Neighbourhood typologies and associations with body mass index and obesity: A cross-sectional study

Abstract

Little research has investigated associations between a combined measure of the food and physical activity (PA) environment, BMI (body-mass-index) and obesity. Cross-sectional data (n=22,889, age 18-86years) from the Yorkshire Health Study were used [2010-2013]. BMI was calculated using self-reported height and weight; obesity=BMI≥30. Neighbourhood was defined as a 2km radial buffer. Food outlets and PA facilities were sourced from Ordnance Survey Points of Interest (PoI) and categorised into 'fast-food', 'large supermarkets', 'convenience and other food retail outlets' and 'physical activity facilities'. Parks were sourced from Open Street Map. Latent class analysis was conducted on these five environmental variables and availability was defined by quartiles of exposure. Linear and logistic regressions were then conducted for BMI and obesity respectively for different neighbourhood types. Models adjusted for age, gender, ethnicity, area-level deprivation, and rural/urban classification. A five-class solution demonstrated best fit and was interpretable. Neighbourhood typologies were defined as; 'low availability', 'moderate availability', 'moderate PA, limited food', 'saturated' and 'moderate PA, ample food'. Compared to low availability, one typology demonstrated lower BMI (saturated, b=-0.50, [95% CI=-0.76, -0.23]), while three showed higher BMI (moderate availability, b=0.49 [0.27, 0.72]; moderate PA, limited food, b=0.30 [0.01, 0.59]; moderate PA, ample food, b=0.32 [0.08, 0.57]). Furthermore, compared to the low availability, saturated neighbourhoods showed lower odds of obesity (OR=0.86 [0.75, 0.99]) while moderate availability showed greater odds of obesity (OR=1.18 [1.05, 1.32]). This study supports population-level approaches to tackling obesity however neighbourhoods contained features that were health-promoting and -constraining.

Green space access in the neighbourhood and childhood obesity

“…Estimates suggest that 3.4 million deaths per year are attributable to obesity worldwide, with around 4% in terms of years‐of‐life‐lost and disability‐adjusted life‐years 1 . Despite the recent evidence showing that the long‐term trends of increasing body weight are starting to slow down, overweight and obesity prevalence remain high 2 . Obesity is associated with a diminished quality of life, numerous comorbidities and a decreased life expectancy of up to 20 years 3 .…”

Examining longitudinal associations between the recreational physical activity environment, change in body mass index, and obesity by age in 8864 Yorkshire Health Study participants

“…A neighbourhood that has a low availability of recreational physical activity (PA) opportunities such as parks, may also contribute to the extent of the obesogenic environment (Hobbs et al, 2017a;Hobbs et al, 2017c). However, a systematic review showed that only land-use mix and urban sprawl were consistently associated with weight status (Mackenbach et al, 2014).…”

Urban green space and obesity in older adults: Evidence from Ireland

“…The greenness of an individual's locality is then calculated as the amount of green space within this buffer zone as a proportion of the total buffer zone area. We choose a 1.6 km radius as it has been used extensively in the literature (see Browning and Lee, 2017 , Hobbs et al, 2017 for full review) and assumes a maximum 20 minute walk to green space (see Teljeur, O'Dowd, Thomas, & Kelly, 2010 ). In addition, Browning and Lee (2017) find evidence that larger buffer sizes (up to 2000 m) are better at predicting physical health than smaller ones.…”