Do physical activity and sedentary time mediate the association of the perceived environment with BMI? The IPEN adult study

Dyck, Delfien Van; Cerin, Ester; Akram, Muhammad; Conway, Terry L.; Macfarlane, Duncan J.; Davey, Rachel; Sarmiento, Olga L.; Christiansen, Lars Breum; Reis, Rodrigo Siqueira; Mitáš, Josef; Aguinaga-Ontoso, Inés; Salvo, Deborah; Sallis, James F.

doi:10.1016/j.healthplace.2020.102366

Cited by 8 publications

(7 citation statements)

References 39 publications

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“…We found weak mediation effects of the relative availability of fast food within lower-density urban community types for the VADR cohort only. In contrast to our study findings, authors of the majority of published studies exploring mediation pathways between neighborhood exposures and T2D or obesity have largely examined the influence of individual-level mediators ( 44 – 46 ). Exceptions include a very small number of studies examining the mediating pathways of neighborhood attributes on obesity ( 47 , 48 ).…”

Section: Discussioncontrasting

confidence: 95%

“…Exceptions include a very small number of studies examining the mediating pathways of neighborhood attributes on obesity (47,48). One of these studies applied causal mediation methods similar to what we did in the present study and identified a suppressive effect of air pollution on the association between greenness and adiposity in China (46), whereas another study examining the same association in Spain found no mediating impacts (48).…”

Section: Discussionmentioning

confidence: 71%

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Neighborhood Socioeconomic Environment and Risk of Type 2 Diabetes: Associations and Mediation Through Food Environment Pathways in Three Independent Study Samples

et al. 2022

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OBJECTIVE We examined whether relative availability of fast-food restaurants and supermarkets mediates the association between worse neighborhood socioeconomic conditions and risk of developing type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS As part of the Diabetes Location, Environmental Attributes, and Disparities Network, three academic institutions used harmonized environmental data sources and analytic methods in three distinct study samples: (1) the Veterans Administration Diabetes Risk (VADR) cohort, a national administrative cohort of 4.1 million diabetes-free veterans developed using electronic health records (EHRs); (2) Reasons for Geographic and Racial Differences in Stroke (REGARDS), a longitudinal, epidemiologic cohort with Stroke Belt region oversampling (N = 11,208); and (3) Geisinger/Johns Hopkins University (G/JHU), an EHR-based, nested case-control study of 15,888 patients with new-onset T2D and of matched control participants in Pennsylvania. A census tract–level measure of neighborhood socioeconomic environment (NSEE) was developed as a community type-specific z-score sum. Baseline food-environment mediators included percentages of (1) fast-food restaurants and (2) food retail establishments that are supermarkets. Natural direct and indirect mediating effects were modeled; results were stratified across four community types: higher-density urban, lower-density urban, suburban/small town, and rural. RESULTS Across studies, worse NSEE was associated with higher T2D risk. In VADR, relative availability of fast-food restaurants and supermarkets was positively and negatively associated with T2D, respectively, whereas associations in REGARDS and G/JHU geographies were mixed. Mediation results suggested that little to none of the NSEE–diabetes associations were mediated through food-environment pathways. CONCLUSIONS Worse neighborhood socioeconomic conditions were associated with higher T2D risk, yet associations are likely not mediated through food-environment pathways.

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionmentioning

confidence: 71%

Neighborhood Socioeconomic Environment and Risk of Type 2 Diabetes: Associations and Mediation Through Food Environment Pathways in Three Independent Study Samples

et al. 2022

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“…The literature on PA as a mediator among walkability, BMI, and obesity has been mixed. Whereas some studies have reported that PA partially mediates the association between walkability and BMI or obesity [14][15][16][17], other studies have found no mediating effect of PA on this association [18][19][20]. Results from our mediation analysis indicate that, in our nationally representative sample of US adults, PA partially mediated the effect of perceived walkability on BMI.…”

Section: Discussioncontrasting

confidence: 55%

“…A growing number of studies have explored PA as a mediator in the association between perceived walkability and obesity. Some studies have indicated that PA partially mediates the association between walkability and BMI or obesity [14][15][16][17], whereas other studies have reported no mediating effect of PA on this association [18][19][20]. Individuals who perceive high levels of walkability in their community may feel safer to spend active time outdoors, perceive fewer barriers to walking outdoors, and, thus, engage in overall higher levels of PA.…”

Section: Introductionmentioning

confidence: 99%

Higher walkability associated with increased physical activity and reduced obesity among United States adults

Wang

Narcisse

McElfish

2022

Obesity

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Objective This study examined associations among perceived neighborhood walkability, physical activity (PA), and obesity among United States adults. Methods Data from the 2020 National Health Interview Survey were analyzed. Walkability was assessed using a summative scale and was categorized as low, medium, or high. PA was categorized as insufficient (0‐149 min/wk) or sufficient (150+ min/wk). Multivariable regressions estimated an association between obesity and BMI and PA/walkability. Mediation analysis was used to partition contribution of PA as a mediator. Effect modification by race and ethnicity in the association between walkability and BMI was explored. Results The sample included N = 31,568 adults. Compared with those in low‐walkability neighborhoods, participants in high‐walkability neighborhoods had increased odds of sufficient PA (odds ratio [OR] = 1.48; 95% CI: 1.30‐1.69) and decreased obesity odds (OR = 0.76; 95% CI: 0.66‐0.87). PA partially mediated the association between walkability and BMI (23.4%; 95% CI: 14.6%‐62.7%). The association between walkability and BMI was modified by race and ethnicity (F[5,567] = 2.75; p = 0.018). Among White, Black, Hispanic, and Asian adults, BMI decreased with increasing walkability; among American Indian/Alaska Native and multiracial/other adults, BMI increased with increasing walkability. Conclusions The findings highlight the importance of investing in the built environment to improve perceptions of walkability and promote PA and healthy weight, as well as developing interventions to target racial and ethnic disparities in these outcomes.

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“…19 Most previous research that showed a positive association of perceived neighborhood-built environment attributes with device-based MVPA and ST were conducted in cities in middle-and high-income countries. 20,21 Considering the distinct features of Latin American cities, it is not likely that these results directly translate from high-income cities to the Latin American region. 22−26 Studies have tended to focus on MVPA (i.e., approximately ≥3 METs) and ST, although there is a lack of evidence of light-intensity PA (i.e., activities ranging between 1.5 and <3 METs) such as casual walking, lifting lightweight objects, light household chores or yard work, and stretching.…”

mentioning

confidence: 99%

Perceived Urban Environment Attributes and Device-Measured Physical Activity in Latin America: An 8-Nation Study

Ferrari

Werneck

Silva

et al. 2022

American Journal of Preventive Medicine

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Do physical activity and sedentary time mediate the association of the perceived environment with BMI? The IPEN adult study

Cited by 8 publications

References 39 publications

Neighborhood Socioeconomic Environment and Risk of Type 2 Diabetes: Associations and Mediation Through Food Environment Pathways in Three Independent Study Samples

Neighborhood Socioeconomic Environment and Risk of Type 2 Diabetes: Associations and Mediation Through Food Environment Pathways in Three Independent Study Samples

Higher walkability associated with increased physical activity and reduced obesity among United States adults

Perceived Urban Environment Attributes and Device-Measured Physical Activity in Latin America: An 8-Nation Study

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