The effect of moving to East Village, the former London 2012 Olympic and Paralympic Games Athletes' Village, on physical activity and adiposity (ENABLE London): a cohort study

Abstract

Summary Background The built environment can affect health behaviours, but longitudinal evidence is limited. We aimed to examine the effect of moving into East Village, the former London 2012 Olympic and Paralympic Games Athletes' Village that was repurposed on active design principles, on adult physical activity and adiposity. Methods In this cohort study, we recruited adults seeking new accommodation in East Village and compared physical activity and built environment measures with these data in control participants who had not moved to East Village. At baseline and after 2 years, we objectively measured physical activity with accelerometry and adiposity with body-mass index and bioimpedance, and we assessed objective measures of and participants' perceptions of change in their built environment. We examined the change in physical activity and adiposity between the East Village and control groups, after adjusting for sex, age group, ethnicity, housing tenure, and household (as a random effect). Findings We recruited participants for baseline assessment between Jan 24, 2013, and Jan 7, 2016, and we followed up the cohort after 2 years, between Feb 24, 2015, and Oct 24, 2017. At baseline, 1819 households (one adult per household) consented to initial contact by the study team. 1278 adults (16 years and older) from 1006 (55%) households participated at baseline; of these participants, 877 (69%) adults from 710 (71%) households were assessed after 2 years, of whom 441 (50%) participants from 343 (48%) households had moved to East Village. We found no effect associated with moving to East Village on daily steps, the time spent doing moderate-to-vigorous physical activity (either in total or in 10-min bouts or more), daily sedentary time, body-mass index, or fat mass percentage between participants who had moved to East Village and those in the control group, despite sizeable improvements in walkability and neighbourhood perceptions of crime and quality among the East Village group relative to their original neighbourhood at baseline. Interpretation Despite large improvements in neighbourhood perceptions and walkability, we found no clear evidence that moving to East Village was associated with increased physical activity. Improving the built environment on its own might be insufficient to increase physical activity. Funding National Institute for Health Research and National Prevention Research Initiative.

The effect of moving to East Village, the former London 2012 Olympic and Paralympic Games Athletes' Village, on mode of travel (ENABLE London study, a natural experiment)

“…Self-reported methods usually report prevalence and the type of trips taken, whereas our objective measures allow the amount of time spent in different travel modes to be quantified. Moreover, although we showed increased use of underground trains and decreased vehicle use associated with moving to East Village, there was no evidence of an effect on levels of walking, cycling or overall measures of physical activity [39]. This raises the possibility of compensatory effects where close proximity to public transport encourages use, but in turn decreases the amount of activity needed to access it.…”

“…Longitudinal analyses were restricted to 578 who had valid GPS data at both baseline and follow-up and baseline characteristics for these 578 adults are shown in Table 1 by East Village/Control group and housing group. Age and sex patterns were similar to those for both the 877 who were followed-up and the 1278 recruited at baseline [39]. However, those with complete GPS data were more likely to be of white ethnic origin and higher managerial, professional or intermediate occupations.…”

“…In particular, the sizeable improvements in access to public transport associated with moving to East Village highlights the legacy of the Olympic Delivery Authority's transport plan for the London 2012 Olympic and Paralympic Games [44], in addition to marked increases in walkability and closer proximity to a local park (by ½ km or more), as well as sizeable improvements in neighbourhood perceptions of safety and quality. The robust longitudinal study design, targeted those who were seeking to move, minimising potential biases that may have occurred by including those who were not seeking to move who may have had potentially different health behaviours [39]. A unique strength of the ENABLE London study is the social diversity of participants, with representation from three housing groups (social, intermediate and market-rent housing), which allowed social gradients in effects on travel mode associated with moving to East Village to be gauged.…”

The Role of Urban Morphology Design on Enhancing Physical Activities and Public Health

“…Some urban designers and planners emphasize on the role of residential density, uses diversity, orientation and design of pedestrian paths in urban spaces on individual health [71]. Accordingly, the physical features of urban spaces involve some factors and features related to human-made environments influencing the obesity, physical activity and nutrition of individuals [72]. Furthermore, the safety from vehicle traffic and security/safety from crime are the features that are common in all components of the behavioral model of the environment and correlate to the physical activity of individuals significantly.…”

“…From among the physical criteria affecting physical activities, spatial safety, accessibility, urban facilities and furniture, spatial integration and connectivity, and environmental comfort were the most important priorities obtained from the analyses. Most of the previous studies have emphasized the existence of a direct relationship between these criteria and physical activities [66][67][68][69][70][71][72][73]. From among the functional criteria, functional diversity and spatial flexibility played a significant role in enhancing physical activities.…”