1
|
Patwary MM, Sakhvidi MJZ, Ashraf S, Dadvand P, Browning MHEM, Alam MA, Bell ML, James P, Astell-Burt T. Impact of green space and built environment on metabolic syndrome: A systematic review with meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:170977. [PMID: 38360326 DOI: 10.1016/j.scitotenv.2024.170977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/03/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
Metabolic Syndrome presents a significant public health challenge associated with an increased risk of noncommunicable diseases such as cardiovascular conditions. Evidence shows that green spaces and the built environment may influence metabolic syndrome. We conducted a systematic review and meta-analysis of observational studies published through August 30, 2023, examining the association of green space and built environment with metabolic syndrome. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 18 studies that met the inclusion criteria and were included in our review. Most were from China (n = 5) and the USA (n = 5), and most used a cross-sectional study design (n = 8). Nine studies (50 %) reported only green space exposures, seven (39 %) reported only built environment exposures, and two (11 %) reported both built environment and green space exposures. Studies reported diverse definitions of green space and the built environment, such as availability, accessibility, and quality, particularly around participants' homes. The outcomes focused on metabolic syndrome; however, studies applied different definitions of metabolic syndrome. Meta-analysis results showed that an increase in normalized difference vegetation index (NDVI) within a 500-m buffer was associated with a lower risk of metabolic syndrome (odds ratio [OR] = 0.90, 95%CI = 0.87-0.93, I2 = 22.3 %, n = 4). A substantial number of studies detected bias for exposure classification and residual confounding. Overall, the extant literature shows a 'limited' strength of evidence for green space protecting against metabolic syndrome and an 'inadequate' strength of evidence for the built environment associated with metabolic syndrome. Studies with more robust study designs, better controlled confounding factors, and stronger exposure measures are needed to understand better what types of green spaces and built environment features influence metabolic syndrome.
Collapse
Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sadia Ashraf
- Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Md Ashraful Alam
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Michelle L Bell
- Yale School of the Environment, Yale University, New Haven, CT, United States
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA; Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Harvard University, Boston, MA, USA
| | - Thomas Astell-Burt
- School of Architecture, Design, and Planning, University of Sydney, Australia
| |
Collapse
|
2
|
Abreu TC, Mackenbach JD, Heuvelman F, Schoonmade LJ, Beulens JW. Associations between dimensions of the social environment and cardiometabolic risk factors: Systematic review and meta-analysis. SSM Popul Health 2024; 25:101559. [PMID: 38148999 PMCID: PMC10749911 DOI: 10.1016/j.ssmph.2023.101559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/27/2023] [Accepted: 11/11/2023] [Indexed: 12/28/2023] Open
Abstract
Aim The social environment (SE), including social contacts, norms and support, is an understudied element of the living environment which impacts health. We aim to comprehensively summarize the evidence on the association between the SE and risk factors of cardiometabolic disease (CMD). Methods We performed a systematic review and meta-analysis based on studies published in PubMed, Scopus and Web of Science Core Collection from inception to 16 February 2021. Studies that used a risk factor of CMD, e.g., HbA1c or blood pressure, as outcome and social environmental factors such as area-level deprivation or social network size as independent variables were included. Titles and abstracts were screened in duplicate. Study quality was assessed using the Newcastle-Ottawa Scale. Data appraisal and extraction were based on the study protocol published in PROSPERO. Data were synthesized through vote counting and meta-analyses. Results From the 7521 records screened, 168 studies reported 1050 associations were included in this review. Four meta-analyses based on 24 associations suggested that an unfavorable social environment was associated with increased risk of cardiometabolic risk factors, with three of them being statistically significant. For example, individuals that experienced more economic and social disadvantage had a higher "CVD risk scores" (OR = 1.54, 95%CI: 1.35 to 1.84). Of the 458 associations included in the vote counting, 323 (71%) pointed towards unfavorable social environments being associated with higher CMD risk. Conclusion Higher economic and social disadvantage seem to contribute to unfavorable CMD risk factor profiles, while evidence for other dimensions of the social environment is limited.
Collapse
Affiliation(s)
- Taymara C. Abreu
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
| | - Joreintje D. Mackenbach
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
| | - Fleur Heuvelman
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
| | - Linda J. Schoonmade
- University Library, Vrije Universiteit Amsterdam, Amsterdam, Noord-Holland, the Netherlands
| | - Joline W.J. Beulens
- Department of Epidemiology & Data Science, Amsterdam UMC - location VUmc, Amsterdam, Noord-Holland, the Netherlands
- Upstream Team, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Utrecht, the Netherlands
- Amsterdam Public Health, Amsterdam Cardiovascular Sciences, Amsterdam, Noord-Holland, the Netherlands
| |
Collapse
|
3
|
Gutiérrez-Esparza G, Martinez-Garcia M, Ramírez-delReal T, Groves-Miralrio LE, Marquez MF, Pulido T, Amezcua-Guerra LM, Hernández-Lemus E. Sleep Quality, Nutrient Intake, and Social Development Index Predict Metabolic Syndrome in the Tlalpan 2020 Cohort: A Machine Learning and Synthetic Data Study. Nutrients 2024; 16:612. [PMID: 38474741 DOI: 10.3390/nu16050612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
This study investigated the relationship between Metabolic Syndrome (MetS), sleep disorders, the consumption of some nutrients, and social development factors, focusing on gender differences in an unbalanced dataset from a Mexico City cohort. We used data balancing techniques like SMOTE and ADASYN after employing machine learning models like random forest and RPART to predict MetS. Random forest excelled, achieving significant, balanced accuracy, indicating its robustness in predicting MetS and achieving a balanced accuracy of approximately 87%. Key predictors for men included body mass index and family history of gout, while waist circumference and glucose levels were most significant for women. In relation to diet, sleep quality, and social development, metabolic syndrome in men was associated with high lactose and carbohydrate intake, educational lag, living with a partner without marrying, and lack of durable goods, whereas in women, best predictors in these dimensions include protein, fructose, and cholesterol intake, copper metabolites, snoring, sobbing, drowsiness, sanitary adequacy, and anxiety. These findings underscore the need for personalized approaches in managing MetS and point to a promising direction for future research into the interplay between social factors, sleep disorders, and metabolic health, which mainly depend on nutrient consumption by region.
Collapse
Affiliation(s)
- Guadalupe Gutiérrez-Esparza
- Researcher for Mexico CONAHCYT, National Council of Humanities, Sciences and Technologies, Mexico City 08400, Mexico
- Clinical Research, National Institute of Cardiology 'Ignacio Chávez', Mexico City 14080, Mexico
| | - Mireya Martinez-Garcia
- Department of Immunology, National Institute of Cardiology 'Ignacio Chávez', Mexico City 14080, Mexico
| | - Tania Ramírez-delReal
- Center for Research in Geospatial Information Sciences, Aguascalientes 20313, Mexico
| | | | - Manlio F Marquez
- Department of Electrocardiology, National Institute of Cardiology 'Ignacio Chavez', Mexico City 14080, Mexico
| | - Tomás Pulido
- Cardiopulmonary Department, National Institute of Cardiology 'Ignacio Chávez', Mexico City 14080, Mexico
| | - Luis M Amezcua-Guerra
- Department of Immunology, National Institute of Cardiology 'Ignacio Chávez', Mexico City 14080, Mexico
| | - Enrique Hernández-Lemus
- Computational Genomics Division, National Institute of Genomic Medicine, Mexico City 14610, Mexico
- Center for Complexity Sciences, Universidad Nacional Autónoma de Mexico, Mexico City 04510, Mexico
| |
Collapse
|
4
|
Barnett A, Martino E, Knibbs LD, Shaw JE, Dunstan DW, Magliano DJ, Donaire-Gonzalez D, Cerin E. The neighbourhood environment and profiles of the metabolic syndrome. Environ Health 2022; 21:80. [PMID: 36057588 PMCID: PMC9440568 DOI: 10.1186/s12940-022-00894-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 08/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND There is a dearth of studies on how neighbourhood environmental attributes relate to the metabolic syndrome (MetS) and profiles of MetS components. We examined the associations of interrelated aspects of the neighbourhood environment, including air pollution, with MetS status and profiles of MetS components. METHODS We used socio-demographic and MetS-related data from 3681 urban adults who participated in the 3rd wave of the Australian Diabetes, Obesity and Lifestyle Study. Neighbourhood environmental attributes included area socio-economic status (SES), population density, street intersection density, non-commercial land use mix, percentages of commercial land, parkland and blue space. Annual average concentrations of NO2 and PM2.5 were estimated using satellite-based land-use regression models. Latent class analysis (LCA) identified homogenous groups (latent classes) of participants based on MetS components data. Participants were then classified into five metabolic profiles according to their MetS-components latent class and MetS status. Generalised additive mixed models were used to estimate relationships of environmental attributes with MetS status and metabolic profiles. RESULTS LCA yielded three latent classes, one including only participants without MetS ("Lower probability of MetS components" profile). The other two classes/profiles, consisting of participants with and without MetS, were "Medium-to-high probability of high fasting blood glucose, waist circumference and blood pressure" and "Higher probability of MetS components". Area SES was the only significant predictor of MetS status: participants from high SES areas were less likely to have MetS. Area SES, percentage of commercial land and NO2 were associated with the odds of membership to healthier metabolic profiles without MetS, while annual average concentration of PM2.5 was associated with unhealthier metabolic profiles with MetS. CONCLUSIONS This study supports the utility of operationalising MetS as a combination of latent classes of MetS components and MetS status in studies of environmental correlates. Higher socio-economic advantage, good access to commercial services and low air pollution levels appear to independently contribute to different facets of metabolic health. Future research needs to consider conducting longitudinal studies using fine-grained environmental measures that more accurately characterise the neighbourhood environment in relation to behaviours or other mechanisms related to MetS and its components.
Collapse
Affiliation(s)
- Anthony Barnett
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St, Melbourne, VIC, Australia.
| | - Erika Martino
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Jonathan E Shaw
- Department of Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - David W Dunstan
- Baker-Deakin Department of Lifestyle and Diabetes, Deakin University, Melbourne, Australia
| | - Dianna J Magliano
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - David Donaire-Gonzalez
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St, Melbourne, VIC, Australia
| | - Ester Cerin
- Mary MacKillop Institute for Health Research, Australian Catholic University, 215 Spring St, Melbourne, VIC, Australia
- Department of Community Medicine, UiT The Artic University of Norway, Tromsø, Norway
- School of Public Health, The University of Hong Kong, 7 Sassoon Rd., Sandy Bay, Hong Kong, Hong Kong, SAR, China
| |
Collapse
|
5
|
Heredia NI, Xu T, Lee M, McNeill LH, Reininger BM. The Neighborhood Environment and Hispanic/Latino Health. Am J Health Promot 2021; 36:38-45. [PMID: 34128383 DOI: 10.1177/08901171211022677] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE Hispanic/Latino adults on the Texas-Mexico border have high rates of chronic disease. Neighborhoods can influence health, though there is a limited research on neighborhood environment and health in Hispanics/Latinos. The purpose of this study was to assess the relation of neighborhood environment with health variables in Hispanic/Latino adults, including physical activity [PA], depression, anxiety, and lab-assessed conditions (type 2 diabetes, metabolic syndrome, and chronic inflammation). METHODS Participants were randomly-selected from a Hispanic/Latino cohort on the Texas-Mexico border. Neighborhood environment, self-reported PA, anxiety, and depression were assessed through questionnaires. Laboratory values determined Type 2 diabetes, metabolic syndrome, and C-reactive protein (CRP). We conducted multivariable linear and logistic regression analyses to assess the associations of neighborhood environment and health variables, controlling for covariates. RESULTS Participants (n = 495) were mostly females, without insurance. After controlling for covariates, crime (Adjusted Odds Ratio [AOR] = 1.59 (95%CI 1.06-2.38), no streetlights (AOR = 1.65, 95%CI 1.06-2.57), and traffic (AOR = 1.74, 95%CI 1.16-2.62) were all significantly associated with anxiety. Only traffic was significantly associated with depression (AOR = 1.61, 95%CI1.05-2.47). A lack of nearby shops (AOR = 0.57, 95%CI 0.38-0.84) and no one out doing PA (AOR = 0.53, 95% CI 0.34-0.83) were both significantly associated with lower odds of meeting PA guidelines. A lack of nearby shops was associated with a 26% increase in the CRP value (β = 0.26, 95%CI 0.04-0.47). DISCUSSION Several neighborhood environment variables were significantly associated with mental health, PA and CRP, though estimates were small. The neighborhood environment is a meaningful contextual variable to consider for health-related interventions in Hispanic/Latino adults, though more study is needed regarding the magnitude of the estimates. TRIAL REGISTRATION NCT01168765.
Collapse
Affiliation(s)
- Natalia I Heredia
- Department of Health Promotion & Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health, TX, USA
| | - Tianlin Xu
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston, School of Public Health, TX, USA
| | | | - Lorna H McNeill
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | |
Collapse
|
6
|
Christensen A, Griffiths C, Hobbs M, Gorse C, Radley D. Accuracy of buffers and self-drawn neighbourhoods in representing adolescent GPS measured activity spaces: An exploratory study. Health Place 2021; 69:102569. [PMID: 33882372 DOI: 10.1016/j.healthplace.2021.102569] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND There continues to be a lack of understanding as to the geographical area at which the environment exerts influence on behaviour and health. This exploratory study compares different potential methods of both researcher- and participant-defined definitions of neighbourhood reflect an adolescent's activity space. METHODS Seven consecutive days of global positioning system (GPS) tracking data were collected at 15 s intervals using a small exploratory adolescent sample of 14-18 year olds (n = 69) in West Yorkshire, England. A total of 304,581 GPS tracking points were collected and compared 30 different definitions of researcher-defined neighbourhoods including radial, network and ellipse buffers at 400 m, 800 m, 1000 m, 1600 m and 3000 m, as well as participant-defined self-drawn neighbourhoods. RESULTS This exploratory study supports emerging evidence cautioning against the use of static neighbourhood definitions for defining exposure. Traditional buffers (network and radial) capture at most 67% of activity space (home radial), and at worst they captured only 3.5% (school network) and range from capturing between 3 and 88% of total time. Similarly, self-drawn neighbourhoods captured only 10% of actual daily movement. Interestingly, 40% of an adolescent's self-drawn neighbourhood was not used. We also demonstrate that buffers capture a range of space (22-95%) where adolescents do not go, thus misclassifying the exposure. CONCLUSION Our exploratory findings demonstrate that neither researcher- nor participant-defined definition of neighbourhood adequately captures adolescent activity space. Further research with larger samples are needed to confirm the findings of this exploratory study.
Collapse
Affiliation(s)
- A Christensen
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK; School of Built Environment and Engineering, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK.
| | - C Griffiths
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - M Hobbs
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, New Zealand
| | - C Gorse
- School of Built Environment and Engineering, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| | - D Radley
- School of Sport, Carnegie, Leeds Beckett University, Leeds, LS6 3QT, UK
| |
Collapse
|
7
|
Dendup T, Feng X, O'Shaughnessy PY, Astell-Burt T. Role of perceived neighbourhood crime in the longitudinal association between perceived built environment and type 2 diabetes mellitus: a moderated mediation analysis. J Epidemiol Community Health 2020; 75:120-127. [PMID: 32967894 DOI: 10.1136/jech-2020-214175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/15/2020] [Accepted: 09/05/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND We examined to what extent perceived neighbourhood crime moderates, associations between type 2 diabetes mellitus (T2DM) and perceived local amenities, recreational facilities, footpaths and public transit, and potential mediation of environmental characteristics-T2DM association by physical activity, social contact, sleep and body mass index (BMI). METHODS The 45 and Up Study data of 36, 224 individuals collected from 2010 to 2015 were analysed in 2019 using multilevel logistic regression to examine the association between T2DM and clustering of unfavourable built environment, and any difference in the association with increasing unfavourable environment and area disadvantage. We performed causal mediation analyses stratified by crime to examine whether crime moderated the strength of identified local amenities-T2DM pathways. RESULTS The results showed that irrespective of crime, perceived lack of local amenities was associated with increased odds of developing T2DM, and BMI mediated 40% and 30.3% of this association among those who reported unsafe and safe daytime crime, respectively. The proportion mediated by BMI among those who reported unsafe and safe night-time crime was 27.3% and 35.1%, respectively. Walking mediated 5.7% of the local amenities-T2DM association among those who reported safe daytime crime. The odds of T2DM increased with rising unfavourable environment and area disadvantage. CONCLUSIONS The results suggest that the availability of neighbourhood amenities may lower T2DM risk by increasing walking and reducing BMI regardless of area crime. Policies to enhance access to local amenities and prevent crime, especially in disadvantaged areas, may support healthy behaviour and physical health that can potentially reduce T2DM risk.
Collapse
Affiliation(s)
- Tashi Dendup
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, University of Wollongong, Wollongong, NSW, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, University of Wollongong, Wollongong, NSW, Australia.,School of Population Health, University of New South Wales, Sydney, NSW, Australia.,Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, NSW, Australia.,National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - P Y O'Shaughnessy
- School of Mathematics and Applied Statistics, University of Wollongong, Wollongong, NSW, Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, University of Wollongong, Wollongong, NSW, Australia .,Menzies Centre for Health Policy, School of Public Health, University of Sydney, Sydney, NSW, Australia.,National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.,School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
8
|
Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) can begin in youth. Prevention is essential to reducing the burden of CVD-related risk factors in childhood and disease development in adulthood. This review addresses the clinical scope of CVD prevention, including a review of conditions encountered, proposed diagnostic criteria, and management strategies. We also highlight the impact of the intrauterine environment on the development of CVD risk. Finally, we highlight the potential role of telehealth in the management of pediatric patients with risk factors for premature CVD. RECENT FINDINGS Growing evidence suggests that maternal obesity, diabetes, and preeclampsia may play an important role in the development of CVD risk among offspring contributing to the development of known traditional CVD risk factors among offspring. As the prevalence of CVD continues to rise, knowledge as well as appropriate diagnosis and management of primordial and traditional risk factors for CVD is needed. The diagnosis and management of CVD risk factors is a central role of the preventive pediatric cardiologist, but it is imperative that the general physician and other pediatric subspecialists be aware of these risk factors, diagnoses, and management strategies. Finally, telehealth may offer an additional method for providing preventive care, including screening and counseling of at risk children and adolescents for traditional risk factors and for providing education regarding risk factors in cases of long distance care and/or during periods of social distancing.
Collapse
|
9
|
Joseph RP, Vega-López S. Associations of perceived neighborhood environment and physical activity with metabolic syndrome among Mexican-Americans adults: a cross sectional examination. BMC Res Notes 2020; 13:306. [PMID: 32591027 PMCID: PMC7320589 DOI: 10.1186/s13104-020-05143-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/17/2020] [Indexed: 12/20/2022] Open
Abstract
Objective This secondary data analysis examined associations among perceived neighborhood environmental factors, physical activity (PA), and the presence of metabolic syndrome (MS) in Mexican–American (MA) adults. Seventy-five MA adults (mean age of 37.9 ± 9.3 years) provided anthropometric, biomarker, and survey data. The Neighborhood Scales Questionnaire evaluated six perceived neighborhood factors: walking environment, aesthetic quality, safety, violence, social cohesion, and activities with neighbors. The Rapid Assessment of PA questionnaire assessed PA. MS was determined according to ATP III criteria. Results PA was significantly associated with MS (OR = .338, CI .204–.738). Neighborhood factors of safety (B = .255, p = .024), walking environment (B = .384, p = .001), and social cohesion (B = .230, p = .043) were positively associated with PA. No other neighborhood factors were significantly related to PA. Analyses examining whether neighborhood factors moderated the relationship between PA and MS were not significant.
Collapse
Affiliation(s)
- Rodney P Joseph
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, 500 N 3rd Street, Phoenix, AZ, 85004, USA.
| | - Sonia Vega-López
- College of Health Solutions and Southwest Interdisciplinary Research Center, Arizona State University, 500 N 3rd Street, Phoenix, AZ, 85004, USA
| |
Collapse
|
10
|
Sprung MR, Faulkner LM, Evans MK, Zonderman AB, Waldstein SR. Neighborhood crime is differentially associated with cardiovascular risk factors as a function of race and sex. J Public Health Res 2019; 8:1643. [PMID: 31857988 PMCID: PMC6902308 DOI: 10.4081/jphr.2019.1643] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/19/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Neighborhood crime may be an important factor contributing to cardiovascular health disparities, and these relations may vary by race and sex. The present investigation evaluated (a) potential differential associations between neighborhood crime and cardiovascular disease (CVD) risk factors within subgroups of African American (AA) and White men and women, and (b) potential mediation by negative affect. Design and Methods: Participants were 1,718 AAs and Whites (58% AA; 54% female; 59% above poverty; ages 30-64 years) living Baltimore, Maryland who completed the first wave of the Healthy Aging in Neighborhoods of Diversity across the Life Span study from 2004-2009. CVD risk factors included body mass index, total serum cholesterol, glucose, and systolic and diastolic blood pressure. A negative affect composite was comprised of self-reported depression, anxiety, anger, vigilance, and perceived stress. Hierarchical multiple regression analyses were used to examine associations between per capita overall and violent crime rates, negative affect, and CVD risk factors. Results: There were significant associations of greater overall crime rate with higher fasting glucose (b=.192, P<0.05), and greater violent crime rate with higher systolic (b=86.50, P<0.05) and diastolic (b=60.12, P<0.05) blood pressure in AA women, but not men. These associations were not explained by negative affect. In Whites, there were no significant associations of overall or violent crime rates with cardiovascular risk factors. Conclusions: AA women may be particularly vulnerable to the negative impact of crime on cardiovascular risk. Preventative efforts aimed toward this group may help to deter the detrimental effects that living in a high crime area may have on one's cardiovascular health.
Collapse
Affiliation(s)
- Mollie R. Sprung
- Veterans Affairs, Pittsburgh Healthcare System, University Drive, Pittsburg, PA
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD
| | - Lauren M.D. Faulkner
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD, USA
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Baltimore, MD, USA
| | - Shari R. Waldstein
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD
| |
Collapse
|
11
|
Baldock KL, Paquet C, Howard NJ, Coffee NT, Taylor AW, Daniel M. Correlates of Discordance between Perceived and Objective Distances to Local Fruit and Vegetable Retailers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071262. [PMID: 30970565 PMCID: PMC6480361 DOI: 10.3390/ijerph16071262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/07/2019] [Accepted: 04/08/2019] [Indexed: 11/26/2022]
Abstract
Background: Perceptions of neighbourhood attributes such as proximity of food retailers that are discordant with objective measures of the same are associated with poor health behaviours and weight gain. Factors associated with discordant perceptions are likely relevant to planning more effective interventions to improve health. Purpose: Analysis of cross-sectional relationships between individual and neighbourhood factors and overestimations of walking distances to local fruit/vegetable retailers (FVR). Methods: Perceived walking times, converted to distances, between participant residences and FVR were compared with objectively-assessed road network distances calculated with a Geographic Information System for n = 1305 adults residing in Adelaide, South Australia. Differences between perceived and objective distances were expressed as ‘overestimated’ distances and were analysed relative to perceptions consistent with objective distances. Cross-sectional associations were evaluated between individual socio-demographic, health, and area-level characteristics and overestimated distances to FVR using multilevel logistic regression. Results: Agreement between objective and perceived distances between participants’ residence and the nearest FVR was only fair (weighted kappa = 0.22). Overestimated distances to FVR were positively associated with mental well-being, and were negatively associated with household income, physical functioning, sense of community, and objective distances to greengrocers. Conclusions: Individual characteristics and features of neighbourhoods were related to overestimated distances to FVR. Sense of connectivity and shared identity may shape more accurate understandings of local resource access, and offer a focal point for tailored public health initiatives that bring people together to achieve improved health behaviour.
Collapse
Affiliation(s)
- Katherine L Baldock
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
| | - Catherine Paquet
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
| | - Natasha J Howard
- Division of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia.
| | - Neil T Coffee
- Centre for Research & Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, ATC 2601, Australia.
| | - Anne W Taylor
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, SA 5001, Australia.
| | - Mark Daniel
- Centre for Research & Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, ATC 2601, Australia.
- South Australian Health and Medical Research Institute, Adelaide, SA 5001, Australia.
- Department of Medicine, St Vincent's Hospital, The University of Melbourne, Melbourne, VIC 3065, Australia.
| |
Collapse
|
12
|
Lee K. The Relationship Between Housing Types and Metabolic and Weight Phenotypes: A Nationwide Survey. Metab Syndr Relat Disord 2019; 17:129-136. [PMID: 30668278 DOI: 10.1089/met.2018.0109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Compared to studies evaluating the effect of environmental factors on weight and health, relationships between housing types and health conditions are understudied. This study aimed to assess the relationship between housing types and metabolic and weight phenotypes using data from the 2014 to 2015 Korea National Health and Nutrition Examination Survey. METHODS A total of 9586 Korean adults (4128 men and 5458 women; mean age, 50.7 ± 16.5 years) were considered for this study. Four metabolic and weight phenotypes were created using presence/absence of metabolic syndrome and body mass index (<25 kg/m2 for normal weight vs. ≥25 kg/m2 for overweight). RESULTS Nonapartment residents were 1.23-fold (95% confidence interval: 1.07-1.42) more likely to have metabolically unhealthy and overweight phenotype compared to apartment residents, after adjusting for sociodemographic characteristics, residence area, health behaviors, and nutritional information awareness. In a subgroup analysis, nonapartment living was associated with higher odds for the metabolically unhealthy and overweight phenotype than living in an apartment in individuals with the following characteristics: age <60 years, education ≥ college, second-third quartile income level, married, living in urban area, alcohol <16 drinks/week, noncurrent smokers, and aware of nutritional information. CONCLUSIONS Housing types may be an indicator for increased risk of metabolic and weight phenotypes in Korean adults and used to select high risk individuals. Uncontrolled confounding factors related to housing types, including property assets and environmental attributes, may contribute to the findings.
Collapse
Affiliation(s)
- Kayoung Lee
- Department of Family Medicine, College of Medicine, Busan Paik Hospital, Inje University, Busan, Republic of Korea
| |
Collapse
|
13
|
Geographic and area-level socioeconomic variation in cardiometabolic risk factor distribution: a systematic review of the literature. Int J Health Geogr 2019; 18:1. [PMID: 30621786 PMCID: PMC6323718 DOI: 10.1186/s12942-018-0165-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/31/2018] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION A growing number of publications report variation in the distribution of cardiometabolic risk factors (CMRFs) at different geographic scales. A review of these variations may help inform policy and health service organisation. AIM To review studies reporting variation in the geographic distribution of CMRFs and its association with various proxy measures of area-level socioeconomic disadvantage (ASED) among the adult ( ≥ 18 years) population across the world. METHODS A systematic search for published articles was conducted in four databases (MEDLINE (Ovid), PubMed, Scopus and Web of Science) considering the interdisciplinary nature of the review question. Population-based cross-sectional and cohort studies on geographic variations of one or more biological proxies of CMRFs with/without an analysed contextual association with ASED were included. Two independent reviewers screened the studies and PRISMA guidelines were followed in the study selection and reporting. RESULT A total of 265 studies were retrieved and screened, resulting in 24 eligible studies. The review revealed reports of variation in the distribution of CMRFs, at varying geographic scales, in multiple countries. In addition, consistent associations between ASED and higher prevalence of CMRFs were demonstrated. The reports were mainly from industrialised nations and small area geographic units were frequently used. CONCLUSION Geographic variation in cardiometabolic risk exists across multiple spatial scales and is positively associated with ASED. This association is independent of individual-level factors and provides an imperative for area-based approaches to informing policy and health service organisation. The study protocol is registered in International prospective register of systematic reviews (Register No: CRD42018115294) PROSPERO 2018.
Collapse
|
14
|
Jia X, Yu Y, Xia W, Masri S, Sami M, Hu Z, Yu Z, Wu J. Cardiovascular diseases in middle aged and older adults in China: the joint effects and mediation of different types of physical exercise and neighborhood greenness and walkability. ENVIRONMENTAL RESEARCH 2018; 167:175-183. [PMID: 30029039 DOI: 10.1016/j.envres.2018.07.003] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 06/12/2018] [Accepted: 07/02/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Both physical exercise and the built environment are associated with cardiovascular diseases (CVDs). Yet, the influence of the multiple dimensions of the built environment and different types of physical exercise on CVDs is not well understood. Further, little is known about the joint effects of physical exercise and the built environment, nor whether one mediates the effect of the other on the risk of CVDs. We aim to investigate the risk of CVDs on middle aged and older Chinese adult populations by analyzing the independent effects, as well as potential interactions and mediation effects of different types of physical exercise and two dimensions of the built environment; namely, greenness and walkability. METHODS Data were collected from a community-based cross-sectional study (n = 1944). The study participants, aged 40 years or older, came from 32 communities across urban, suburban, and rural areas in Longzihu district of Bengbu, a typical second-tier city in eastern China. Physical exercise data were obtained from the International Physical Activity Questionnaire (IPAQ) question survey. We used a satellite-based Normalized Difference Vegetation Index (NDVI) score to assess greenness exposure. We used both the Walk Score index and the Neighborhood Environment Walkability Scale (NEWS) to assess walkability. Multilevel logistic regression, also known as mixed-effects logistic regression, was used to estimate the associations between physical exercise and the built environment (greenness and walkability) on CVD outcomes while accounting for within-community and within-subdistrict correlations. We followed Baron and Kenny's framework and used bootstrapping to quantify the mediation of physical exercise between built environment and CVD outcomes. Stratified analysis was conducted by age (middle aged and older adults) and gender. RESULTS Compared to the reference group with little to low physical activities, we found a significantly reduced risk of hypertension (about 20-45% reduction) and coronary heart disease (about 35-55% reduction) among those with moderate to high activities in walking/square dancing or morning exercising/Tai Chi, and a significantly reduced risk of stroke (about 25% reduction) among those with moderate to high activities in walking/square dancing. Compared to the reference group with low NDVI-based greenness exposure, we found a significant reduction in risk of hypertension (about 55-85% reduction), coronary heart disease (about 75% reduction) and stroke (about 45% reduction) among those with moderate to high levels of exposure. Compared to the reference groups with low walkability, we observed about 30-60% lower risk of hypertension and coronary heart disease associated with moderate to high levels of Walk score, and about 20-30% lower risk of hypertension and stroke associated with moderate to high levels of NEWS-based walkability. We found no interactions between physical exercise and the built environment. The associations of greenness and walkability with CVDs were partially explained by physical exercise (up to 55% of the total effect). CONCLUSIONS Both physical exercise and built environment factors were associated with the risk of CVDs. Our observed association between CVDs and neighborhood greenness exposure and walkability was explained, in part, by physical exercises. Such a role, if confirmed in future studies, could have important implications for policies and programs aimed at increasing green spaces and improving walkability in both urban and rural settings as strategies to promote physical exercise in middle aged and older population.
Collapse
Affiliation(s)
- Xianjie Jia
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Ying Yu
- Department of Physiology, Bengbu Medical College, Bengbu, China
| | - Wanning Xia
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China
| | - Shahir Masri
- Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, USA
| | - Mojgan Sami
- Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, USA
| | - Zhixiong Hu
- Department of Statistics, University of California, Irvine, USA
| | - Zhaoxia Yu
- Department of Statistics, University of California, Irvine, USA
| | - Jun Wu
- Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, USA.
| |
Collapse
|
15
|
Malambo P, De Villiers A, Lambert EV, Puoane T, Kengne AP. Associations of perceived neighbourhood safety from traffic and crime with overweight/obesity among South African adults of low-socioeconomic status. PLoS One 2018; 13:e0206408. [PMID: 30379921 PMCID: PMC6209311 DOI: 10.1371/journal.pone.0206408] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 10/14/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The relationship between perceived neighbourhood safety from traffic and crime with overweight/obesity can provide intervention modalities for obesity, yet no relevant study has been conducted in sub-Saharan African contexts. We investigated the association between perceived neighbourhood safety from traffic and crime with overweight/obesity among urban South African adults. METHODS This cross-sectional study included 354 adults aged ≥35 years drawn from the Prospective Urban Rural Epidemiology (PURE) cohort study. The Neighborhood Walkability Scale-Africa (NEWS-A) was used to evaluate the perceived neighbourhood safety. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to examine the associations between perceived neighborhood safety and overweight/obesity defined "normal weight" and "overweight/obese" using the 25 Kg/m2 cutoff criterion. RESULTS In the overall sample, adults who agreed that "the speed of traffic on most nearby roads in their neighborhood was usually slow" were less likely to be overweight/obese (adjusted OR = 0.42; 95%CI 0.23-0.76). Those who agreed that "there was too much crime in their neighborhood to go outside for walks or play during the day" were more likely to be overweight/obese (OR = 2.41; 1.09-5.29). These associations were driven by significant associations in women, and no association in men, with significant statistical interactions. CONCLUSION Perceived neighborhood safety from traffic and crime was associated with overweight/obesity among South African adults. Our findings provide preliminary evidence on the need to secure safer environments for walkability. Future work should also consider perceptions of the neighbourhood related to food choice.
Collapse
Affiliation(s)
- Pasmore Malambo
- Faculty of Community and Health Sciences School of Public Health, University of Western Cape, Cape Town, South Africa
| | - Anniza De Villiers
- Non-communicable Diseases Unit, South African Medical Research Council, Cape Town, South Africa
| | - Estelle V. Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Thandi Puoane
- Faculty of Community and Health Sciences School of Public Health, University of Western Cape, Cape Town, South Africa
| | - Andre P. Kengne
- Non-communicable Diseases Unit, South African Medical Research Council, Cape Town, South Africa
| |
Collapse
|
16
|
Baldock KL, Paquet C, Howard NJ, Coffee NT, Taylor AW, Daniel M. Gender-specific associations between perceived and objective neighbourhood crime and metabolic syndrome. PLoS One 2018; 13:e0201336. [PMID: 30048521 PMCID: PMC6062143 DOI: 10.1371/journal.pone.0201336] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 07/13/2018] [Indexed: 12/02/2022] Open
Abstract
Much research has considered the relationship between neighbourhood crime and physical activity, but few studies have assessed clinical outcomes consequent to behaviour, such as cardiometabolic risk. Fewer still have simultaneously assessed perceived and objective measures of crime. Perceptions of crime and actual victimisation vary according to gender; thus, this study sought to assess: 1) correspondence between perceived and objective neighbourhood crime; and 2) gender-specific associations between perceived and reported crime and metabolic syndrome, representing cardiometabolic risk. The indirect effect of neighbourhood crime on metabolic syndrome via walking was additionally evaluated. An Australian population-based biomedical cohort study (2004–2007) collected biomedical, socio-demographic, and neighbourhood perceptions data from n = 1,172 urban-dwelling, adults. Area-level reported crime rates were standardised and linked to individual data based on participants' residential location. Correspondence between actual and perceived crime measures was assessed using Pearson correlation coefficients. Cross-sectional associations between crime and metabolic syndrome were analysed using generalised estimating equations regression models accounting for socio-demographic factors and area-level income. Correspondence between perceived and objective crime was small to medium among men and women (r = 0.17 to 0.33). Among men, metabolic syndrome was related to rates of violent (OR = 1.21, 95% CI 1.08–1.35) and total crime (OR = 1.17, 95% CI 1.04–1.32), after accounting for perceived crime. Among women, metabolic syndrome was related to perceived crime (OR = 1.35, 95% CI 1.14–1.60) after accounting for total reported crime. Among women, there were indirect effects of perceived crime and property crime on metabolic syndrome through walking. Results indicate that crime, an adverse social exposure, is linked to clinical health status. Crime rates, and perceptions of crime and safety, differentially impact upon cardiometabolic health according to gender. Social policy and public health strategies targeting crime reduction, as well as strategies to increase perceptions of safety, have potential to contribute to improved cardiometabolic outcomes.
Collapse
Affiliation(s)
- Katherine L. Baldock
- Centre for Population Health Research, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
- * E-mail:
| | - Catherine Paquet
- Centre for Population Health Research, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Natasha J. Howard
- Wardliparingga Aboriginal Research Unit, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Neil T. Coffee
- Centre for Research & Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Anne W. Taylor
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Mark Daniel
- Centre for Research & Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Department of Medicine, St Vincent’s Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| |
Collapse
|
17
|
Braun LM, Rodriguez DA, Song Y, Meyer KA, Lewis CE, Reis JP, Gordon-Larsen P. Changes in walking, body mass index, and cardiometabolic risk factors following residential relocation: Longitudinal results from the CARDIA study. JOURNAL OF TRANSPORT & HEALTH 2016; 3:426-439. [PMID: 28163997 PMCID: PMC5282825 DOI: 10.1016/j.jth.2016.08.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND While many studies have found the built environment to be associated with walking, most have used cross-sectional research designs and few have examined more distal cardiometabolic outcomes. This study contributes longitudinal evidence based on changes in walking, body mass index (BMI), and cardiometabolic risk following residential relocation. METHODS We examined 1,079 participants in the CARDIA study who moved residential locations between 2000 and 2006 (ages 32-46 in 2000, 49% white/51% black, 55% female). We created a walkability index from measures of population density, street connectivity, and food and physical activity resources, measured at participants' pre- and post-move residential locations. Outcomes measured before and after the move included walking, BMI, waist circumference, blood pressure, insulin resistance, triglycerides, cholesterol, atherogenic dyslipidemia, and C-reactive protein. Fixed effects (FE) models were used to estimate associations between within-person change in walkability and within-person change in each outcome. These estimates were compared to those from random effects (RE) models to assess the implications of unmeasured confounding. RESULTS In FE models, a one-SD increase in walkability was associated with a 0.81 mmHg decrease in systolic blood pressure [95% CI: (-1.55, -0.07)] and a 7.36 percent increase in C-reactive protein [95% CI: (0.60, 14.57)]. Although several significant associations were observed in the RE models, Hausman tests suggested that these estimates were biased for most outcomes. RE estimates were most commonly biased away from the null or in the opposite direction of effect as the FE estimates. CONCLUSIONS Greater walkability was associated with lower blood pressure and higher C-reactive protein in FE models, potentially reflecting competing health risks and benefits in dense, walkable environments. RE models tended to overstate or otherwise misrepresent the relationship between walkability and health. Approaches that base estimates on variation between individuals may be subject to bias from unmeasured confounding, such as residential self-selection.
Collapse
Affiliation(s)
- Lindsay M. Braun
- Department of City and Regional Planning, University of North Carolina at Chapel Hill
| | - Daniel A. Rodriguez
- Department of City and Regional Planning, University of California, Berkeley
| | - Yan Song
- Department of City and Regional Planning, University of North Carolina at Chapel Hill
| | - Katie A. Meyer
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Cora E. Lewis
- Division of Preventive Medicine, Department of Medicine , University of Alabama at Birmingham
| | - Jared P. Reis
- National Heart, Lung, and Blood Institute, Prevention and Population Sciences Program
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
- Carolina Population Center, University of North Carolina at Chapel Hill
| |
Collapse
|
18
|
Sugiyama T, Niyonsenga T, Howard NJ, Coffee NT, Paquet C, Taylor AW, Daniel M. Residential proximity to urban centres, local-area walkability and change in waist circumference among Australian adults. Prev Med 2016; 93:39-45. [PMID: 27664538 DOI: 10.1016/j.ypmed.2016.09.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 08/24/2016] [Accepted: 09/19/2016] [Indexed: 10/21/2022]
Abstract
Consistent associations have been observed between macro-level urban sprawl and overweight/obesity, but whether residential proximity to urban centres predicts adiposity change over time has not been established. Further, studies of local-area walkability and overweight/obesity have generated mixed results. This study examined 4-year change in adults' waist circumference in relation to proximity to city centre, proximity to closest suburban centre, and local-area walkability. Data were from adult participants (n=2080) of a cohort study on chronic conditions and health risk factors in Adelaide, Australia. Baseline data were collected in 2000-03 with a follow-up in 2005-06. Multilevel regression models examined in 2015 the independent and joint associations of the three environmental measures with change in waist circumference, accounting for socio-demographic covariates. On average, waist circumference rose by 1.8cm over approximately 4years. Greater distance to city centre was associated with a greater increase in waist circumference. Participants living in distal areas (20km or further from city centre) had a greater increase in waist circumference (mean increase: 2.4cm) compared to those in proximal areas (9km or less, mean increase: 1.2cm). Counterintuitively, living in the vicinity of a suburban centre was associated with a greater increase in adiposity. Local-area walkability was not significantly associated with the outcome. Residential proximity to city centre appears to be protective against excessive increases in waist circumference. Controlled development and targeted interventions in the urban fringe may be needed to tackle obesity. Additional research needs to assess behaviours that mediate relationships between sprawl and obesity.
Collapse
Affiliation(s)
- Takemi Sugiyama
- Institute for Health and Ageing, Australian Catholic University, Melbourne, VIC, Australia; Spatial Epidemiology and Evaluation Research Group, University of South Australia, Adelaide, SA, Australia; Centre for Design Innovation, Faculty of Health Arts & Design, Swinburne University of Technology, Melbourne, VIC, Australia.
| | - Theo Niyonsenga
- Spatial Epidemiology and Evaluation Research Group, University of South Australia, Adelaide, SA, Australia
| | - Natasha J Howard
- Spatial Epidemiology and Evaluation Research Group, University of South Australia, Adelaide, SA, Australia
| | - Neil T Coffee
- Spatial Epidemiology and Evaluation Research Group, University of South Australia, Adelaide, SA, Australia
| | - Catherine Paquet
- Spatial Epidemiology and Evaluation Research Group, University of South Australia, Adelaide, SA, Australia; Research Centre of the Douglas Mental Health University Institute, Verdun, Québec, Canada
| | - Anne W Taylor
- Population Research and Outcome Studies, The University of Adelaide, SA, Australia
| | - Mark Daniel
- Spatial Epidemiology and Evaluation Research Group, University of South Australia, Adelaide, SA, Australia; Department of Medicine, The University of Melbourne, St Vincent's Hospital, Melbourne, VIC, Australia; South Australian Health & Medical Research Institute, Adelaide, SA, Australia
| |
Collapse
|
19
|
Malambo P, Kengne AP, De Villiers A, Lambert EV, Puoane T. Built Environment, Selected Risk Factors and Major Cardiovascular Disease Outcomes: A Systematic Review. PLoS One 2016; 11:e0166846. [PMID: 27880835 PMCID: PMC5120821 DOI: 10.1371/journal.pone.0166846] [Citation(s) in RCA: 163] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 11/05/2016] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Built environment attributes have been linked to cardiovascular disease (CVD) risk. Therefore, identifying built environment attributes that are associated with CVD risk is relevant for facilitating effective public health interventions. OBJECTIVE To conduct a systematic review of literature to examine the influence of built environmental attributes on CVD risks. DATA SOURCE Multiple database searches including Science direct, CINAHL, Masterfile Premier, EBSCO and manual scan of reference lists were conducted. INCLUSION CRITERIA Studies published in English between 2005 and April 2015 were included if they assessed one or more of the neighborhood environmental attributes in relation with any major CVD outcomes and selected risk factors among adults. DATA EXTRACTION Author(s), country/city, sex, age, sample size, study design, tool used to measure neighborhood environment, exposure and outcome assessments and associations were extracted from eligible studies. RESULTS Eighteen studies met the inclusion criteria. Most studies used both cross-sectional design and Geographic Information System (GIS) to assess the neighborhood environmental attributes. Neighborhood environmental attributes were significantly associated with CVD risk and CVD outcomes in the expected direction. Residential density, safety from traffic, recreation facilities, street connectivity and high walkable environment were associated with physical activity. High walkable environment, fast food restaurants, supermarket/grocery stores were associated with blood pressure, body mass index, diabetes mellitus and metabolic syndrome. High density traffic, road proximity and fast food restaurants were associated with CVDs outcomes. CONCLUSION This study confirms the relationship between neighborhood environment attributes and CVDs and risk factors. Prevention programs should account for neighborhood environmental attributes in the communities where people live.
Collapse
Affiliation(s)
- Pasmore Malambo
- University of Western Cape, School of Public Health, Robert Sobukwe Rd, Bellville, Cape Town, 7535, South Africa
- * E-mail:
| | - Andre P. Kengne
- Non-communicable disease Unit, South African Medical Research Council, Francie van Zijl Drive, Parowvallei, P.O. Box 19070, 7505 Tygerberg, Cape Town, South Africa
| | - Anniza De Villiers
- Non-communicable disease Unit, South African Medical Research Council, Francie van Zijl Drive, Parowvallei, P.O. Box 19070, 7505 Tygerberg, Cape Town, South Africa
| | - Estelle V. Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Boundary Road, Newlands, 7700, Cape Town, South Africa
| | - Thandi Puoane
- University of Western Cape, School of Public Health, Robert Sobukwe Rd, Bellville, Cape Town, 7535, South Africa
| |
Collapse
|
20
|
Braun LM, Rodríguez DA, Evenson KR, Hirsch JA, Moore KA, Diez Roux AV. Walkability and cardiometabolic risk factors: Cross-sectional and longitudinal associations from the Multi-Ethnic Study of Atherosclerosis. Health Place 2016; 39:9-17. [PMID: 26922513 PMCID: PMC5015685 DOI: 10.1016/j.healthplace.2016.02.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 02/01/2016] [Accepted: 02/11/2016] [Indexed: 12/28/2022]
Abstract
We used data from 3227 older adults in the Multi-Ethnic Study of Atherosclerosis (2004-2012) to explore cross-sectional and longitudinal associations between walkability and cardiometabolic risk factors. In cross-sectional analyses, linear regression was used to estimate associations of Street Smart Walk Score® with glucose, triglycerides, HDL and LDL cholesterol, systolic and diastolic blood pressure, and waist circumference, while logistic regression was used to estimate associations with odds of metabolic syndrome. Econometric fixed effects models were used to estimate longitudinal associations of changes in walkability with changes in each risk factor among participants who moved residential locations between 2004 and 2012 (n=583). Most cross-sectional and longitudinal associations were small and statistically non-significant. We found limited evidence that higher walkability was cross-sectionally associated with lower blood pressure but that increases in walkability were associated with increases in triglycerides and blood pressure over time. Further research over longer time periods is needed to understand the potential for built environment interventions to improve cardiometabolic health.
Collapse
Affiliation(s)
- Lindsay M Braun
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Daniel A Rodríguez
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kelly R Evenson
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jana A Hirsch
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kari A Moore
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Ana V Diez Roux
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| |
Collapse
|
21
|
Sugiyama T, Howard NJ, Paquet C, Coffee NT, Taylor AW, Daniel M. Do relationships between environmental attributes and recreational walking vary according to area-level socioeconomic status? J Urban Health 2015; 92:253-64. [PMID: 25604935 PMCID: PMC4411313 DOI: 10.1007/s11524-014-9932-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Residents of areas with lower socioeconomic status (SES) are known to be less physically active during leisure time. Neighborhood walkability has been shown to be related to recreational walking equally in low and high SES areas. This cross-sectional study tested whether associations of specific environmental attributes, measured objectively and subjectively, with walking for recreation were moderated by area-level SES. The data of the North West Adelaide Health Study collected in 2007 (n = 1500, mean age 57) were used. Self-reported walking frequency was the outcome of the study. Environmental exposure measures included objectively measured walkability components (residential density, intersection density, land use mix, and net retail area ratio) and perceived attributes (access to destinations, neighborhood esthetics, walking infrastructure, traffic/barriers, and crime safety). Participants' suburbs were categorized into low and high SES areas using an indicator of socioeconomic disadvantage. Low SES areas had lower scores in residential density, neighborhood esthetics, walking infrastructure, traffic/barriers, and crime safety. Recreational walking was associated with residential density, access to destinations, esthetics, traffic/barriers, and crime safety. Effect modification was observed for two attributes (out of nine): residential density was associated with walking only in low SES areas, while walking infrastructure was associated with walking only in high SES areas. The associations of neighborhood environmental attributes with recreational walking were largely consistent across SES groups. However, low SES areas were disadvantaged in most perceived environmental attributes related to recreational walking. Improving such attributes in low SES neighborhoods may help close socioeconomic disparities in leisure time physical activity.
Collapse
Affiliation(s)
- Takemi Sugiyama
- Spatial Epidemiology and Evaluation Research Group, Sansom Institute for Health Research & School of Population Health, University of South Australia, Adelaide, SA, 5001, Australia,
| | | | | | | | | | | |
Collapse
|
22
|
Sundquist K, Eriksson U, Mezuk B, Ohlsson H. Neighborhood walkability, deprivation and incidence of type 2 diabetes: a population-based study on 512,061 Swedish adults. Health Place 2014; 31:24-30. [PMID: 25463914 DOI: 10.1016/j.healthplace.2014.10.011] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 09/29/2014] [Accepted: 10/28/2014] [Indexed: 10/24/2022]
Abstract
Neighborhood walkability has been associated with increased physical activity, but only a few studies have explored the association between walkability and health outcomes related to physical activity, such as type 2 diabetes. The aim of this study was to investigate the association between objectively assessed neighborhood walkability and the 4-year incidence of type 2 diabetes in a sample of 512,061 Swedish adults aged 18 years and older. Neighborhoods were defined by 408 administratively defined geographical areas in the city of Stockholm. We found a negative association between walkability and type 2 diabetes (OR=1.33, 95% CI=1.13-1.55) that remained significant after adjusting for neighborhood deprivation. This association, however, no longer remained statistically significant after adjusting for individual socio-demographic factors. These results were also confirmed using a co-sibling design. Future studies are encouraged to further explore the potential effect of a broader array of the neighborhood built environment on health outcomes related to physical activity.
Collapse
Affiliation(s)
- Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Jan Waldenströms Gata 35, SE-205 02 Malmö, Sweden.
| | - Ulf Eriksson
- Center for Primary Health Care Research, Lund University, Jan Waldenströms Gata 35, SE-205 02 Malmö, Sweden.
| | - Briana Mezuk
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, PO Box 980212, Richmond, 23238 VA, USA.
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Jan Waldenströms Gata 35, SE-205 02 Malmö, Sweden.
| |
Collapse
|
23
|
Sugiyama T, Paquet C, Howard NJ, Coffee NT, Taylor AW, Adams RJ, Daniel M. Public open spaces and walking for recreation: moderation by attributes of pedestrian environments. Prev Med 2014; 62:25-9. [PMID: 24518008 DOI: 10.1016/j.ypmed.2014.01.030] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 01/28/2014] [Accepted: 01/31/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study examined whether attributes of pedestrian environments moderate the relationships between access to public open spaces (POS) and adults' recreational walking. METHODS Data were collected from participants of the North West Adelaide Health Study in 2007. Recreational walking was determined using self-reported walking frequency. Measures of POS access (presence, count, and distance to the nearest POS) were assessed using a Geographic Information System. Pedestrian environmental attributes included aesthetics, walking infrastructure, barrier/traffic, crime concern, intersection density, and access to walking trails. Regression analyses examined whether associations between POS access and recreational walking were moderated by pedestrian environmental attributes. RESULTS The sample included 1574 participants (45% men, mean age: 55). POS access measures were not associated with recreational walking. However, aesthetics, walking infrastructure, and access to walking trail were found to moderate the POS-walking relationships. The presence of POS was associated with walking among participants with aesthetically pleasing pedestrian environments. Counter-intuitively, better access to POS was associated with recreational walking for those with poorer walking infrastructure or no access to walking trails. CONCLUSION Local pedestrian environments moderate the relationships between access to POS and recreational walking. Our findings suggest the presence of complex relationships between POS availability and pedestrian environments.
Collapse
Affiliation(s)
- Takemi Sugiyama
- Spatial Epidemiology and Evaluation Research Group, Sansom Institute for Health Research, School of Population Health, University of South Australia, Adelaide, Australia.
| | - Catherine Paquet
- Spatial Epidemiology and Evaluation Research Group, Sansom Institute for Health Research, School of Population Health, University of South Australia, Adelaide, Australia; Research Centre of the Douglas Mental Health University Institute, Canada
| | - Natasha J Howard
- Spatial Epidemiology and Evaluation Research Group, Sansom Institute for Health Research, School of Population Health, University of South Australia, Adelaide, Australia
| | - Neil T Coffee
- Spatial Epidemiology and Evaluation Research Group, Sansom Institute for Health Research, School of Population Health, University of South Australia, Adelaide, Australia
| | - Anne W Taylor
- Discipline of Medicine, The University of Adelaide, Australia
| | - Robert J Adams
- Discipline of Medicine, The University of Adelaide, Australia
| | - Mark Daniel
- Spatial Epidemiology and Evaluation Research Group, Sansom Institute for Health Research, School of Population Health, University of South Australia, Adelaide, Australia; Department of Medicine, St. Vincent's Hospital, The University of Melbourne, Australia
| |
Collapse
|