International Journal of Environmental Research and Public Health

Editorial

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6 pages, 303 KiB

Open AccessEditorial

Obesity and Urban Environments

by Peter Congdon

Int. J. Environ. Res. Public Health 2019, 16(3), 464; https://doi.org/10.3390/ijerph16030464 - 05 Feb 2019

Cited by 52 | Viewed by 10149

Abstract

Obesity is a major public health issue, affecting both developed and developing societies. Obesity increases the risk for heart disease, stroke, some cancers, and type II diabetes. While individual behaviours are important risk factors, impacts on obesity and overweight of the urban physical [...] Read more.

Obesity is a major public health issue, affecting both developed and developing societies. Obesity increases the risk for heart disease, stroke, some cancers, and type II diabetes. While individual behaviours are important risk factors, impacts on obesity and overweight of the urban physical and social environment have figured large in the recent epidemiological literature, though evidence is incomplete and from a limited range of countries. Prominent among identified environmental influences are urban layout and sprawl, healthy food access, exercise access, and the neighbourhood social environment. This paper reviews the literature and highlights the special issue contributions within that literature. Full article

(This article belongs to the Special Issue Obesity and Urban Environments)

Research

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11 pages, 316 KiB

Open AccessArticle

Perceived Neighbourhood Problems over Time and Associations with Adiposity

by Anne Ellaway, Ruth Dundas, Jonathan R. Olsen and Paul G. Shiels

Int. J. Environ. Res. Public Health 2018, 15(9), 1854; https://doi.org/10.3390/ijerph15091854 - 28 Aug 2018

Cited by 11 | Viewed by 3566

Abstract

There is growing interest in understanding which aspects of the local environment influence obesity. Using data from the longitudinal West of Scotland Twenty-07 study (n = 2040) we examined associations between residents’ self-reported neighbourhood problems, measured over a 13-year period, and nurse-measured [...] Read more.

There is growing interest in understanding which aspects of the local environment influence obesity. Using data from the longitudinal West of Scotland Twenty-07 study (n = 2040) we examined associations between residents’ self-reported neighbourhood problems, measured over a 13-year period, and nurse-measured body weight and size (body mass index, waist circumference, waist–hip ratio) and percentage body fat. We also explored whether particular measures such as abdominal obesity, postulated as a marker for stress, were more strongly related to neighbourhood conditions. Using life course models adjusted for sex, cohort, household social class, and health behaviours, we found that the accumulation of perceived neighbourhood problems was associated with percentage body fat. In cross-sectional analyses, the strongest relationships were found for contemporaneous measures of neighbourhood conditions and adiposity. When analyses were conducted separately by gender, perceived neighbourhood stressors were strongly associated with central obesity measures (waist circumference, waist–hip ratio) among both men and women. Our findings indicate that chronic neighbourhood stressors are associated with obesity. Neighbourhood environments are modifiable, and efforts should be directed towards improving deleterious local environments to reduce the prevalence of obesity. Full article

(This article belongs to the Special Issue Obesity and Urban Environments)

15 pages, 381 KiB

Open AccessArticle

Exploring Neighborhood Environments and Active Commuting in Chennai, India

by Deepti Adlakha, J. Aaron Hipp, James F. Sallis and Ross C. Brownson

Int. J. Environ. Res. Public Health 2018, 15(9), 1840; https://doi.org/10.3390/ijerph15091840 - 26 Aug 2018

Cited by 19 | Viewed by 4964

Abstract

Few studies assess built environment correlates of active commuting in low-and-middle-income countries (LMICs), but the different context could yield distinct findings. Policies and investments to promote active commuting remain under-developed in LMICs like India, which grapples with traffic congestion, lack of activity-supportive infrastructure, [...] Read more.

Few studies assess built environment correlates of active commuting in low-and-middle-income countries (LMICs), but the different context could yield distinct findings. Policies and investments to promote active commuting remain under-developed in LMICs like India, which grapples with traffic congestion, lack of activity-supportive infrastructure, poor enforcement of traffic rules and regulations, air pollution, and overcrowding. This cross-sectional study investigated associations between home neighborhood environment characteristics and active commuting in Chennai, India. Adults (N = 370, 47.2% female, mean age = 37.9 years) were recruited from 155 wards in the metropolitan area of Chennai in southern India between January and June 2015. Participants self-reported their usual mode of commute to work, with responses recoded into three categories: (1) multi-modal or active commuting (walking and bicycling; n = 56); (2) public transit (n = 52); and (3) private transport (n = 111). Environmental attributes around participants’ homes were assessed using the Neighborhood Environment Walkability Scale for India (NEWS-India). Associations between environmental characteristics and likelihood of active commuting and public transit use were modeled using logistic regression with private transport (driving alone or carpool) as the reference category, adjusting for age, gender, and household car ownership. Consistent with other international studies, participants living in neighborhoods with a mix of land uses and a transit stop within a 10-minute walk from home were more likely to use active commuting (both p < 0.01). Land-use mix was significantly associated with the use of public transit compared to private transport (adjusted odds ratio (aOR) = 5.2, p = 0.002). Contrary to findings in high-income countries, the odds of active commuting were reduced with improved safety from crime (aOR = 0.2, p = 0.003), aesthetics (aOR = 0.2, p = 0.05), and street connectivity (aOR = 0.2, p = 0.003). Different environmental attributes were associated with active commuting, suggesting that these relationships are complex and may distinctly differ from those in high-income countries. Unexpected inverse associations of perceived safety from crime and aesthetics with active commuting emphasize the need for high-quality epidemiologic studies with greater context specificity in the study of physical activity in LMICs. Findings have public health implications for India and suggest that caution should be taken when translating evidence across countries. Full article

(This article belongs to the Special Issue Obesity and Urban Environments)

19 pages, 803 KiB

Open AccessArticle

Local Food Environments, Suburban Development, and BMI: A Mixed Methods Study

by Maureen Murphy, Hannah Badland, Helen Jordan, Mohammad Javad Koohsari and Billie Giles-Corti

Int. J. Environ. Res. Public Health 2018, 15(7), 1392; https://doi.org/10.3390/ijerph15071392 - 02 Jul 2018

Cited by 25 | Viewed by 5731

Abstract

More than half the world’s population now live in urban settlements. Worldwide, cities are expanding at their fringe to accommodate population growth. Low-density residential development, urban sprawl, and car dependency are common, contributing to physical inactivity and obesity. However, urban design and planning [...] Read more.

More than half the world’s population now live in urban settlements. Worldwide, cities are expanding at their fringe to accommodate population growth. Low-density residential development, urban sprawl, and car dependency are common, contributing to physical inactivity and obesity. However, urban design and planning can modify urban form and enhance health by improving access to healthy food, public transport, and services. This study used a sequential mixed methods approach to investigate associations between food outlet access and body mass index (BMI) across urban-growth and established areas of Melbourne, Australia, and identify factors that influence local food environments. Population survey data for 3141 adults were analyzed to examine associations, and 27 interviews with government, non-government, and private sector stakeholders were conducted to contextualize results. Fast food density was positively associated with BMI in established areas and negatively associated in urban-growth areas. Interrelated challenges of car dependency, poor public transport, and low-density development hampered healthy food access. This study showed how patterns of suburban development influence local food environments and health outcomes in an urbanized city context and provides insights for other rapidly growing cities. More nuanced understandings of the differential effect of food environments within cities have potential to guide intra-city planning for improving health and reducing inequities. Full article

(This article belongs to the Special Issue Obesity and Urban Environments)

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11 pages, 1381 KiB

Open AccessArticle

Association between Access to Public Open Spaces and Physical Activity in a Mediterranean Population at High Cardiovascular Risk

by Antoni Colom, Miguel Fiol, Maurici Ruiz, Montserrat Compa, Marga Morey, Manuel Moñino and Dora Romaguera

Int. J. Environ. Res. Public Health 2018, 15(6), 1285; https://doi.org/10.3390/ijerph15061285 - 17 Jun 2018

Cited by 11 | Viewed by 4412

Abstract

Background: Regular physical activity is an important preventive factor of cardiovascular disease. Proximity and density of public open spaces are important modifying factors on the practice of physical activity. This article explores the cross-sectional relationship between access to public open spaces (POS) [...] Read more.

Background: Regular physical activity is an important preventive factor of cardiovascular disease. Proximity and density of public open spaces are important modifying factors on the practice of physical activity. This article explores the cross-sectional relationship between access to public open spaces (POS) and leisure time physical activity (LTPA) in elderly participants at high cardiovascular risk from PREDIMED-Baleares. Method: 428 elderly subjects at high cardiovascular risk, participating in the PREDIMED trial, from Palma de Mallorca (Spain) were assessed using Geographic Information Systems, and access to POS was determined. The quantity and intensity of LTPA was calculated using the Minnesota Leisure-Time Physical Activity Questionnaire. In order investigate the association between access to POS and LTPA, generalized linear regression models were used. Results: Better access to POS was not consistently associated with total LTPA. Only distance to the nearest park showed a borderline significant positive associated with total LTPA and moderate-vigorous LTPA but was not associated with light LTPA. Conclusions: Although living near POS was not associated to total LTPA, higher levels of moderate-vigorous LTPA were associated to distances to the nearest park. Future work should be conducted on a larger sample size, integrating a longitudinal design, and greater heterogeneity in POS access and introducing objective measures of physical activity. Full article

(This article belongs to the Special Issue Obesity and Urban Environments)

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15 pages, 14656 KiB

Open AccessArticle

A Community-Driven Approach to Generate Urban Policy Recommendations for Obesity Prevention

by Julia Díez, Pedro Gullón, María Sandín Vázquez, Belén Álvarez, María Del Prado Martín, María Urtasun, Maite Gamarra, Joel Gittelsohn and Manuel Franco

Int. J. Environ. Res. Public Health 2018, 15(4), 635; https://doi.org/10.3390/ijerph15040635 - 30 Mar 2018

Cited by 24 | Viewed by 8849

Abstract

There is an increasing research interest in targeting interventions at the neighborhood level to prevent obesity. Healthy urban environments require including residents’ perspectives to help understanding how urban environments relate to residents’ food choices and physical activity levels. We describe an innovative community-driven [...] Read more.

There is an increasing research interest in targeting interventions at the neighborhood level to prevent obesity. Healthy urban environments require including residents’ perspectives to help understanding how urban environments relate to residents’ food choices and physical activity levels. We describe an innovative community-driven process aimed to develop environmental recommendations for obesity prevention. We conducted this study in a low-income area in Madrid (Spain), using a collaborative citizen science approach. First, 36 participants of two previous Photovoice projects translated their findings into policy recommendations, using an adapted logical framework approach. Second, the research team grouped these recommendations into strategies for obesity prevention, using the deductive analytical strategy of successive approximation. Third, through a nominal group session including participants, researchers, public health practitioners and local policy-makers, we discussed and prioritized the obesity prevention recommendations. Participants identified 12 policy recommendations related to their food choices and 18 related to their physical activity. The research team grouped these into 11 concrete recommendations for obesity prevention. The ‘top-three’ ranked recommendations were: (1) to adequate and increase the number of public open spaces; (2) to improve the access and cost of existing sports facilities and (3) to reduce the cost of gluten-free and diabetic products. Full article

(This article belongs to the Special Issue Obesity and Urban Environments)

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14 pages, 4041 KiB

Open AccessArticle

‘Obesogenic’ School Food Environments? An Urban Case Study in The Netherlands

by Joris Timmermans, Coosje Dijkstra, Carlijn Kamphuis, Marlijn Huitink, Egbert Van der Zee and Maartje Poelman

Int. J. Environ. Res. Public Health 2018, 15(4), 619; https://doi.org/10.3390/ijerph15040619 - 28 Mar 2018

Cited by 32 | Viewed by 8088

Abstract

(1) Background: This study aimed to explore and define socio-economic (SES) differences in urban school food environments in The Netherlands. (2) Methods: Retail food outlets, ready-to-eat products, in-store food promotions and food advertisements in public space were determined within 400 m walking distance [...] Read more.

(1) Background: This study aimed to explore and define socio-economic (SES) differences in urban school food environments in The Netherlands. (2) Methods: Retail food outlets, ready-to-eat products, in-store food promotions and food advertisements in public space were determined within 400 m walking distance of all secondary schools in the 4th largest city of The Netherlands. Fisher’s exact tests were conducted. (3) Results: In total, 115 retail outlets sold ready-to-eat food and drink products during school hours. Fast food outlets were more often in the vicinity of schools in lower SES (28.6%) than in higher SES areas (11.5%). In general, unhealthy options (e.g., fried snacks, sugar-sweetened beverages (SSB)) were more often for sale, in-store promoted or advertised in comparison with healthy options (e.g., fruit, vegetables, bottled water). Sport/energy drinks were more often for sale, and fried snacks/fries, hamburgers/kebab and SSB were more often promoted or advertised in lower SES areas than in higher SES-areas. (4) Conclusion: In general, unhealthy food options were more often presented than the healthy options, but only a few SES differences were observed. The results, however, imply that efforts in all school areas are needed to make the healthy option the default option during school time. Full article

(This article belongs to the Special Issue Obesity and Urban Environments)

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17 pages, 2115 KiB

Open AccessArticle

Gender Difference and Spatial Heterogeneity in Local Obesity

by Hee-Jung Jun and Mi Namgung

Int. J. Environ. Res. Public Health 2018, 15(2), 311; https://doi.org/10.3390/ijerph15020311 - 10 Feb 2018

Cited by 13 | Viewed by 4632

Abstract

This study asks if there is gender-specific spatial heterogeneity in local obesity. By using the 2015 Korea Community Health Survey and employing spatial analyses, this study found that there is considerable gender-specific spatial heterogeneity in local obesity rates. More specifically, we found that: [...] Read more.

This study asks if there is gender-specific spatial heterogeneity in local obesity. By using the 2015 Korea Community Health Survey and employing spatial analyses, this study found that there is considerable gender-specific spatial heterogeneity in local obesity rates. More specifically, we found that: (1) local obesity rates are more spatially dependent for women than for men; (2) environmental factors, in general, have stronger effects on local obesity rates for women than for men; (3) environmental factors have more spatially varying effects on local obesity rates for women than for men. Based on these findings, we suggest that policies for obesity prevention should not be based on the assumption of spatial homogeneity and gender indifference, but rather should be refined based on gender-specific spatial heterogeneity in local obesity. Full article

(This article belongs to the Special Issue Obesity and Urban Environments)

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1198 KiB

Open AccessArticle

Variations in Obesity Rates between US Counties: Impacts of Activity Access, Food Environments, and Settlement Patterns

by Peter Congdon

Int. J. Environ. Res. Public Health 2017, 14(9), 1023; https://doi.org/10.3390/ijerph14091023 - 07 Sep 2017

Cited by 22 | Viewed by 6862

Abstract

There is much ongoing research about the effect of the urban environment as compared with individual behaviour on growing obesity levels, including food environment, settlement patterns (e.g., sprawl, walkability, commuting patterns), and activity access. This paper considers obesity variations between US counties, and [...] Read more.

There is much ongoing research about the effect of the urban environment as compared with individual behaviour on growing obesity levels, including food environment, settlement patterns (e.g., sprawl, walkability, commuting patterns), and activity access. This paper considers obesity variations between US counties, and delineates the main dimensions of geographic variation in obesity between counties: by urban-rural status, by region, by area poverty status, and by majority ethnic group. Available measures of activity access, food environment, and settlement patterns are then assessed in terms of how far they can account for geographic variation. A county level regression analysis uses a Bayesian methodology that controls for spatial correlation in unmeasured area risk factors. It is found that environmental measures do play a significant role in explaining geographic contrasts in obesity. Full article

(This article belongs to the Special Issue Obesity and Urban Environments)

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