Obesity

Human management in the built environment and obesity: Looking for other ways to read this?

Research on the built environment in adults has not, for the most part, distinguished between the life stages of adulthood.

Community program staff and evaluators may find it hard to know which human management of the built environment they should measure on the basis of the health behaviors and outcomes they are trying to affect. Sixteen of the 20 studies included both group-level and individual-level factors in assessing the relation between the built environment and obesity, with 10 of these 16 studies 4143—495152 using multilevel modeling strategies to account for the correlations between observations within defined areas. Sturm and Datar 41 found that lower area prices for fruits and vegetables were associated with decreases in children's BMIs over a 3-year period, but measures of food availability were not associated with changes in BMI over the 3-year period. Relations were stronger among Whites than among Blacks. Unsynchronized definitions, together with diverse operationalisations such as: access to, accessibility of, or relative density of built environmental factors have led to a myriad of environmental measures used between studies [ 33 ]. The availability of certain types of food choices—one aspect of the food environment—can be measured by means of food pricing, quality, and variety.

  • The study also reported differences in other weight-related anthropometric measures such as waist circumference, hip circumferences, and triceps skinfold, which were assessed in only a few primary studies. This social patterning of food availability may not be as evident in other developed nations, where healthy foods may be more readily available across socioeconomic groups.

  • Ewing et al.

  • Evidence from an ecological analysis of obesity and vehicle miles of travel in California.

  • Often metrics and measures are not developed solely for the question at hand but are derived from existing data sources, which may result in methodological compromises. The link between obesity and the built environment.

INTRODUCTION

He cited a popular heuristic that divides commuters into four categories based on their attitudes toward cycling: strong and fearless fewer than 1 percententhused and confident about 7 percentinterested but concerned 60 percentand uninterested 33 percent Geller, Page 10 Share Cite. Objective The aim of this article is to examine briefly the nature and complexity of the problem of obesity and to present evidence about the elements of the built environment that are associated with obesity.

Therefore, the contextual envrionment that influence obesity rates may not be universal across developed nations A total of 1, abstracts were obtained, and 20 articles met the inclusion criteria. Abstract Biological, psychological, behavioral, and social factors are unable to fully explain or curtail the obesity epidemic. Playground proximity, fast-food restaurant proximity distance in miles from child's home to nearest playground or fast-food restaurantand neighborhood safety measured by the numbers of serious crimes and emergency calls.

In terms of energy expenditure, an umbrella review was carried out in for correlates of physical activities, where most of the associations for specific behaviours such as walking, cycling and active transport were shown to be inconsistent [ 56 ]. This includes consideration of both residential managemdnt and activity hyman, as well as the connection between these spheres. Then participants discussed how the built environment can be changed to combat obesity, and how environmental health research and interventions can impact this growing public health problem. A recent Nature study suggested that the gap of BMI between residents in urban and rural areas is closing, mostly by an unprecedented increase in rural BMI across the globe in recent years [ 64 ]. Data were also available on physical inactivity and fruit and vegetable intake. In contrast, people who previously were using the bus and then no longer did so increased their BMI over time, became more sedentary, and engaged in less physical activity Brown et al.

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We thank Dr. The county-level, but not metropolitan-level, sprawl index was associated with BMI and risk of obesity. Given the striking worldwide prevalence of overweight and obesity and the resulting burden on individuals and societies, it is important to eludicate its determinants and find approaches for sustainable reduction and prevention.

Interventions for preventing obesity in children. The built, the areal units of Census data—block, block group, and tract—represent aggregations of populations created for data collection and are thus without consistent geographic size. A previously developed county-level sprawl index was created that incorporated dimensions of residential density, land-use mix, degree of centering extent to which development is focused on region's core or regional subcentersand street accessibility length and size of blocks. Schematic of article abstraction from a Medline search for a review of obesity and the built environment.

Studying adolescents in China, Li et al. TABLE 2. Longitudinal analyses revealed no statistically significant associations between urban sprawl and changes in BMI over time. Measured height and weight were used to compute a continuous BMI variable. Evidence regarding the mechanisms through which the built environment may influence obesity i.

What are the Challenges of Measuring the Built Environment?

Envirnment appropriate geographic scale for active-living research is far from clear and can only be determined empirically. Obesity results from a complex interaction between diet, physical activity, and the environment. For young children who are unable to obtain their own food, influences on parental food choices for the home, such as the cost of foods, may be a key environmental factor influencing consumption and, in turn, weight gain.

  • The aim of this article is to examine briefly the nature and complexity of the problem of obesity and to present evidence about the elements of the built environment that are associated with obesity.

  • Thus, the lack of healthful food purchasing choices in a lower-income neighborhood would be seen conceptually as having a greater impact on residents than the same lack of shopping choices in a more affluent area. The relationship between obesity and the prevalence of fast food restaurants: state-level analysis.

  • Similarly, wnvironment it is the interaction of the individual with his or her environment that influences health, measures and concepts may differ for men and women, for families as compared with the elderly or children, and for persons or groups with relatively fewer or greater social or economic resources. Residents of low-walkability neighborhoods had higher BMIs

  • Research comparing externally measured attributes of communities, such as physical appearance, walkability, and safety, with assessments made by residents has demonstrated the value of considering both perspectives 74— Reid Ewing.

  • Use of community-participatory research methods, which involve stakeholders in both the design and interpretation of research, is an important way to incorporate the perspectives of the community and add to our understanding of these seeming contradictions

  • We assessed risk of bias and summarised results structured by built environmental themes such as food environment, physical activity environment, urban—rural disparity, socioeconomic status and air pollution.

Self-reported heights and weights were used to calculate BMI. Several methodological issues were of concern, including the inconsistency of measurements of the built environment across studies, the cross-sectional design of most investigations, and the focus on aspects of either diet or physical activity but not both. Diez Roux. Neighborhood playgrounds, fast food restaurants, and crime: relationships to overweight in low-income preschool children.

To search the entire text of this book, type in your search term here and press Enter. Recent discussions regarding obssity obesity epidemic have focused on the role the environment plays in increasing energy consumption and decreasing energy expenditure 23— Research comparing externally measured attributes of communities, such as physical appearance, walkability, and safety, with assessments made by residents has demonstrated the value of considering both perspectives 74— Research on the built environment and obesity among youths could benefit from a stronger consideration of life-course stage in the selection of measures.

INTRODUCTION

Two additional studies humab met the inclusion criteria were found by searching the reference sections of the 18 review articles. Since people can be conceptualized as nested within their groups or communities, multilevel modeling techniques take into consideration the nesting or hierarchical structure of these data The metropolitan area sprawl index created by Ewing et al. The relevant articles were evaluated with regard to study design, population studied i.

Am J Human management in the built environment and obesity. Risks of bias was predominantly high, and we pointed out aspects in the methods, measures, analyses, and reporting that may increase our understanding of the assumed influence of built environments on obesity in future studies. Managemennt fact, she noted, one recent study found that residents in food deserts buy most of their junk food at supermarkets Vaughan et al. Food is also a complex substance, she observed, encompassing a variety of types and nutrients. Related Topics. Likewise, a review conducted by the Community Preventive Services Task Force a on interventions to support healthier foods and beverages in schools found positive evidence for meal interventions, fruit and vegetable snack interventions, and multicomponent interventions.

Black JL, Macinko Environmsnt. The built environment includes the physical makeup of where we live, learn, work, and play—our homes, schools, businesses, streets and sidewalks, open spaces, and transportation options. Cross-sectional survey of 10, study participants aged 16— years residing in the county Atlanta, Georgia, region. Factors shaping the human exposome in the built environment: opportunities for engineering control.

Background

Also, you can type in a page number and press Enter to go directly to that the built in the book. Nationally, obesity costs U. Greater BMI was also associated with greater area-level disadvantage scores of the census tract where participants shopped. In general, neighbourhoods of fewer economic resources have a higher density of smaller convenience stores and fast-food outlets, which have been associated with increased BMI. No association was found between proximity to playgrounds, proximity to fast-food restaurants, or neighborhood crime and risk of overweight or being at risk for overweight.

First author, year of publication, objectives of systematic review; eligibility criteria, study manxgement and spatial coverage of primary studies such as countries, states, etc. Similarly, analyses of business locations often rely on postal ZIP codes, defining a business's area of influence by the geography of local mail delivery. Full references of included reviews. Interactive and independent associations between the socioeconomic and objective built environment on the neighbourhood level and individual health: A systematic review of multilevel studies. Public Health Nutr. Within this community, land-use mix was statistically significantly associated with BMI.

Finally, two studies examined measures relating to transportation 37 The wide range of conceptualization and operationalization of measures of the built environment makes it challenging to compare results across studies. The relevant articles were evaluated with regard to study design, population studied i. Proximity may serve as a surrogate measure of influence, with aspects of the built environment closest to a residence being seen as having a stronger influence than those farther away. Evidence regarding the mechanisms through which the built environment may influence obesity i.

A Spreading Epidemic

In studies carried out across large areas, creating metrics equally appropriate to rural, urban, and suburban areas is challenging. They examined four variables, including average area prices for meats, dairy products, fruits and vegetables, and fast food. Examining the relationships among built environment, physical activity, and body mass index in El Paso, TX. Baseline findings from a British survey of aging.

Cite this article Lam, T. Limitations of this umbrella review include the possibility of mahagement recent primary studies in relatively understudied fields since we only included systematic reviews. Nationally, obesity costs U. Of these, 45 full-text articles were screened in which 30 met the inclusion criteria. Residents of low-walkability neighborhoods had higher BMIs

Burden of Obesiry Resistance: Compared to What? Reprints and Permissions. Feng et al. A recent Nature study suggested that the gap of BMI between residents in urban and rural areas is closing, mostly by an unprecedented increase in rural BMI across the globe in recent years [ 64 ]. Examining models for spatial autocorrelation in the unexplained variance can reveal nonstationarity in the model and may shed light on important but overlooked small-area effects 70 Fruit and vegetable intake in African Americans: income and store characteristics. Does living in a disadvantaged area entail limited opportunities to purchase fresh fruit and vegetables in terms of price, availability, and variety?

Databases searched and temporal search range of each review. The average walking trip is 0. Canberra: AIHW, He cited a popular heuristic that divides commuters into four categories based on their attitudes toward cycling: strong and fearless fewer than 1 percententhused and confident about 7 percentinterested but concerned 60 percentand uninterested 33 percent Geller, A meta-analysis included in the same study showed an overall OR for being overweight of 1.

What is the Built Environment?

The latest and most comprehensive food environment buolt by Wilkins et al. Global burden of disease comparison. Related articles in Web of Science Google Scholar. These studies mirror our review results for the food and physical activity environments, respectively. They examined four variables, including average area prices for meats, dairy products, fruits and vegetables, and fast food.

Finally, professional bodies such as the Australian Medical Association, The Royal Australian College of General Practitioners, Doctors Reform Society, Rural Doctors Association and Doctors for the Environment are well placed to develop position statements and media releases, and lobby for healthy built environments. Comparison of residents' and third parties' perceptions of the urban neighborhood of Gospel Oaks, London. The primary studies in this review were highly heterogeneous in pollution measurement methods and associations varied by age, sex and type of pollutants. Study Qual Results Obes. This has also been observed for neighborhoods in Chicago, Illinois Cancer Causes Control. Risks of bias were predominantly high.

Holsten JE. Community Strategies. ROBIS: a new tool to assess risk of bias in systematic reviews was developed. Inequality in the built environment underlies key health disparities in physical activity and obesity. Int J Hyg Environ Health. For food- and physical activity environments, associations were generally very small or absent, although some characteristics within these domains were consistently associated with weight status such as fast-food exposure, urbanisation, land use mix and urban sprawl. The dependent variable was measured by the change in BMI over the 3-year period.

Publication types

Reproduced with the permission of Lisa Solution et al. Although this review focused on objectively measured aspects of the built environment, behavioral theory would suggest the need to consider both externally observable, objective influences and the interpretation of those attributes by community residents, through measurement of subjective or perceived environmental traits. Lopez, 50 Cross-sectional US study using data from the BRFSS onadults who resided in metropolitan areas An urban sprawl index, with values ranging from 0 towas developed for each of US metropolitan areas. This includes consideration of both residential space and activity space, as well as the connection between these spheres. Studies that used measures of access to food included either a measure of distance to the nearest fast-food restaurant 36 or grocery store 52 or a measure of the density of food outlets within a defined area 38414546but not both.

The accessibility of activities is thought to be the primary determinant of travel choices, affecting both physical activity and dietary behaviors. The study of group-level factors in epidemiology: rethinking variables, study designs, and analytical approaches. Diez Roux. Geographical clustering of prostate cancer grade and stage at diagnosis, before and after adjustment for risk factors. Research into the association between the built environment and obesity faces several methodological challenges.

The number of physical activity facilities and resources e. Investigating associations between the built environment and obesity within different age groups is important to our understanding of how these relations play out across the life span. Environmental and lifestyle factors associated with overweight and obesity in Perth, Australia. When investigating measures of distance, it may still be necessary to use multilevel models to adjust for area-level confounders, such as neighborhood social cohesion or socioeconomic status, which may be associated with both the distance a person has to travel to the nearest facility or food store and the person's risk of obesity. Levels of assessment between and within studies varied from entire counties down to the individual level.

Kathy J. Although there was no information as to whether or not prices actually influenced the purchase or consumption of fruits and vegetables, within this population of children, the price of foods seemed to have a greater effect on BMI than the availability of foods. Three objectively measured variables, including the type of street the resident lived on cul-de-sac, highway, or otherwhether there were sidewalks none or on one or both sides of the roadand a measure of poor spatial access to recreational facilities. For example, access to play spaces for young children may incorporate several dimensions beyond convenient locations within walking distance, since it may be unlikely that very young children are allowed to walk to playgrounds without adult supervision. The presence of several types of food stores within census tracts where people resided, including supermarkets, grocery stores, convenience stores, full-service restaurants, fast-food franchises, and limited-service restaurants, were used to characterize the built environment.

No mannagement found in the average distance to a play space by BMI status mean distances for obese and nonobese children were m and m, respectively. This resulted in a total of 17 articles 33— Glanz et al. And how do we promote more physical activity and determine its effectiveness in maintaining a healthy weight?

BMC Public Health. Playgrounds and bike lanes have sometimes been viewed as frivolous or out of place in the urban environment, but new research shows that making it convenient the built environment have an active lifestyle may go a long way toward preventing serious—and expensive—health problems. BMC Public Health ; Only two of the studies published were longitudinal cohort studies 4149 ; one found a statistically significant association between the built environment and obesity 41 and the other found no association 49raising questions as to self-selection and directionality of effect. J Sports Sci. The accessibility of activities is thought to be the primary determinant of travel choices, affecting both physical activity and dietary behaviors.

  • Therefore, the contextual mechanisms that influence obesity rates may not be universal across developed nations

  • Cross-sectional survey of 1, healthy sedentary workers and homemakers aged 18—59 years living in areas within the top and bottom quintiles of social disadvantage in Perth, Australia. PapasMia A.

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  • Ewing et al.

  • Bikeability—such as the presence of bike lane or bike path features. Increased mixed land use and daily distance walked were associated with reduced obesity; increased time spent in a car was associated with increased obesity.

As with most social and environmental drivers, general practitioners GPs can have a vital role in advocating for the health of patients, through participating in health research that informs the development of built environments. Cancer Causes Control. J Community Health. Obesogenic behaviours do not occur in isolation but are a product of myriad of individual-level and contextual processes.

Envrionment mass index in elementary school children, the built environment area food prices and food outlet density. Built and social environments associations with adolescent overweight and activity. In this article we review research on the influence of the built environment on obesity. Five studies did not include categories of BMI, examining it only as a continuous variable 40414651 Both of these studies found positive associations between the number of recreational facilities and the likelihood of being overweight. Summary of the evidence for an association between the built environment and risk of obesity, by type of exposure measurement. This restriction produced 15 empirical studies of the built environment and obesity.

Obes Facts. Density of convenience stores Density of fast-food outlets Affordable fresh-food outlets. Full search strategy for all databases.

Email alerts Article activity alert. While the znd by Liu et al. Self-reported heights and weights were used to calculate BMI. Are inner cities bad for obesity health? Understanding the influence of both access to healthy foods and opportunities for physical activity is critical to obtaining a comprehensive picture of the relation between the built environment and obesity. At this stage, more work is needed to explore environmental influences on diet and physical activity, both within the United States and abroad, in order to facilitate our understanding of and elucidate the population-level determinants of obesity.

View author publications. The factors that influence increases in energy consumption and decreases in energy expenditure are complex and are currently the focus of much research 21 J Sports Sci. However, some issues in primary studies remained poignant: despite improved methodological rigour of exposure assessment, these efforts have not borne fruit, neither in increased significant associations nor in more consistency in association directions, and measures used remained heterogeneous. Casagrande et al. Issue Section:.

Poor persons, for example, are thought to hmuan more affected by their built environments because their activity spaces are smaller and they are more constrained by lack of transportation and opportunities for mobility. In a study carried out in Perth, Australia, Giles-Corti and Donovan 79 found that residents of low-socioeconomic-status neighborhoods had better spatial access to recreational facilities than residents of high-socioeconomic-status neighborhoods but perceived their neighborhoods as less conducive to physical activity. Information was available at the census tract level, and the distance from the residence to the grocery store was estimated from the centroid of the residential census tract to the centroid of the grocery store census tract. Cross-sectional community-wide health survey of adults from a primarily Hispanic community in Texas. Is sprawl unhealthy? Abstract Obesity results from a complex interaction between diet, physical activity, and the environment.

Schools, Workplaces, and Communities at Large

Of the 20 studies reviewed, measurement of the built environment varied, with little overlap across studies see table 2 for a list of measures. More than half of the investigations reviewed 4143—495152 incorporated measures of both group-level variables and individual-level variables within a multilevel framework 68 ; the majority of them were published within the last year 44—49 Proximity may serve as a surrogate measure of influence, with aspects of the built environment closest to a residence being seen as having a stronger influence than those farther away. Data on study design, study populations, and measurement of exposures and outcomes for these 20 articles are summarized in table 1. The average walking trip is 0.

Lower scores indicated less sprawl. Article Navigation. Burdette and Whitaker, Issue Section:. Google Scholar PubMed. The accessibility of activities is thought to be the primary determinant of travel choices, affecting both physical activity and dietary behaviors.

Environmejt used to investigate the relationships between the built environment and obesity were found to be dissimilar across studies and varied from indirect to direct. Medline was used as the primary search engine, given its wide accessibility and common use in public health research. Research to date has focused on three life stages: childhood, adolescence, and adulthood. Centers for Disease Control and Prevention. Sturm and Datar, Citing articles via Web of Science

Only one of the three studies conducted in populations of children 41 found a statistically significant positive association between the built environment and BMI, whereas 16 of the 17 studies conducted in adolescent and adult populations found a statistically significant positive association between some aspect of the built environment and BMI. Sturm and Datar, The built environment, in particular, has been thought to play an important role in influencing obesity by creating a climate that promotes increased energy consumption and a reduction in energy expenditure Similarly, because it is the interaction of the individual with his or her environment that influences health, measures and concepts may differ for men and women, for families as compared with the elderly or children, and for persons or groups with relatively fewer or greater social or economic resources. One of the major differences between the 17 articles 343537—5052 that documented a positive statistically significant association and the three 333651 that did not was the age of the study population. Studying adolescents in China, Li et al. Directionality is difficult to establish within cross-sectional investigations; for example, persons who are obese may be less likely to prioritize access to physical activity and healthy foods in comparison with nonobese persons when selecting residential locations.

He added that this connection between health and the built wnvironment is garnering increased attention worldwide, noting human management in the built environment and obesity that six of the goals and 14 of the targets in the United Nations Sustainable Development Goals are connected to urban planning or design United Nations, What is the Built Environment? Risks of bias was predominantly high, and we pointed out aspects in the methods, measures, analyses, and reporting that may increase our understanding of the assumed influence of built environments on obesity in future studies. Create Quick log.

We thank Dr. Page 20 Share Cite. It simply does not make any sense that a 2,pound machine that we call an automobile drives 2 miles in order to get 1 quart of milk. Some used indirect measures and sometimes outdated data, despite the fast development of the foodscape [ 39 ]. All of these health challenges can be connected to urban planning, city design, and social policies, he asserted.

Across all interventions, those related to public transports had the most significant associations, even though the included primary studies overlapped largely with Patterson and colleagues [ 48 ]. Page 9 Share Cite. General findings: quantitative results in case of meta-analyses in the forms of risk ratios, odd ratios or hazard ratios. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. The relationship between built environments and physical activity: a systematic review.

The more activities available within a given travel time, the better the accessibility of tue location. Cross-sectional survey of 10, study participants aged 16— years residing in the county Atlanta, Georgia, region. Obesity relationships with community design, physical activity, and time spent in cars. Sixteen of the 20 studies included both group-level and individual-level factors in assessing the relation between the built environment and obesity, with 10 of these 16 studies 4143—495152 using multilevel modeling strategies to account for the correlations between observations within defined areas.

For food- and physical activity environments, associations were generally very small or absent, although some characteristics within these domains were consistently associated with weight status such as fast-food exposure, urbanisation, land human management in the built environment and obesity mix and urban sprawl. Rising rural body-mass index is envidonment main driver of the global obesity epidemic in adults. A review of reviews in children and adults. This manual explains the importance of understanding and measuring the built environment and provides a tool for doing so. Data on study design, study populations, and measurement of exposures and outcomes for these 20 articles are summarized in table 1. The difference in BMI was fairly small—about a 5 percent difference at age 18—but, Rodriguez emphasized, this difference has substantial implications for a large population.

Active community environments and health: the relationship of walkable and safe communities to individual health. The more activities available within a given travel time, the better the accessibility of a location. For example, data from the US Census provide inexpensive and easily available measures of some aspects of the built environment. The contextual effect of the local food environment on residents' diets: The Atherosclerosis Risk in Communities Study. To meet inclusion criteria, articles had to 1 have a direct measure of body weight and 2 have an objective measure of the built environment. Besides the physical availability of food outlets, Sturm and Datar 41 additionally examined the cost of foods within metropolitan areas where children resided.

Environmen network influences and the adoption of obesity-related behaviours in adults: A critical interpretative synthesis review. The core features assessed in the BE Tool include: Built environment infrastructure—such as road types, curb cuts and ramps, intersections and crosswalks, traffic control, and public transportation. National health survey: First results, A place for play. A systematic review of built environment and health.

On the other hand, traditional individual-level studies, such as those examining physical inactivity and risk of overweight, are unable to investigate the role of group-level factors, such as the availability of human management in the built environment and obesity facilities within residential neighborhoods, in explaining variability in overweight between individuals Summary of the evidence for an association between the built environment and risk of obesity, by type of exposure measurement. Two additional studies that met the inclusion criteria were found by searching the reference sections of the 18 review articles. Google Scholar PubMed. Gov't, P. The association between sprawl index and BMI was partially mediated through the number of minutes walked in the past month. Kathy J.

Food environment—such as access to grocery stores, convenience stores, and farmers markets. Built environment and health. Successful strategies require governments and local communities to work together to initiate programs in schools, workplaces, and communities, and to involve food producers, industries, and consumer associations. Metrics details. The built environment includes the physical makeup of where we live, learn, work, and play—our homes, schools, businesses, streets and sidewalks, open spaces, and transportation options. Canberra: AIHW,

The literature search and environment and of duplicates was done with support of a librarian. Methods Seven databases were searched for eligible publications from the year onwards. You are where you shop: grocery store locations, weight, and neighborhoods. Two investigations examining metropolitan indices of sprawl 4351 found no statistically significant association with obesity. ROBIS include two main aspects, one is set out to identify concerns with the review process, and the other on judging risk of bias during different stages of the review including eligibility criteria and selection of articles, information collection, study appaisal and knowledge synthesis.

Neighborhood playgrounds, fast food restaurants, and crime: relationships to overweight in low-income preschool children. Investigating associations between the bilt environment and obesity within different age groups is important to our understanding of how these relations play out across the life span. Studies were conducted within both child and adult populations in the United States, Australia, and Europe, allowing for cross-national comparisons of the associations under investigation. The relevant articles were evaluated with regard to study design, population studied i.

However, he added, this model did not account for infrastructure changes, so road trauma increased with more people walking or biking. Page 17 Share Cite. Social environment and physical activity: a review of concepts and evidence. Environmental influences on food choice, physical activity and energy balance.

Conflicting results were evident for the association between land-use mix and risk of obesity. The differential impact of land-use mix on risk of obesity within non-Hispanic White envirnment versus Hispanic communities warrants further investigation. Density of convenience stores Density of fast-food outlets Affordable fresh-food outlets. General findings: quantitative results in case of meta-analyses in the forms of risk ratios, odd ratios or hazard ratios. The factors that influence increases in energy consumption and decreases in energy expenditure are complex and are currently the focus of much research 21 ,

Canberra: ABS, Inagami et al. The built environment and obesity.

In a study carried out in Perth, Australia, Giles-Corti and Donovan 79 found that residents hhe low-socioeconomic-status neighborhoods had better spatial access to recreational facilities than residents of high-socioeconomic-status neighborhoods but perceived their neighborhoods as less conducive to physical activity. Lopez, Sturm and Datar, Lower scores indicated less sprawl.

Research to date has focused on three life stages: childhood, adolescence, and adulthood. Sturm and Datar, Given the detrimental health consequences of obesity and the rapidly rising rates, successful prevention efforts are urgently needed. Only one of the three studies conducted in populations of children 41 found a statistically significant positive association between the built environment and BMI, whereas 16 of the 17 studies conducted in adolescent and adult populations found a statistically significant positive association between some aspect of the built environment and BMI. Because the overarching goal of this field of research is to explain and potentially change two fundamental human behaviors physical activity and food consumptionthe use of behavioral theory may provide guidelines as to how we should anticipate that the environment will influence these behaviors and ultimately rates of obesity.

Correspondingly, disability-adjusted life years due to high BMI increased from human management in the built environment and obesity perindividuals [ 3 ]. For example, in the included managwment, indices including multiple food outlets were more consistently associated with adult obesity compared to individual outlets [ 21 ]. All of these health challenges can be connected to urban planning, city design, and social policies, he asserted. She added that the changes in health outcomes after these multicomponent interventions were implemented were modest, and it is not clear how to scale them up or make them sustainable.

  • Casagrande et al. While the former refers to obesogenic behaviours such as physical activity and diet; the latter includes biological responses to environmental exposures, such as how air pollution might affect weight through inflammation.

  • Study author s and year ref.

  • Tseng et al.

  • Environmental and lifestyle factors associated with overweight and obesity in Perth, Australia. Land-use mix is the degree to which residential, commercial, and institutional parcels of land are located close together

Measuring the food environment and its effects on obesity in the United States: a systematic review of methods and results. When investigating measures of distance, it may still be necessary to use multilevel models to adjust for area-level confounders, such as neighborhood social cohesion or socioeconomic status, which may be associated with both the distance a person has to travel to the nearest facility or food store and the person's risk of obesity. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. The use of adult definitions within this investigation may have introduced misclassification, which could have contributed to the null results.

Reprints and Permissions. Related articles in Web of Science Google Scholar. For example, distance and travel time to a resource such as a hospital are often of interest, because they capture one dimension of access to health care. Not a MyNAP member yet? PubMed Google Scholar

  • Reprints and Permissions. The other two studies investigating the built environment and obesity among children reported null results 33 ,

  • More on this topic Blues from the Neighborhood?

  • The built environment and obesity: a systematic review of the epidemiologic evidence.

  • How long will it take to improve behavior and health? The number of physical activity facilities and resources e.

  • On the other hand, Cobb et al. Commute time and well-being among Canadian adults.

In contrast, Rutt and Coleman 40 found a positive association between increasingly mixed land use and increased risk of obesity. PapasMia A. Examining models for spatial autocorrelation in the unexplained variance can reveal nonstationarity in the model and may shed light on important but overlooked small-area effects 70 It is the focus of the majority of research on proximity of recreational and dietary facilities.

Although ecologic studies may be useful in examining the effect of a group-level variable, such built environment county-level sprawl, as a predictor of group-level variability in obesity rates, they are unable to investigate the contribution manaement individual-level factors, such as physical inactivity, to between-group differences. Within this community, land-use mix was statistically significantly associated buitl BMI. Aggregate county-level indictors of the daily travel time to work measured using US Census data and the average number of daily vehicle miles traveled using data from the California Department of Transportation, as well as population density. Email alerts Article activity alert. Although the use of multilevel modeling methods is an important advancement, there is additional information to be gained by adopting more spatially explicit analytical tools as well. The built environment encompasses a range of physical and social elements that make up the structure of a community and may influence obesity. In a recent study of access and safety within neighborhoods in Boston, Massachusetts, Cradock et al.

Nationally, obesity costs U. He reported that emerging cross-sectional evidence shows that environmental factors, when combined, are related to less overweight and obesity around the world. Environmental measures assessed were connectivity number of intersections within a 1-km household radiusnet residential density, and land-use mix.

Understanding the influence of both access to healthy foods and opportunities for physical activity is critical to obtaining a comprehensive picture of the relation between the built environment and obesity. The use of adult definitions within this investigation may have introduced misclassification, which could have contributed to the null results. The search terms were built based on often used definitions and synomyms of the built environment and their commonly studied components, all possible operationalisations of weight-related outcomes such as weight status in categories, BMI, weight in kilograms, waist circumference, etc. These behaviours are conceptualized mainly through energy imbalance: higher obesogenicity means a surplus of energy intake and a deficiency of energy expenditure. Three of the investigations 444749 specifically examined the impact of the built environment on overweight in adolescents.

Beyond the research sphere, this review enables policy makers, urban planners, public health workers and other professions at the intersection between the built environment and health to rapidly gain insights in the current evidence base in this field. On the other hand, traditional individual-level studies, such as those examining physical inactivity and risk of overweight, are unable to investigate the role of group-level factors, such as the availability of recreational facilities within residential neighborhoods, in explaining variability in overweight between individuals Burden of Antimicrobial Resistance: Compared to What? How long will it take to improve behavior and health? Funding N. Measured height and weight were used to compute a continuous BMI variable.

Three objectively measured variables, including the type of street the resident lived on cul-de-sac, highway, or otherwhether there were sidewalks none or on one or both sides of the roadand a measure of poor spatial access to recreational facilities. Rutt and Coleman, A systematic review of built environment factors related to physical activity and obesity risk: Implications for smart growth urban planning.

Two measures of the built environment included square the per fast-food restaurant and population per fast-food restaurant. Within the United States, national guidelines recommend defining childhood overweight status by applying age- ih sex-adjusted norms and using percentile cutpoints to classify overweight. Cochrane reviews, article no. Neighborhood playgrounds, fast food restaurants, and crime: relationships to overweight in low-income preschool children. If the observations in Boston and Chicago are applicable to Cincinnati, it may be possible that access to safe play space, versus any play space, may be more relevant in the lives of these young children.

Associations were found between decreasing numbers of square miles per fast-food restaurant and increasing population per fast-food restaurant and an increasing statewide prevalence of obesity. You are where you shop: grocery store locations, weight, and neighborhoods. Data were also available on physical inactivity and fruit and vegetable intake. These characteristics are considered in more detail below. The determinants of daily travel-activity patterns: relative location and sociodemographic factors. Saelens et al.

Environnent the 18 cross-sectional investigations, three were ecologic studies with measures of both the built environment and obesity collected at the area level. Factors associated with adolescents' physical inactivity in Xi'an City, China. They examined four variables, including average area prices for meats, dairy products, fruits and vegetables, and fast food.

As for future systematic reviews, included reviews suggest that both individual and neighbourhood SES are important effect modifiers for the associations between the built environment on health and obesitj both should be considered in future studies; especially in terms of possible interactions between neighbourhood SES, built environment and sex or envionment [ 30 ]. In fact, she noted, one recent study found that residents in food deserts buy most of their junk food at supermarkets Vaughan et al. Studies that used measures of access to food included either a measure of distance to the nearest fast-food restaurant 36 or grocery store 52 or a measure of the density of food outlets within a defined area 38414546but not both. One might argue that the association between the built environment and weight is a bridge too far, and that it would be logical to review the epidemiological evidence on associations with intermediate, more proximal outcomes, such as obesogenic behaviours [ 54 ]. Sallis, Mark Stevenson, Neville Owen, City planning and population health: A global challenge, —, Copyrightwith permission from Elsevier. Doyle et al. Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking.

We asessed risk of bias utilizing ROBIS, a validated tool designed specifically environmet asses risk of bias in systematic reviews [ 26 ]. Many economic and political forces contribute to the problem, from budget cuts human management in the built environment and obesity slash school physical education and sports programs to the proliferation of vending machines on school campuses. An envidonment sprawl index, with values ranging from 0 towas developed for each of US metropolitan areas. The modifying role of age and sex were occasionally explored, and results were sometimes stratified, but they were rarely discussed. Burdette and Whitaker 36 used measured weights and heights of a sample of 7, urban, low-income children aged 3 and 4 years and applied age- and sex-specific BMI percentiles to classify overweight. Rutt and Coleman 40 examined the association between neighborhood measures of access to physical activity and BMI in a predominantly Hispanic adult community, a population with extremely high rates of obesity Lower scores indicated less sprawl.

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