Mediterranean Built Environment and Precipitation as Modulator Factors on Physical Activity in Obese Mid-Age and Old-Age Adults with Metabolic Syndrome: Cross-Sectional Study

Abstract

When promoting physical activity (PA) participation, it is important to consider the plausible environmental determinants that may affect this practice. The impact of objectively-measured public open spaces (POS) and walk-friendly routes on objectively-measured and self-reported PA was explored alongside the influence of rainy conditions on this association, in a Mediterranean sample of overweight or obese senior adults with metabolic syndrome. Cross-sectional analyses were undertaken on 218 PREDIMED-Plus trial participants aged 55–75 years, from the city of Palma, in Mallorca (Spain). Indicators of access to POS and walk-friendly routes were assessed in a 1.0 and 0.5 km sausage network walkable buffers around each participant’s residence using geographic information systems. Mean daily minutes of self-reported leisure-time brisk walking, and accelerometer objectively-measured moderate-to-vigorous PA in bouts of at least 10 min (OM-MVPA) were measured. To investigate the association between access to POS and walk-friendly routes with PA, generalized additive models with a Gaussian link function were used. Interaction of rainy conditions with the association between access to POS and walk-friendly routes with OM-MVPA was also examined. Better access to POS was not statistically significantly associated with self-reported leisure-time brisk walking or OM-MVPA. A positive significant association was observed only between distance of walk-friendly routes contained or intersected by buffer and OM-MVPA, and was solely evident on non-rainy days. In this elderly Mediterranean population, only access to walk-friendly routes had an influence on accelerometer-measured PA. Rainy conditions during the accelerometer wear period did appear to modify this association.

Temperature and Rain Moderate the Effect of Neighborhood Walkability on Walking Time for Seniors in Barcelona

“…On the other hand, while temperature does not seem to be playing a specific role among those who reside in high walkable environments, the presence of rain was significantly associated with lower walking levels among this second group of seniors. This is in line with Colom, Ruiz, Wärnberg, et al (2019), who found that rain especially had an effect on walkable routes in promoting outdoor physical activity among older adults [27]. These results could be explained, on the one hand, by the fact that sidewalks and pedestrian crossings (which are more present compared to low-walkable neighborhoods) are especially slippery and might present puddles in rain conditions and therefore, fear of falling among seniors could be especially aggravated [38,39].…”

“…Furthermore, and in colder settings, Clarke et al (2017) found that under snow conditions, older adults who lived in very walkable neighborhoods walked to 25% fewer destinations [26]. Lastly, by analyzing a Mediterranean context, Colom et al (2019) found that while route walkability had an influence on accelerometer-measured physical activity, rainy conditions during the accelerometer wearing period modified this association [27].…”

Determinants of Non-Adherence to Exercise or Physical Activity in People with Metabolic Syndrome: A Mixed Methods Review

“…Each of the three studies with a high risk of bias scored "high" for the domain of study attrition, due to inadequate response rates, 38 inadequate reasons provided for participant drop-out, 39 reported differences in participant characteristics between those who completed the study and those who did not, 38 or a lack of reporting on potential differences between those who completed the study and those who did not. 39,40 In assessing methodological quality, agreement between the two reviewers was fair (kappa = 0.29, 95% CI −0.07 to 0.65), with independent ratings and final consensus by domain recorded. The qualitative study 43 adequately described nine out of ten items in the CASP tool, but the relationship between researcher and participants was deemed to have not been adequately considered (Figure 3).…”

“…Twenty-nine of 34 determinants were only evaluated in one quantitative study, therefore these were downgraded for inconsistency. Where there was an absence of rationale for sample sizes, [38][39][40] sample sizes were considered adequate; thus, no determinants were downgraded for imprecision. 34 No determinants were upgraded as there was no evidence of moderate or large effect sizes or exposure-response gradients.…”

Effects of Enriched Physical Activity Environments on Balance and Fall Prevention in Older Adults: A Scoping Review

“…The outcome measures that were reported in the selected studies included a combination of physical activity level (Colom et al, 2019;Forte et al, 2019;Gell, Rosenberg, Carlson, Kerr, & Belza, 2015;Giehl, Hallal, Corseuil, Schneider, & d'Orsi, 2016;Hanibuchi, Kawachi, Nakaya, Hirai, & Kondo, 2011;Huang, Kung, & Hu, 2018;Janssen et al, 2014;Kolbe-Alexander, Pacheco, Tomaz, Karpul, & Lambert, 2015;Li, Fisher, Brownson, & Bosworth, 2005; Y. Lu, Chen, Yang, & Gou, 2018;Mazzei, Gillan, & Cloutier, 2014;Nagel, Carlson, Bosworth, & Michael, 2008;Parra, Gomez, Fleischer, & Pinzon, 2010;Rosbergen, Grimley, Hayward, & Brauer, 2019;Rosbergen et al, 2017;Sato, Inoue, Du, & Funk, 2019;Timmermans et al, 2016;Winters et al, 2015), falling rates (Campbell et al, 2005;Cumming et al, 1999;Day et al, 2002;Lannin et al, 2007;Nikolaus & Bach, 2003;Pardessus et al, 2002;Stevens, Holman, Bennett, & De Klerk, 2001) Engel et al, 2016;Lannin et al, 2007;Lin, Wolf, Hwang, Gong, & Chen, 2007;Nicholson, McKean, & Burkett, 2014;Pighills, Torgerson, Sheldon, Drummond, & Bland, 2011;Rosbergen et al, 2017), ADL (Lannin et al, 2007;Law, Barnett, Yau, & Gray, 2013;Law, Fong, & Yau, 2018;Liu, Jones, Formyduval, & Clark, 2016;…”