assessed the quality of the studies with Newcastle-Ottawa Scale (NOS). We meta-analysed exposure-outcome combinations when ≥3 associations from high quality papers were available. Results are expressed as OR, 95%CI. From 7,671 records screened, 208 were included. Of these, 92% were conducted in high income countries, 58% were cross-sectional studies, and 20% were of poor quality. Among the 208 studies, 746 relevant associations were investigated. The largest number of associations investigated was on the dimension Economic and Social Disadvantage (ESD; 59%), followed by Social Relationships and Norms (21%) and Discrimination and Segregation (9%). Less evidence was found for the remaining dimensions. Meta-analysis of 14 exposure-outcome combinations indicated that worse SE was associated with increased odds of CMD outcomes. Despite this tendency, only the association between ESD and heart failure was statistically significant (1.58, 1.11-2.27; n = 4; I2=92%). Generally, heterogeneity was high. In conclusion, higher levels of ESD seem to contribute to increased risk of heart failure. The existing literature is highly heterogeneous and varies notably in terminology. Moreover, the dimensions Social Cohesion and Social Capital, Crime and Safety, Civic Participation and Engagement and Disorder and Incivilities are underexplored in relation to CMD. (PROSPERO-ID: CRD42021223035).

Key messages

• Worse SE was associated with increased odds of CMD outcomes, with higher levels of Economic and Social Disadvantage being statistically significantly associated with increased risk of heart failure.

• The existing literature is highly heterogeneous and varies notably in study design and terminology.

Real-life effects of nudging and pricing strategies in the supermarket to promote healthy diets

Background

Unhealthy dietary patterns pose a major public health challenge. Individual-level efforts to promote heathy diets (e.g. nutrition education) have limited effect on the long term. Context-specific interventions focussing on point-of-purchase may create opportunities for sustainable dietary changes. We evaluated real-life effects of nudging and pricing strategies in supermarkets on dietary intake.

Methods

In this parallel cluster-randomised controlled trial, we randomized 12 Dutch supermarkets in socially deprived neighbourhoods to a control group (n = 6), or intervention group (n = 6). Healthy food nudges were implemented in intervention stores across 13 food groups, combined with healthy product price decreases and unhealthy product price increases. Eligible participants were aged 30-80 years and regular shoppers at participating stores. The primary outcome was dietary guideline adherence measured via an index score (0-150), at baseline and after 3, 6 and 12 months. Secondary outcomes included parameters of cardiometabolic health (HbA1c, lipid profile, and waist circumference), the percentage of healthy food purchases in the supermarket, socio-cognitive factors, and supermarket customer satisfaction. Effects were analysed with linear mixed models.

Results

This study included 173 participants from intervention clusters and 220 from control clusters. Preliminary evaluation of the 3-month follow-up data revealed no effectiveness of the nudging and pricing strategies compared to the control supermarkets in terms of dietary guideline adherence (β -0.8, 95%CI -4.2; 2.7). Results on all outcomes will be available at time of the conference.

Conclusions

This novel supermarket trial is the first to evaluate real-life long-term effects of nudging and pricing strategies based on a comprehensive set of study outcomes and using a strong methodological design. Findings can direct future design of context-specific interventions focussing on the promotion of healthy diets.

Key messages

• Context-specific interventions focussing on point-of-purchase may create opportunities for sustainable dietary changes.

• Findings from this supermarket trial testing real-life and long-term effects of nudging and pricing strategies can direct future design of context-specific interventions focussing on healthy diets.

An appeal to our government for nationwide policies in the prevention of cardiovascular disease

The high prevalence and burden of cardiovascular diseases (CVD) is largely attributable to unhealthy lifestyle factors such as smoking, alcohol consumption, physical inactivity and unhealthy food habits. Prevention of CVD, through the promotion of healthy lifestyles, appears to be a Sisyphean task for healthcare professionals, as the root causes of an unhealthy lifestyle lie largely outside their scope. Since most lifestyle choices are habitual and a response to environmental cues, rather than rational and deliberate choices, nationwide policies targeting the context in which lifestyle behaviours occur may be highly effective in the prevention of CVD. In this point-of-view article, we emphasise the need for government policies beyond those mentioned in the National Prevention Agreement in the Netherlands to effectively reduce the CVD risk, and we address the commonly raised concerns regarding ‘paternalism’.

The effect of on-shelf sugar labeling on beverage sales in the supermarket: a comparative interrupted time series analysis of a natural experiment

BACKGROUND

Nutrition labels show potential in increasing healthy food and beverage purchases, but their effectiveness seems to depend on the type of label, the targeted food category and the setting, and evidence on their impact in real-world settings is limited. The aim of this study was to evaluate the effectiveness of an industry-designed on-shelf sugar label on the sales of beverages with no, low, medium and high sugar content implemented within a real-world supermarket.

METHODS

In week 17 of 2019, on-shelf sugar labels were implemented by a Dutch supermarket chain. Non-alcoholic beverages were classified using a traffic-light labeling system and included the beverage categories "green" for sugar free (< 1.25 g/250 ml), "blue" for low sugar (1.25-6.24 g/250 ml), "yellow" for medium sugar (6.25-13.5 g/250 ml) and "amber" for high sugar (> 13.5 g/250 ml). Store-level data on beverage sales and revenue from 41 randomly selected supermarkets for 13 weeks pre-implementation and 21 weeks post-implementation were used for analysis. In total, 30 stores implemented the on-shelf sugar labels by week 17, and the 11 stores that had not were used as comparisons. Outcome measures were differences in the number of beverages sold in the four label categories and the total revenue from beverage sales in implementation stores relative to comparison stores. Analyses were conducted using a multiple-group Interrupted Time Series Approach. Results of individual store data were combined using random effect meta-analyses.

RESULTS

At the end of the intervention period, the changes in sales of beverages with green (B 3.4, 95%CI -0.3; 7.0), blue (B 0.0, 95%CI -0.6; 0.7), yellow (B 1.3, 95%CI -0.9; 3.5), and amber (B 0.9, 95%CI -5.5; 7.3) labels were not significantly different between intervention and comparison stores. The changes in total revenues for beverages at the end of the intervention period were also not significantly different between intervention and comparison stores.

CONCLUSION

The implementation of an on-shelf sugar labeling system did not significantly decrease unhealthy beverage sales or significantly increase healthier beverage sales. Nutrition labeling initiatives combined with complementary strategies, such as pricing strategies or other healthy food nudging approaches, should be considered to promote healthier beverage purchases.

Environmental and individual characteristics associated with car use across Europe

Background

This study aimed to determine which neighbourhood- and individual-level characteristics were associated with car driving in adults of five urban areas across Europe, and to determine the percentage of variance in car driving explained by characteristics at both levels.

Methods

Neighbourhood environment characteristics potentially related to car use were identified from the literature. These characteristics were subsequently assessed using a Google Street View audit and available GIS databases, in 59 administrative residential neighbourhoods in five European urban areas. Car driving (min/week) and individual level characteristics were self-reported by study participants (analytic sample n = 4,258). We used linear multilevel regression analyses to assess cross-sectional associations of individual and neighbourhood-level characteristics with weekly minutes of car driving, and assessed explained variance at each level and for the total model.

Results

Higher residential density (β:-2.61, 95%CI: -4.99;-0.22) and higher land-use mix (β:-3.73, 95%CI: -5.61;-1.86) were significantly associated with fewer weekly minutes of car driving. At the individual level, higher age (β: 1.47, 95%CI: 0.60;2.33), male sex (β: 43.2, 95%CI:24.7; 61.7), being employed (β:80.1, 95%CI: 53.6; 106.5) and ≥3 person household composition (β: 47.4, 95%CI: 20.6;74.2) were associated with higher weekly minutes of car driving. Individual and neighbourhood characteristics contributed about equally to explained variance in minutes of weekly car driving, with 2% and 3% respectively.

Conclusions

Residential density and land-use mix were consistently associated with minutes of weekly car driving, besides age, sex, employment and household composition. Although total explained variance was low, both individual- and neighbourhood-level characteristics were similarly important in their associations with car use in five European urban areas.

Key messages

Both individual and neighbourhood level characteristics contributed equally to explained variation in car driving, across Europe. Higher residential density and land-use mix are consistently associated with lower care use.

Exploring the relationship between perceived barriers to healthy eating and dietary behaviours in European adults

PURPOSE

Dietary behaviours may be influenced by perceptions of barriers to healthy eating. Using data from a large cross-European study (N = 5900), we explored associations between various perceived barriers to healthy eating and dietary behaviours among adults from urban regions in five European countries and examined whether associations differed across regions and socio-demographic backgrounds.

METHODS

Frequency of consumption of fruit, vegetables, fish, fast food, sugar-sweetened beverages, sweets, breakfast and home-cooked meals were split by the median into higher and lower consumption. We tested associations between barriers (irregular working hours; giving up preferred foods; busy lifestyle; lack of willpower; price of healthy food; taste preferences of family and friends; lack of healthy options and unappealing foods) and dietary variables using multilevel logistic regression models. We explored whether associations differed by age, sex, education, urban region, weight status, household composition or employment.

RESULTS

Respondents who perceived any barrier were less likely to report higher consumption of healthier foods and more likely to report higher consumption of fast food. 'Lack of willpower', 'time constraints' and 'taste preferences' were most consistently associated with consumption. For example, those perceiving lack of willpower ate less fruit [odds ratio (OR) 0.57; 95% confidence interval (CI) 0.50-0.64], and those with a busy lifestyle ate less vegetables (OR 0.54; 95% CI 0.47-0.62). Many associations differed in size, but not in direction, by region, sex, age and household composition.

CONCLUSION

Perceived 'lack of willpower', 'time constraints' and 'taste preferences' were barriers most strongly related to dietary behaviours, but the association between various barriers and lower intake of fruit and vegetables was somewhat more pronounced among younger participants and women.

The relation between sleep duration and sedentary behaviours in European adults

Too much sitting, and both short and long sleep duration are associated with obesity, but little is known on the nature of the relations between these behaviours. We therefore examined the associations between sleep duration and time spent sitting in adults across five urban regions in Europe. We used cross-sectional survey data from 6,037 adults (mean age 51.9 years (SD 16.4), 44.0% men) to assess the association between self-reported short (<6 h per night), normal (6-8 h per night) and long (>8 h per night) sleep duration with self-report total time spent sitting, time spent sitting at work, during transport, during leisure and while watching screens. The multivariable multilevel linear regression models were tested for moderation by urban region, age, gender, education and weight status. Because short sleepers have more awake time to be sedentary, we also used the percentage of awake time spent sedentary as an outcome. Short sleepers had 26.5 min day(-1) more sedentary screen time, compared with normal sleepers (CI 5.2; 47.8). No statistically significant associations were found with total or other domains of sedentary behaviour, and there was no evidence for effect modification. Long sleepers spent 3.2% higher proportion of their awake time sedentary compared with normal sleepers. Shorter sleep was associated with increased screen time in a sample of European adults, irrespective of urban region, gender, age, educational level and weight status. Experimental studies are needed to assess the prospective relation between sedentary (screen) time and sleep duration.

Perceived environmental correlates of cycling for transport among adults in five regions of Europe

Regular cycling for transport is an important potential contributor to daily physical activity among adults. Characteristics of the physical environment are likely to influence cycling for transport. The current study investigated associations between perceived physical environmental neighbourhood factors and adults' cycling for transport across five urban regions across Europe, and whether such associations were moderated by age, gender, education and urban region. A total of 4,612 adults from five European regions provided information about their transport-related cycling and their neighbourhood physical environmental perceptions in an online survey. Hurdle models adjusted for the clustering within neighbourhoods were performed to estimate associations between perceived physical environmental neighbourhood factors and odds of engaging in cycling for transport and minutes of cycling for transport per week. Inhabitants of neighbourhoods that were perceived to be polluted, having better street connectivity, having lower traffic speed levels and being less pleasant to walk or cycle in had higher levels of cycling for transport. Moderation analyses revealed only one interaction effect by gender. This study indicates that cycling for transport is associated with a number of perceived physical environmental neighbourhood factors across five urban regions across Europe. Our results indicated that the majority of the outcomes identified were valid for all subgroups of age, gender, education and across regions in the countries included in the study.

Neighbourhood typology based on virtual audit of environmental obesogenic characteristics

Virtual audit (using tools such as Google Street View) can help assess multiple characteristics of the physical environment. This exposure assessment can then be associated with health outcomes such as obesity. Strengths of virtual audit include collection of large amount of data, from various geographical contexts, following standard protocols. Using data from a virtual audit of obesity-related features carried out in five urban European regions, the current study aimed to (i) describe this international virtual audit dataset and (ii) identify neighbourhood patterns that can synthesize the complexity of such data and compare patterns across regions. Data were obtained from 4,486 street segments across urban regions in Belgium, France, Hungary, the Netherlands and the UK. We used multiple factor analysis and hierarchical clustering on principal components to build a typology of neighbourhoods and to identify similar/dissimilar neighbourhoods, regardless of region. Four neighbourhood clusters emerged, which differed in terms of food environment, recreational facilities and active mobility features, i.e. the three indicators derived from factor analysis. Clusters were unequally distributed across urban regions. Neighbourhoods mostly characterized by a high level of outdoor recreational facilities were predominantly located in Greater London, whereas neighbourhoods characterized by high urban density and large amounts of food outlets were mostly located in Paris. Neighbourhoods in the Randstad conurbation, Ghent and Budapest appeared to be very similar, characterized by relatively lower residential densities, greener areas and a very low percentage of streets offering food and recreational facility items. These results provide multidimensional constructs of obesogenic characteristics that may help target at-risk neighbourhoods more effectively than isolated features.

Exploring why residents of socioeconomically deprived neighbourhoods have less favourable perceptions of their neighbourhood environment than residents of wealthy neighbourhoods

Residents of socioeconomically deprived areas perceive their neighbourhood as less conducive to healthy behaviours than residents of more affluent areas. Whether these unfavourable perceptions are based on objective neighbourhood features or other factors is poorly understood. We examined individual and contextual correlates of socioeconomic inequalities in neighbourhood perceptions across five urban regions in Europe. Data were analysed from 5205 participants of the SPOTLIGHT survey. Participants reported perceptions of their neighbourhood environment with regard to aesthetics, safety, the presence of destinations and functionality of the neighbourhood, which were summed into an overall neighbourhood perceptions score. Multivariable multilevel regression analyses were conducted to investigate whether the following factors were associated with socioeconomic inequalities in neighbourhood perceptions: objectively observed neighbourhood features, neighbourhood social capital, exposure to the neighbourhood, self-rated health and lifestyle behaviours. Objectively observed traffic safety, aesthetics and the presence of destinations in the neighbourhood explained around 15% of differences in neighbourhood perceptions between residents of high and low neighbourhoods; levels of neighbourhood social cohesion explained around 52%. Exposure to the neighbourhood, self-rated health and lifestyle behaviours were significant correlates of neighbourhood perceptions but did not contribute to socioeconomic differences. This cross-European study provided evidence that socioeconomic differences in neighbourhood perceptions are not only associated with objective neighbourhood features but also with social cohesion. Levels of physical activity, sleep duration, self-rated health, happiness and neighbourhood preference were also associated with neighbourhood perceptions.

Self-defined residential neighbourhoods: size variations and correlates across five European urban regions

The neighbourhood is recognized as an important unit of analysis in research on the relation between obesogenic environments and development of obesity. One important challenge is to define the limits of the residential neighbourhood, as perceived by study participants themselves, in order to improve our understanding of the interaction between contextual features and patterns of obesity. An innovative tool was developed in the framework of the SPOTLIGHT project to identify the boundaries of neighbourhoods as defined by participants in five European urban regions. The aims of this study were (i) to describe self-defined neighbourhood (size and overlap with predefined residential area) according to the characteristics of the sampling administrative neighbourhoods (residential density and socioeconomic status) within the five study regions and (ii) to determine which individual or/and environmental factors are associated with variations in size of self-defined neighbourhoods. Self-defined neighbourhood size varies according to both individual factors (age, educational level, length of residence and attachment to neighbourhood) and contextual factors. These findings have consequences for how residential neighbourhoods are defined and operationalized and can inform how self-defined neighbourhoods may be used in research on associations between contextual characteristics and health outcomes such as obesity.

Neighbourhood social capital: measurement issues and associations with health outcomes

We compared ecometric neighbourhood scores of social capital (contextual variation) to mean neighbourhood scores (individual and contextual variation), using several health-related outcomes (i.e. self-rated health, weight status and obesity-related behaviours). Data were analysed from 5,900 participants in the European SPOTLIGHT survey. Factor analysis of the 13-item social capital scale revealed two social capital constructs: social networks and social cohesion. The associations of ecometric and mean neighbourhood-level scores of these constructs with self-rated health, weight status and obesity-related behaviours were analysed using multilevel regression analyses, adjusted for key covariates. Analyses using ecometric and mean neighbourhood scores, but not mean neighbourhood scores adjusted for individual scores, yielded similar regression coefficients. Higher levels of social network and social cohesion were not only associated with better self-rated health, lower odds of obesity and higher fruit consumption, but also with prolonged sitting and less transport-related physical activity. Only associations with transport-related physical activity and sedentary behaviours were associated with mean neighbourhood scores adjusted for individual scores. As analyses using ecometric scores generated the same results as using mean neighbourhood scores, but different results when using mean neighbourhood scores adjusted for individual scores, this suggests that the theoretical advantage of the ecometric approach (i.e. teasing out individual and contextual variation) may not be achieved in practice. The different operationalisations of social network and social cohesion were associated with several health outcomes, but the constructs that appeared to represent the contextual variation best were only associated with two of the outcomes.

Psychosocial environment: definitions, measures and associations with weight status--a systematic review

Socio-ecological models suggest that many elements of the social environment act as upstream determinants of obesity. This systematic review examined definitions, measures and strength of associations between the psychosocial environment and adult weight status. Studies were included if they were conducted on adults, the outcome was weight status, carried out in any developed country and investigated at least one psychosocial environmental construct. Six databases for primary studies were searched: EMBASE, MEDLINE, PsycINFO, Scopus, Web of Science and the Cochrane Library. We restricted our search to studies published in English between January 1995 and February 2015. An adapted 'Quality Assessment Tool for Quantitative Studies' was used to evaluate risk of bias of included studies. Out of 14,784 screened records, 42 articles were assessed using full text. A total of 19 studies were included. The strongest associations with weight status were found for social capital and collective efficacy, although few studies found significant associations. There was heterogeneity in the definitions and metrics of psychosocial environmental constructs. There is limited evidence that greater social capital and collective efficacy are associated with healthier weight status. The research conducted to date has not robustly identified relations. We highlight challenges to undertaking research and establishing causality in this field and provide recommendations for further research.

Mismatch between perceived and objectively measured environmental obesogenic features in European neighbourhoods

Findings from research on the association between the built environment and obesity remain equivocal but may be partly explained by differences in approaches used to characterize the built environment. Findings obtained using subjective measures may differ substantially from those measured objectively. We investigated the agreement between perceived and objectively measured obesogenic environmental features to assess (1) the extent of agreement between individual perceptions and observable characteristics of the environment and (2) the agreement between aggregated perceptions and observable characteristics, and whether this varied by type of characteristic, region or neighbourhood. Cross-sectional data from the SPOTLIGHT project (n = 6037 participants from 60 neighbourhoods in five European urban regions) were used. Residents' perceptions were self-reported, and objectively measured environmental features were obtained by a virtual audit using Google Street View. Percent agreement and Kappa statistics were calculated. The mismatch was quantified at neighbourhood level by a distance metric derived from a factor map. The extent to which the mismatch metric varied by region and neighbourhood was examined using linear regression models. Overall, agreement was moderate (agreement < 82%, kappa < 0.3) and varied by obesogenic environmental feature, region and neighbourhood. Highest agreement was found for food outlets and outdoor recreational facilities, and lowest agreement was obtained for aesthetics. In general, a better match was observed in high-residential density neighbourhoods characterized by a high density of food outlets and recreational facilities. Future studies should combine perceived and objectively measured built environment qualities to better understand the potential impact of the built environment on health, particularly in low residential density neighbourhoods.

Interactions of individual perceived barriers and neighbourhood destinations with obesity-related behaviours in Europe

Perceived barriers towards physical activity and healthy eating as well as local availability of opportunities (destinations in the neighbourhood) are important determinants of obesity-related behaviours in adults. Little is known, however, about how these factors interact with the behaviours. Data were analysed from 5,205 participants of the SPOTLIGHT survey, conducted in 60 neighbourhoods in urban regions of five different countries across Europe. A virtual audit was conducted to collect data on the presence of destinations in each neighbourhood. Direct associations of, and interactions between, the number of individual perceived barriers and presence of destinations with obesity-related behaviours (physical activity and dietary behaviours) were analysed using multilevel regression analyses, adjusted for key covariates. Perceiving more individual barriers towards physical activity and healthy eating was associated with lower odds of physical activity and healthy eating. The presence of destinations such as bicycle lanes, parks and supermarkets was associated with higher levels of physical activity and healthier dietary behaviours. Analyses of additive interaction terms suggested that the interaction of destinations and barriers was competitive, such that the presence of destinations influenced obesity-related behaviours most among those perceiving more barriers. These explorative findings emphasize the interest and importance of combining objective (e.g. virtual neighbourhood audit) methods and subjective (e.g. individual perceived barriers collected in a survey) to better understand how the characteristics of the residential built environment can shape obesity-related behaviours depending on individual characteristics.