Interrelationships Between Walkability, Air Pollution, Greenness, and Body Mass Index.

PubMed

James, Peter; Kioumourtzoglou, Marianthi-Anna; Hart, Jaime E; Banay, Rachel F; Kloog, Itai; Laden, Francine

2017-11-01

Recent studies have linked urban environmental factors and body mass index (BMI); however, such factors are often examined in isolation, ignoring correlations across exposures. Using data on Nurses' Health Study participants living in the Northeastern United States in 2006, we estimated associations between neighborhood walkability (a composite of population density, street connectivity, and business access), greenness (from satellite imagery), and ambient air pollution (from satellite-based spatiotemporally resolved PM2.5 predictions and weighted monthly average concentrations of NO2 from up to five nearest monitors) and self-reported BMI using generalized additive models, allowing for deviations from linearity using penalized splines. Among 23,435 women aged 60-87 years, we observed nonlinear associations between walkability and BMI and between PM2.5 and BMI in single-exposure models adjusted for age, race, and individual- and area-level socioeconomic status. When modeling all exposures simultaneously, only the association between walkability and BMI remained nonlinear and nonmonotonic. Increasing walkability was associated with increasing BMI at lower levels of walkability (walkability index <1.8), while increasing walkability was linked to lower BMI in areas of higher walkability (walkability index >1.8). A 10 percentile increase in walkability, right above 1.8 was associated with a 0.84% decrease in log BMI. The relationship between walkability and BMI existed only among younger participants (<71 years old). Neighborhood walkability was nonlinearly linked to lower BMI independent of air pollution and greenness. Our findings highlight the importance of accounting for nonlinear confounding by interrelated urban environmental factors when investigating associations between the environment and BMI.

Associations between Neighborhood Walkability and Incident and Ongoing Asthma in Children.

PubMed

Simons, Elinor; Dell, Sharon D; Moineddin, Rahim; To, Teresa

2018-06-01

Childhood asthma has shown variable associations with children's physical activity. Neighborhood walkability captures community features that promote walking and is protective against some chronic conditions, such as obesity and diabetes. We evaluated associations between home neighborhood walkability and incident and ongoing childhood asthma. In this population-based cohort study, we used prospectively collected administrative healthcare data for the Province of Ontario housed at the Institute for Clinical Evaluative Sciences. We followed an administrative data cohort of 326,383 Toronto children born between 1997 and 2003, inclusive, until ages 8-15 years. Home neighborhood walkability quintile was measured using a validated walkability index with four dimensions: population density, dwelling density, access to retail and services, and street connectivity. Incident asthma was defined by time of entry into the validated Ontario Asthma Surveillance Information System database, which requires two outpatient visits for asthma within two consecutive years or any hospitalization for asthma and follows children with asthma longitudinally starting at any age. Associations between walkability and incident asthma were examined using Cox proportional hazards models. Associations between ongoing asthma and walkability in each year of life were examined using generalized linear mixed models. Twenty-one percent of children (n = 69,628) developed incident asthma and were followed longitudinally in the Ontario Asthma Surveillance Information System database. Low birth home neighborhood walkability was associated with an increased incidence of asthma (hazard ratio, 1.11; 95% confidence interval, 1.08-1.14). Among children with asthma, low walkability in a given year of a child`s life was associated with greater odds of ongoing asthma in the same year (odds ratio, 1.12; 95% confidence interval, 1.09-1.14). Children living in neighborhoods with low walkability were at increased

Effects of Neighborhood Walkability on Physical Activity and Sedentary Behavior Long-Term Post-Bariatric Surgery.

PubMed

Reid, Ryan E R; Carver, Tamara E; Reid, Tyler G R; Picard-Turcot, Marie-Aude; Andersen, Kathleen M; Christou, Nicolas V; Andersen, Ross E

2017-06-01

ᅟ: Chronic inactivity and weight regain are serious health concerns following bariatric surgery. Neighborhood walkability is associated with higher physical activity and lower obesity rates in normal weight populations. Explore the influence of neighborhood walkability on physical activity and sedentarism among long-term post-bariatric surgery patients. Fifty-eight adults aged 50.5 ± 9.1 years, with a BMI of 34.6 ± 9.7 kg/m 2 having undergone surgery 9.8 ± 3.15 years earlier participated in this study. Participants were asked to wear an ActivPAL™ tri-axial accelerometer attached to their mid-thigh for 7-consecutive days, 24 hours/day. The sample was separated into those that live in Car-Dependent (n = 23), Somewhat Walkable (n = 14), Very Walkable (n = 16), and Walker's Paradise (n = 5) neighborhoods as defined using Walk Score®. ANCOVA was performed comparing Walk Score® categories on steps and sedentary time controlling for age and sex. Neighborhood walkability did not influence either daily steps (F (3, 54) = 0.921, p = 0.437) or sedentary time (F (3, 54) = 0.465, p = 0.708), Car-Dependent (6359 ± 2712 steps, 9.54 ± 2.46 hrs), Somewhat Walkable (6563 ± 2989 steps, 9.07 ± 2.70 hrs), Very Walkable (5261 ± 2255 steps, 9.97 ± 2.06 hrs), and Walker's Paradise (6901 ± 1877 steps, 10.14 ± 0.815 hrs). Walkability does not appear to affect sedentary time or physical activity long-term post-surgery. As the built-environment does not seem to influence activity, sedentarism, or obesity as it does with a normal weight population, work needs to be done to tailor physical activity programming after bariatric surgery.

Walkability and Physical Activity

PubMed Central

Reis, Rodrigo Siqueira; Hino, Adriano Akira Ferreira; Rech, Cassiano Ricardo; Kerr, Jacqueline; Hallal, Pedro Curi

2013-01-01

Background Evidence from developing countries is limited on how income level for a given neighborhood is related to physical activity among its residents. Purpose The goal of the study was to examine the association between walkability and physical activity outcomes, and the effect of income on the relationship between walkability and physical activity in adults. Methods The Spaces for Physical Activity in Adults Study (ESPACOS Project) took place in Curitiba, Brazil. Data were collected in 2010 in 32 census tracts selected to vary in income and walkability, as measured by GIS. Participants were 697 individuals aged 18–65 years (52.0% were women) randomly sampled from the selected neighborhoods. The International Physical Activity Questionnaire was used to measure physical activity. All analyses were conducted in 2012. Results The proportion of those who walked for transportation for ≥150 minutes/week was 21.1% in low-walkability areas, and ranged from 33.5% to 35.0% in high-walkability areas. A total of 12.6% of residents were found to walk for leisure for ≥150 minutes/week; this result did not vary across quadrants of walkability and income level. The prevalence of leisure-time moderate-to-vigorous physical activity (MVPA) was 7.1–10.5 percentage points higher in high-compared to low-walkability areas. After adjusting for all individual confounders, walkability showed an independent association with walking for transport (OR=2.10, 95% CI=1.31, 3.37, p=0.002) and leisure-time MVPA (OR=1.57; 95% CI=1.06, 2.32; p=0.024). Neighborhood income level was independently associated with leisure-time MVPA (OR=1.70; 95% CI=1.06, 2.74, p=0.029). No association was found between walkability and walking for leisure. No interaction was found between walkability and neighborhood income level. Conclusions This study, among adults living in Curitiba, Brazil, confirms findings from studies of high-income countries showing that walkability is positively associated with

Association of the built environment with physical activity and obesity in older persons.

PubMed

Berke, Ethan M; Koepsell, Thomas D; Moudon, Anne Vernez; Hoskins, Richard E; Larson, Eric B

2007-03-01

We examined whether older persons who live in areas that are conducive to walking are more active or less obese than those living in areas where walking is more difficult. We used data from the Adult Changes in Thought cohort study for a cross-sectional analysis of 936 participants aged 65 to 97 years. The Walkable and Bikable Communities Project previously formulated a walkability score to predict the probability of walking in King County, Washington. Data from the cohort study were linked to the walkability score at the participant level using a geographic information system. Analyses tested for associations between walkability score and activity and body mass index. Higher walkability scores were associated with significantly more walking for exercise across buffers (circular zones around each respondent's home) of varying radii (for men, odds ratio [OR]=5.86; 95% confidence interval [CI]=1.01, 34.17 to OR=9.14; CI=1.23, 68.11; for women, OR=1.63; CI=0.94, 2.83 to OR=1.77; CI=1.03, 3.04). A trend toward lower body mass index in men living in more walkable neighborhoods did not reach statistical significance. Findings suggest that neighborhood characteristics are associated with the frequency of walking for physical activity in older people. Whether frequency of walking reduces obesity prevalence is less clear.

Google walkability: a new tool for local planning and public health research?

PubMed

Vargo, Jason; Stone, Brian; Glanz, Karen

2012-07-01

We investigate the association of different composite walkability measures with individual walking behaviors to determine if multicomponent metrics of walkability are more useful for assessing the health impacts of the built environment than single component measures. We use a previously published composite walkability measure as well as a new measure that was designed to represent easier methods of combination and which includes 2 metrics obtained using Google data sources. Logistic regression was used to assess the relationship between walking behavior and walkability metrics. Our results suggest that composite measures of walkability are more consistent predictors of walking behavior than single component measures. Furthermore, a walkability measure developed using free, publicly available data from Google was found to be nearly as effective in predicting walking outcomes as a walkability measure derived without such publicly and nationally available measures. Our findings demonstrate the effectiveness of free and locally relevant data for assessing walkable environments. This facilitates the use of locally derived and adaptive tools for evaluating the health impacts of the built environment.

A European perspective on GIS-based walkability and active modes of transport.

PubMed

Grasser, Gerlinde; van Dyck, Delfien; Titze, Sylvia; Stronegger, Willibald J

2017-02-01

The association between GIS-based walkability and walking for transport is considered to be well established in USA and in Australia. Research on the association between walkability and cycling for transport in European cities is lacking. The aim of this study was to test the predictive validity of established walkability measures and to explore alternative walkability measures associated with walking and cycling for transport in a European context. Outcome data were derived from the representative cross-sectional survey ( n  = 843) ‘Radfreundliche Stadt’ of adults in the city of Graz (Austria). GIS-based walkability was measured using both established measures (e.g. gross population density, household unit density, entropy index, three-way intersection density, IPEN walkability index) and alternative measures (e.g. proportion of mixed land use, four-way intersection density, Graz walkability index). ANCOVAs were conducted to examine the adjusted association between walkability measures and outcomes. Household unit density, proportion of mixed land use, three-way intersection density and IPEN walkability index were positively associated with walking for transport, but the other measures were not. All walkability measures were positively associated with cycling for transport. The established walkability measures were applicable to a European city such as Graz. The alternative walkability measures performed well in a European context. Due to measurement issues the association between these walkability measures and walking for transport needs to be investigated further. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Validation of walk score for estimating neighborhood walkability: an analysis of four US metropolitan areas.

PubMed

Duncan, Dustin T; Aldstadt, Jared; Whalen, John; Melly, Steven J; Gortmaker, Steven L

2011-11-01

Neighborhood walkability can influence physical activity. We evaluated the validity of Walk Score(®) for assessing neighborhood walkability based on GIS (objective) indicators of neighborhood walkability with addresses from four US metropolitan areas with several street network buffer distances (i.e., 400-, 800-, and 1,600-meters). Address data come from the YMCA-Harvard After School Food and Fitness Project, an obesity prevention intervention involving children aged 5-11 years and their families participating in YMCA-administered, after-school programs located in four geographically diverse metropolitan areas in the US (n = 733). GIS data were used to measure multiple objective indicators of neighborhood walkability. Walk Scores were also obtained for the participant's residential addresses. Spearman correlations between Walk Scores and the GIS neighborhood walkability indicators were calculated as well as Spearman correlations accounting for spatial autocorrelation. There were many significant moderate correlations between Walk Scores and the GIS neighborhood walkability indicators such as density of retail destinations and intersection density (p < 0.05). The magnitude varied by the GIS indicator of neighborhood walkability. Correlations generally became stronger with a larger spatial scale, and there were some geographic differences. Walk Score(®) is free and publicly available for public health researchers and practitioners. Results from our study suggest that Walk Score(®) is a valid measure of estimating certain aspects of neighborhood walkability, particularly at the 1600-meter buffer. As such, our study confirms and extends the generalizability of previous findings demonstrating that Walk Score is a valid measure of estimating neighborhood walkability in multiple geographic locations and at multiple spatial scales.

Does Physical Activity Mediate the Associations Between Local-Area Descriptive Norms, Built Environment Walkability, and Glycosylated Hemoglobin?

PubMed

Carroll, Suzanne J; Niyonsenga, Theo; Coffee, Neil T; Taylor, Anne W; Daniel, Mark

2017-08-23

Associations between local-area residential features and glycosylated hemoglobin (HbA 1c ) may be mediated by individual-level health behaviors. Such indirect effects have rarely been tested. This study assessed whether individual-level self-reported physical activity mediated the influence of local-area descriptive norms and objectively expressed walkability on 10-year change in HbA 1c . HbA 1c was assessed three times for adults in a 10-year population-based biomedical cohort ( n = 4056). Local-area norms specific to each participant were calculated, aggregating responses from a separate statewide surveillance survey for 1600 m road-network buffers centered on participant addresses (local prevalence of overweight/obesity (body mass index ≥25 kg/m²) and physical inactivity (<150 min/week)). Separate latent growth models estimated direct and indirect (through physical activity) effects of local-area exposures on change in HbA 1c , accounting for spatial clustering and covariates (individual-level age, sex, smoking status, marital status, employment and education, and area-level median household income). HbA 1c worsened over time. Local-area norms directly and indirectly predicted worsening HbA 1c trajectories. Walkability was directly and indirectly protective of worsening HbA 1c . Local-area descriptive norms and walkability influence cardiometabolic risk trajectory through individual-level physical activity. Efforts to reduce population cardiometabolic risk should consider the extent of local-area unhealthful behavioral norms and walkability in tailoring strategies to improve physical activity.

Does Physical Activity Mediate the Associations between Local-Area Descriptive Norms, Built Environment Walkability, and Glycosylated Hemoglobin?

PubMed Central

Daniel, Mark

2017-01-01

Associations between local-area residential features and glycosylated hemoglobin (HbA1c) may be mediated by individual-level health behaviors. Such indirect effects have rarely been tested. This study assessed whether individual-level self-reported physical activity mediated the influence of local-area descriptive norms and objectively expressed walkability on 10-year change in HbA1c. HbA1c was assessed three times for adults in a 10-year population-based biomedical cohort (n = 4056). Local-area norms specific to each participant were calculated, aggregating responses from a separate statewide surveillance survey for 1600 m road-network buffers centered on participant addresses (local prevalence of overweight/obesity (body mass index ≥25 kg/m2) and physical inactivity (<150 min/week)). Separate latent growth models estimated direct and indirect (through physical activity) effects of local-area exposures on change in HbA1c, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, marital status, employment and education, and area-level median household income). HbA1c worsened over time. Local-area norms directly and indirectly predicted worsening HbA1c trajectories. Walkability was directly and indirectly protective of worsening HbA1c. Local-area descriptive norms and walkability influence cardiometabolic risk trajectory through individual-level physical activity. Efforts to reduce population cardiometabolic risk should consider the extent of local-area unhealthful behavioral norms and walkability in tailoring strategies to improve physical activity. PMID:28832552

Validation of Walk Score® for Estimating Neighborhood Walkability: An Analysis of Four US Metropolitan Areas

PubMed Central

Duncan, Dustin T.; Aldstadt, Jared; Whalen, John; Melly, Steven J.; Gortmaker, Steven L.

2011-01-01

Neighborhood walkability can influence physical activity. We evaluated the validity of Walk Score® for assessing neighborhood walkability based on GIS (objective) indicators of neighborhood walkability with addresses from four US metropolitan areas with several street network buffer distances (i.e., 400-, 800-, and 1,600-meters). Address data come from the YMCA-Harvard After School Food and Fitness Project, an obesity prevention intervention involving children aged 5–11 years and their families participating in YMCA-administered, after-school programs located in four geographically diverse metropolitan areas in the US (n = 733). GIS data were used to measure multiple objective indicators of neighborhood walkability. Walk Scores were also obtained for the participant’s residential addresses. Spearman correlations between Walk Scores and the GIS neighborhood walkability indicators were calculated as well as Spearman correlations accounting for spatial autocorrelation. There were many significant moderate correlations between Walk Scores and the GIS neighborhood walkability indicators such as density of retail destinations and intersection density (p < 0.05). The magnitude varied by the GIS indicator of neighborhood walkability. Correlations generally became stronger with a larger spatial scale, and there were some geographic differences. Walk Score® is free and publicly available for public health researchers and practitioners. Results from our study suggest that Walk Score® is a valid measure of estimating certain aspects of neighborhood walkability, particularly at the 1600-meter buffer. As such, our study confirms and extends the generalizability of previous findings demonstrating that Walk Score is a valid measure of estimating neighborhood walkability in multiple geographic locations and at multiple spatial scales. PMID:22163200

Refining The Grain: Using Resident-Based Walkability Audits To Better Understand Walkable Urban Form.

PubMed

Schlossberg, Marc; Johnson-Shelton, Deb; Evers, Cody; Moreno, Geraldine

Researchers use measures of street connectivity to assess neighborhood walkability and many studies show a relationship between neighborhood design and walking activity. Yet, the core of those connectivity measures are based on constructs designed for analyzing automobile mobility - the street network - not pedestrian movement. This paper examines the effect of a finer grained characterization of street connectivity and illustrates the idea using parent ratings of street and intersection walkability for children throughout a suburban school district in Oregon. Several policy and practice recommendations are presented, including a discussion that extends Michael Southworth's (1993; 2005) foundational representation of streets and the walkable city using a refined, more pedestrian-centered approach to visualizing connectivity and walkable urban form.

Walkability for Different Urban Granularities

NASA Astrophysics Data System (ADS)

Hollenstein, D.; Bleisch, S.

2016-06-01

The positive effects of low-intensity physical activity are widely acknowledged and in this context walking is often promoted as an active form of transport. Under the concept of walkability the role of the built environment in encouraging walking is investigated. For that purpose, walkability is quantified area-wise by measuring a varying set of built environment attributes. In purely GIS-based approaches to studying walkability, indices are generally built using existing and easily accessible data. These include street network design, population density, land use mix, and access to destinations. Access to destinations is usually estimated using either a fixed radius, or distances in the street network. In this paper, two approaches to approximate a footpath network are presented. The two footpath networks were built making different assumptions regarding the walkability of different street types with respect to more or less restrictive safety preferences. Information on sidewalk presence, pedestrian crossings, and traffic restrictions were used to build both networks. The first network comprises car traffic free areas only. The second network includes streets with low speed limits that have no sidewalks. Both networks are compared to the more commonly used street network in an access-to-distance analysis. The results suggest that for the generally highly walkable study area, access to destination mostly depends on destination density within the defined walkable distance. However, on single street segments access to destinations is diminished when only car traffic free spaces are assumed to be walkable.

Walk Score® and the prevalence of utilitarian walking and obesity among Ontario adults: A cross-sectional study.

PubMed

Chiu, Maria; Shah, Baiju R; Maclagan, Laura C; Rezai, Mohammad-Reza; Austin, Peter C; Tu, Jack V

2015-07-01

Evidence from large, population-based studies about the association between neighbourhood walkability and the prevalence of obesity is limited. The study population consisted of 106,337 people aged 20 or older living in urban and suburban Ontario, who participated in the National Population Health Survey and the Canadian Community Health Survey from 1996/1997 to 2008. Based on their postal code, individuals were grouped into one of five walkability categories, ranging from very car-dependent to "Walker's Paradise," according to the Street Smart Walk Score®, a composite measure of neighbourhood walkability. Logistic regression models, adjusted for demographic, socioeconomic and lifestyle characteristics, were used to estimate odds ratios relating neighbourhood walkability to overweight/obesity and physical activity. Compared with residents of "Walker's Paradise" areas, those in very car-dependent areas had significantly higher odds of being overweight or obese. Despite similar levels of leisure physical activity among residents of all walkability areas, those in "Walker's Paradise" areas reported more utilitarian walking and weighed, on average, 3.0 kg less than did those in very car-dependent areas. Living in a low-walkability area is associated with a higher prevalence of overweight/obesity. Neighbourhood walkability is related to the frequency of utilitarian walking.

Does Pedestrian Danger Mediate the Relationship between Local Walkability and Active Travel to Work?

PubMed

Slater, Sandy J; Nicholson, Lisa; Abu Zayd, Haytham; Chriqui, Jamie Friedman

2016-01-01

Environmental and policy factors play an important role in influencing people's lifestyles, physical activity (PA), and risks for developing obesity. Research suggests that more walkable communities are needed to sustain lifelong PA behavior, but there is a need to determine what local built environment features facilitate making being active the easy choice. This county-level study examined the association between local walkability (walkability and traffic calming scales), pedestrian danger, and the percent of adults who used active transport to work. Built environment and PA outcome measures were constructed for the 496 most populous counties representing 74% of the U.S. population. Geographic information system-based walkability scales were constructed and include a census of roads located within the counties using 2011 Navteq data. The pedestrian danger index (PDI) includes data collected from the Fatality Analysis Reporting System 2009-2011, and measures the likelihood of a pedestrian being hit and killed by a vehicle. Four continuous outcome measures were constructed using 2009-2013 American Community Survey county-level 5-year estimates. The measures represent the percentage of workers living in a county who worked away from home and (1) walked to work; (2) biked to work; (3) took public transit; and (4) used any form of active transport. Linear regression and mediation analyses were conducted to examine the association between walkability, PDI, and active transport. Models accounted for clustering within state with robust SEs, and controlled for median household income, families with children in poverty, race, ethnicity, urbanicity, and region. The walkability scale was significantly negatively associated with the PDI (β = -0.06, 95% CI = -0.111, -0.002). In all models, the PDI was significantly negatively associated with all active travel-related outcomes at the p < 0.01 level. The walkability scale was positively associated with all four

Neighborhood Walkable Urban Form and C-Reactive Protein

EPA Science Inventory

Background: Walkable urban form predicts physical activity and lower body mass index, which lower C-reactive protein (CRP). However, urban form is also related to pollution, noise, social and health behavior, crowding, and other stressors, which may complement or contravene walka...

Healthy neighborhoods: walkability and air pollution.

PubMed

Marshall, Julian D; Brauer, Michael; Frank, Lawrence D

2009-11-01

The built environment may influence health in part through the promotion of physical activity and exposure to pollution. To date, no studies have explored interactions between neighborhood walkability and air pollution exposure. We estimated concentrations of nitric oxide (NO), a marker for direct vehicle emissions), and ozone (O(3)) and a neighborhood walkability score, for 49,702 (89% of total) postal codes in Vancouver, British Columbia, Canada. NO concentrations were estimated from a land-use regression model, O(3) was estimated from ambient monitoring data; walkability was calculated based on geographic attributes such as land-use mix, street connectivity, and residential density. All three attributes exhibit an urban-rural gradient, with high walkability and NO concentrations, and low O(3) concentrations, near the city center. Lower-income areas tend to have higher NO concentrations and walkability and lower O(3) concentrations. Higher-income areas tend to have lower pollution (NO and O(3)). "Sweet-spot" neighborhoods (low pollution, high walkability) are generally located near but not at the city center and are almost exclusively higher income. Increased concentration of activities in urban settings yields both health costs and benefits. Our research identifies neighborhoods that do especially well (and especially poorly) for walkability and air pollution exposure. Work is needed to ensure that the poor do not bear an undue burden of urban air pollution and that neighborhoods designed for walking, bicycling, or mass transit do not adversely affect resident's exposure to air pollution. Analyses presented here could be replicated in other cities and tracked over time to better understand interactions among neighborhood walkability, air pollution exposure, and income level.

Objectively measured walkability and active transport and weight-related outcomes in adults: a systematic review.

PubMed

Grasser, Gerlinde; Van Dyck, Delfien; Titze, Sylvia; Stronegger, Willibald

2013-08-01

The aim of this study was to investigate which GIS-based measures of walkability (density, land-use mix, connectivity and walkability indexes) in urban and suburban neighbourhoods are used in research and which of them are consistently associated with walking and cycling for transport, overall active transportation and weight-related measures in adults. A systematic review of English publications using PubMed, Science Direct, Active Living Research Literature Database, the Transportation Research Information Service and reference lists was conducted. The search terms utilised were synonyms for GIS in combination with synonyms for the outcomes. Thirty-four publications based on 19 different studies were eligible. Walkability measures such as gross population density, intersection density and walkability indexes most consistently correlated with measures of physical activity for transport. Results on weight-related measures were inconsistent. More research is needed to determine whether walkability is an appropriate measure for predicting weight-related measures and overall active transportation. As most of the consistent correlates, gross population density, intersection density and the walkability indexes have the potential to be used in planning and monitoring.

Do psychosocial factors moderate the association between neighborhood walkability and adolescents' physical activity?

PubMed

De Meester, Femke; Van Dyck, Delfien; De Bourdeaudhuij, Ilse; Deforche, Benedicte; Cardon, Greet

2013-03-01

Ecological models emphasize the interaction between individuals and their environment. Furthermore, they posit that environmental variables influence physical activity (PA) not only directly but also indirectly through their interaction with other factors. This study explored if the association between neighborhood walkability and adolescents' PA is moderated by psychosocial factors using data from the Belgian Environmental PA Study in Youth (BEPAS-Y). BEPAS-Y recruited adolescents from 32 neighborhoods differing in objectively determined neighborhood walkability and income. Between 2008 and 2009, 637 adolescents (13-15 years; 49.4% boys) completed a survey measuring socio-demographic and psychosocial factors and wore an accelerometer for seven days. Multilevel-regression analyses revealed that for adolescents living in low-income neighborhoods, the association between neighborhood walkability and PA is moderated by perceived barriers and perceived benefits toward PA. Neighborhood walkability was positively associated with PA among adolescents, living in low-income neighborhoods, who perceived many barriers and few benefits, while for adolescents who perceived few barriers and many benefits, the PA level was high, irrespective of neighborhood walkability. For adolescents, living in high-income neighborhoods, none of the psychosocial attributes moderated the association between neighborhood walkability and PA. These findings provide some support for the predicted interactions posited by ecological models. Improving neighborhood walkability might increase PA-levels of adolescents living in low-income neighborhoods, with less positive psychosocial profiles, or in other words; those who are most difficult to reach through PA interventions. However, in order to increase PA in large populations, interventions focusing solely on improving neighborhood walkability may not have the desired effect. Copyright © 2013 Elsevier Ltd. All rights reserved.

Walkability and physical activity: findings from Curitiba, Brazil.

PubMed

Siqueira Reis, Rodrigo; Hino, Adriano Akira Ferreira; Ricardo Rech, Cassiano; Kerr, Jacqueline; Curi Hallal, Pedro

2013-09-01

Evidence from developing countries is limited on how income level for a given neighborhood is related to physical activity among its residents. The goal of the study was to examine the association between walkability and physical activity outcomes, and the effect of income on the relationship between walkability and physical activity in adults. The Spaces for Physical Activity in Adults Study (ESPACOS Project) took place in Curitiba, Brazil. Data were collected in 2010 in 32 census tracts selected to vary in income and walkability, as measured by GIS. Participants were 697 individuals aged 18-65 years (52.0% were women) randomly sampled from the selected neighborhoods. The International Physical Activity Questionnaire was used to measure physical activity. All analyses were conducted in 2012. The proportion of those who walked for transportation for ≥ 150 minutes/week was 21.1% in low-walkability areas, and ranged from 33.5% to 35.0% in high-walkability areas. A total of 12.6% of residents were found to walk for leisure for ≥ 150 minutes/week; this result did not vary across quadrants of walkability and income level. The prevalence of leisure-time moderate-to-vigorous physical activity (MVPA) was 7.1-10.5 percentage points higher in high-compared to low-walkability areas. After adjusting for all individual confounders, walkability showed an independent association with walking for transport (OR=2.10, 95% CI=1.31, 3.37, p=0.002) and leisure-time MVPA (OR=1.57, 95% CI=1.06, 2.32, p=0.024). Neighborhood income level was independently associated with leisure-time MVPA (OR=1.70, 95% CI=1.06, 2.74, p=0.029). No association was found between walkability and walking for leisure. No interaction was found between walkability and neighborhood income level. This study, among adults living in Curitiba, Brazil, confirms findings from studies of high-income countries showing that walkability is positively associated with physical activity. People living in high-walkability

An objective index of walkability for research and planning in the Sydney metropolitan region of New South Wales, Australia: an ecological study.

PubMed

Mayne, Darren J; Morgan, Geoffrey G; Willmore, Alan; Rose, Nectarios; Jalaludin, Bin; Bambrick, Hilary; Bauman, Adrian

2013-12-24

Walkability describes the capacity of the built environment to support walking for various purposes. This paper describes the construction and validation of two objective walkability indexes for Sydney, Australia. Walkability indexes using residential density, intersection density, land use mix, with and without retail floor area ratio were calculated for 5,858 Sydney Census Collection Districts in a geographical information system. Associations between variables were evaluated using Spearman's rho (ρ). Internal consistency and factor structure of indexes were estimated with Cronbach's alpha and principal components analysis; convergent and predictive validity were measured using weighted kappa (κw) and by comparison with reported walking to work at the 2006 Australian Census using logistic regression. Spatial variation in walkability was assessed using choropleth maps and Moran's I. A three-attribute abridged Sydney Walkability Index comprising residential density, intersection density and land use mix was constructed for all Sydney as retail floor area was only available for 5.3% of Census Collection Districts. A four-attribute full index including retail floor area ratio was calculated for 263 Census Collection Districts in the Sydney Central Business District. Abridged and full walkability index scores for these 263 areas were strongly correlated (ρ=0.93) and there was good agreement between walkability quartiles (κw=0.73). Internal consistency ranged from 0.60 to 0.71, and all index variables loaded highly on a single factor. The percentage of employed persons who walked to work increased with increasing walkability: 3.0% in low income-low walkability areas versus 7.9% in low income-high walkability areas; and 2.1% in high income-low walkability areas versus 11% in high income-high walkability areas. The adjusted odds of walking to work were 1.05 (0.96-1.15), 1.58 (1.45-1.71) and 3.02 (2.76-3.30) times higher in medium, high and very high compared to low

A retrospective study on changes in residents' physical activities, social interactions, and neighborhood cohesion after moving to a walkable community.

PubMed

Zhu, Xuemei; Yu, Chia-Yuan; Lee, Chanam; Lu, Zhipeng; Mann, George

2014-12-01

This study is to examine changes in residents' physical activities, social interactions, and neighborhood cohesion after they moved to a walkable community in Austin, Texas. Retrospective surveys (N=449) were administered in 2013-2014 to collect pre- and post-move data about the outcome variables and relevant personal, social, and physical environmental factors. Walkability of each resident's pre-move community was measured using the Walk Score. T tests were used to examine the pre-post move differences in the outcomes in the whole sample and across sub-groups with different physical activity levels, neighborhood conditions, and neighborhood preferences before the move. After the move, total physical activity increased significantly in the whole sample and all sub-groups except those who were previously sufficiently active; lived in communities with high walkability, social interactions, or neighborhood cohesion; or had moderate preference for walkable neighborhoods. Walking in the community increased in the whole sample and all subgroups except those who were previously sufficiently active, moved from high-walkability communities, or had little to no preference for walkable neighborhoods. Social interactions and neighborhood cohesion increased significantly after the move in the whole sample and all sub-groups. This study explored potential health benefits of a walkable community in promoting physically and socially active lifestyles, especially for populations at higher risk of obesity. The initial result is promising, suggesting the need for more work to further examine the relationships between health and community design using pre-post assessments. Copyright © 2014 Elsevier Inc. All rights reserved.

Assessing Built Environment Walkability using Activity-Space Summary Measures.

PubMed

Tribby, Calvin P; Miller, Harvey J; Brown, Barbara B; Werner, Carol M; Smith, Ken R

There is increasing emphasis on active transportation, such as walking, in transportation planning as a sustainable form of mobility and in public health as a means of achieving recommended physical activity and better health outcomes. A research focus is the influence of the built environment on walking, with the ultimate goal of identifying environmental modifications that invite more walking. However, assessments of the built environment for walkability are typically at a spatially disaggregate level (such as street blocks) or at a spatially aggregate level (such as census block groups). A key issue is determining the spatial units for walkability measures so that they reflect potential walking behavior. This paper develops methods for assessing walkability within individual activity spaces : the geographic region accessible to an individual during a given walking trip. We first estimate street network-based activity spaces using the shortest path between known trip starting/ending points and a travel time budget that reflects potential alternative paths. Based on objective walkability measures of the street blocks, we use three summary measures for walkability within activity spaces: i) the average walkability score across block segments (representing the general level of walkability in the activity space); ii) the standard deviation (representing the walkability variation), and; iii) the network autocorrelation (representing the spatial coherence of the walkability pattern). We assess the method using data from an empirical study of built environment walkability and walking behavior in Salt Lake City, Utah, USA. We visualize and map these activity space summary measures to compare walkability among individuals' trips within their neighborhoods. We also compare summary measures for activity spaces versus census block groups, with the result that they agree less than half of the time.

Assessing Built Environment Walkability using Activity-Space Summary Measures

PubMed Central

Tribby, Calvin P.; Miller, Harvey J.; Brown, Barbara B.; Werner, Carol M.; Smith, Ken R.

2015-01-01

There is increasing emphasis on active transportation, such as walking, in transportation planning as a sustainable form of mobility and in public health as a means of achieving recommended physical activity and better health outcomes. A research focus is the influence of the built environment on walking, with the ultimate goal of identifying environmental modifications that invite more walking. However, assessments of the built environment for walkability are typically at a spatially disaggregate level (such as street blocks) or at a spatially aggregate level (such as census block groups). A key issue is determining the spatial units for walkability measures so that they reflect potential walking behavior. This paper develops methods for assessing walkability within individual activity spaces: the geographic region accessible to an individual during a given walking trip. We first estimate street network-based activity spaces using the shortest path between known trip starting/ending points and a travel time budget that reflects potential alternative paths. Based on objective walkability measures of the street blocks, we use three summary measures for walkability within activity spaces: i) the average walkability score across block segments (representing the general level of walkability in the activity space); ii) the standard deviation (representing the walkability variation), and; iii) the network autocorrelation (representing the spatial coherence of the walkability pattern). We assess the method using data from an empirical study of built environment walkability and walking behavior in Salt Lake City, Utah, USA. We visualize and map these activity space summary measures to compare walkability among individuals’ trips within their neighborhoods. We also compare summary measures for activity spaces versus census block groups, with the result that they agree less than half of the time. PMID:27213027

Physical activity and concordance between objective and perceived walkability.

PubMed

Arvidsson, Daniel; Kawakami, Naomi; Ohlsson, Henrik; Sundquist, Kristina

2012-02-01

The study's purpose was to investigate concordance between objective and perceived neighborhood walkability, their associations with self-reported walking and objective physical activity, and sociodemographic characteristics of individuals in neighborhoods with objectively assessed high walkability who misperceive it as low. In 1925 individuals age 20-66 yr of both high and low neighborhood walkability recruited from administrative areas in the city of Stockholm, Sweden, objective neighborhood walkability was assessed within a 1000-m radius of each individual's residential address using geographic information systems. Perceived walkability was based on the Neighborhood Environment Walkability Scale. Walking was assessed using the International Physical Activity Questionnaire, and total physical activity and moderate-to-vigorous physical activity (MVPA) were assessed by an accelerometer (ActiGraph). Sociodemographic characteristics were self-reported. Objective and perceived neighborhood walkability agreed in 67.0% of the individuals, with κ = 0.34 (95% confidence interval (CI) = 0.30-0.38). One-third of the individuals in neighborhoods with objectively assessed high walkability misperceived it as low. This nonconcordance was more common among older and married/cohabiting individuals. After adjustment for sociodemographic characteristics, high objective neighborhood walkability was associated with 35.0 (95% CI = 14.6-64.6) and 10.5 (95% CI = -5.2 to 28.5) more minutes per week of walking for transportation and leisure, respectively, and 2.8 (95% CI = 0.9-5.0) more minutes per day of MVPA. High perceived neighborhood walkability was associated with 41.5 (95% CI = 15.8-62.9) and 21.8 (95% CI = 2.8-40.0) more minutes per week of walking for transportation and leisure, respectively, and 1.7 (95% CI = -0.3 to 3.7) more minutes per day of MVPA. Objective and perceived neighborhood walkability both contribute to the amount of walking and objective physical activity. Both

A Disadvantaged Advantage in Walkability: Findings from ...

EPA Pesticide Factsheets

Urban form-the structure of the built environment-can influence physical activity, yet little is known about how walkable design differs according to neighborhood sociodemographic composition. We studied how walkable urban form varies by neighborhood sociodemographic composition, region, and urbanicity across the United States. Using linear regression models and 2000-2001 US Census data, we investigated the relationship between 5 neighborhood census characteristics (income, education, racial/ethnic composition, age distribution, and sex) and 5 walkability indicators in almost 65,000 census tracts in 48 states and the District of Columbia. Data on the built environment were obtained from the RAND Corporation's (Santa Monica, California) Center for Population Health and Health Disparities (median block length, street segment, and node density) and the US Geological Survey's National Land Cover Database (proportion open space and proportion highly developed). Disadvantaged neighborhoods and those with more educated residents were more walkable (i.e., shorter block length, greater street node density, more developed land use, and higher density of street segments). However, tracts with a higher proportion of children and older adults were less walkable (fewer street nodes and lower density of street segments), after adjustment for region and level of urbanicity. Research and policy on the walkability-health link should give nuanced attention to the gap between perso

Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Environmental Domain.

PubMed

Saelens, Brian E; Arteaga, S Sonia; Berrigan, David; Ballard, Rachel M; Gorin, Amy A; Powell-Wiley, Tiffany M; Pratt, Charlotte; Reedy, Jill; Zenk, Shannon N

2018-04-01

There is growing interest in how environment is related to adults' weight and activity and eating behaviors. However, little is known about whether environmental factors are related to the individual variability seen in adults' intentional weight loss or maintenance outcomes. The environmental domain subgroup of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project sought to identify a parsimonious set of objective and perceived neighborhood and social environment constructs and corresponding measures to include in the assessment of response to adult weight-loss treatment. Starting with the home address, the environmental domain subgroup recommended for inclusion in future weight-loss or maintenance studies constructs and measures related to walkability, perceived land use mix, food outlet accessibility (perceived and objective), perceived food availability, socioeconomics, and crime-related safety (perceived and objective) to characterize the home neighborhood environment. The subgroup also recommended constructs and measures related to social norms (perceived and objective) and perceived support to characterize an individual's social environment. The 12 neighborhood and social environment constructs and corresponding measures provide a succinct and comprehensive set to allow for more systematic examination of the impact of environment on adults' weight loss and maintenance. © 2018 The Obesity Society.

Correlates of non-concordance between perceived and objective measures of walkability.

PubMed

Gebel, Klaus; Bauman, Adrian; Owen, Neville

2009-04-01

Objective and self-reported physical environmental attributes have been related to physical activity. We examined the characteristics of adults who are resident in objectively identified high walkable neighborhoods but whose perceptions of neighborhood attributes are not concordant with objective attributes relating to high walkability. Neighborhood built-environment attributes relating to walkability (dwelling density, intersection density, land use mix, and net retail area) were determined objectively, using Geographic Information System databases; data on corresponding perceptions of local environment attributes (from the Neighborhood Environment Walkability Scale) were derived from a self-completion survey of a socially diverse sample of 2,650 adults aged 19 to 65. Objective and perceived walkability attributes were categorized using median splits, and correlates of non-concordance were determined using multiple logistic regression models. There was a fair overall agreement between objectively determined walkability and perceived walkability (Kappa = 0.35, 95% CI = 0.31-0.39). Among those resident in objectively assessed high walkable areas (n = 1,063), 32.1% perceived them to be low walkable; conversely, 32.7% (n = 1,021) resident in objectively determined low walkability areas perceived them to be high. For residents of objectively determined high walkable areas, the characteristics that differentiated those with perceptions of low walkability (non-concordant perceptions) from those with concordant perceptions of high walkability were: not being university-educated (OR = 1.47, 95% CI = 1.06-2.04); having lower household incomes (OR = 1.54, 95% CI = 1.09-2.17); being overweight (OR = 1.46, 95% CI = 1.03-2.07); and walking fewer days per week for transport (OR = 1.75, 95% CI = 1.11-2.70). Higher walking times and more positive cognitive variables were noted among participants who lived in a neighborhood with low walkability that was perceived as high compared

Is walkability associated with a lower cardiometabolic risk?

PubMed

Coffee, Neil T; Howard, Natasha; Paquet, Catherine; Hugo, Graeme; Daniel, Mark

2013-05-01

Walkability of residential environments has been associated with more walking. Given the health benefits of walking, it is expected that people living in locations with higher measured walkability should have a lower risk of cardiometabolic diseases. This study tested the hypothesis that higher walkability was associated with a lower cardiometabolic risk (CMR) for two administrative spatial units and three road buffers. Data were from the North West Adelaide Health Study first wave of data collected between 2000 and 2003. CMR was expressed as a cumulative sum of six clinical risk markers, selected to reflect components of the metabolic syndrome. Walkability was based on an established methodology and operationalised as dwelling density, intersection density, land-use mix and retail footprint. Walkability was associated with lower CMR for the three road buffer representations of the built environment but not for the two administrative spatial units. This may indicate a limitation in the use of administrative spatial units for analyses of walkability and health outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Neighbourhood walkability, road density and socio-economic status in Sydney, Australia.

PubMed

Cowie, Christine T; Ding, Ding; Rolfe, Margaret I; Mayne, Darren J; Jalaludin, Bin; Bauman, Adrian; Morgan, Geoffrey G

2016-04-27

Planning and transport agencies play a vital role in influencing the design of townscapes, travel modes and travel behaviors, which in turn impact on the walkability of neighbourhoods and residents' physical activity opportunities. Optimising neighbourhood walkability is desirable in built environments, however, the population health benefits of walkability may be offset by increased exposure to traffic related air pollution. This paper describes the spatial distribution of neighbourhood walkability and weighted road density, a marker for traffic related air pollution, in Sydney, Australia. As exposure to air pollution is related to socio-economic status in some cities, this paper also examines the spatial distribution of weighted road density and walkability by socio-economic status (SES). We calculated walkability, weighted road density (as a measure of traffic related air pollution) and SES, using predefined and validated measures, for 5858 Sydney neighbourhoods, representing 3.6 million population. We overlaid tertiles of walkability and weighted road density to define "sweet-spots" (high walkability-low weighted road density), and "sour- spots" (low walkability-high weighted road density) neighbourhoods. We also examined the distribution of walkability and weighted road density by SES quintiles. Walkability and weighted road density showed a clear east-west gradient across the region. Our study found that only 4 % of Sydney's population lived in sweet-spot" neighbourhoods with high walkability and low weighted road density (desirable), and these tended to be located closer to the city centre. A greater proportion of neighbourhoods had health limiting attributes of high weighted road density or low walkability (about 20 % each), and over 5 % of the population lived in "sour-spot" neighbourhoods with low walkability and high weighted road density (least desirable). These neighbourhoods were more distant from the city centre and scattered more widely. There were

Measuring Neighborhood Walkable Environments: A Comparison of Three Approaches

PubMed Central

Chiang, Yen-Cheng; Sullivan, William; Larsen, Linda

2017-01-01

Multiple studies have revealed the impact of walkable environments on physical activity. Scholars attach considerable importance to leisure and health-related walking. Recent studies have used Google Street View as an instrument to assess city streets and walkable environments; however, no study has compared the validity of Google Street View assessments of walkable environment attributes to assessments made by local residents and compiled from field visits. In this study, we involved nearby residents and compared the extent to which Google Street View assessments of the walkable environment correlated with assessments from local residents and with field visits. We determined the assessment approaches (local resident or field visit assessments) that exhibited the highest agreement with Google Street View. One city with relatively high-quality walkable environments and one city with relatively low-quality walkable environments were examined, and three neighborhoods from each city were surveyed. Participants in each neighborhood used one of three approaches to assess the walkability of the environment: 15 local residents assessed the environment using a map, 15 participants made a field visit to assess the environment, and 15 participants used Google Street View to assess the environment, yielding a total of 90 valid samples for the two cities. Findings revealed that the three approaches to assessing neighborhood walkability were highly correlated for traffic safety, aesthetics, sidewalk quality, and physical barriers. Compared with assessments from participants making field visits, assessments by local residents were more highly correlated with Google Street View assessments. Google Street View provides a more convenient, low-cost, efficient, and safe approach to assess neighborhood walkability. The results of this study may facilitate future large-scale walkable environment surveys, effectively reduce expenses, and improve survey efficiency. PMID:28587186

An objective index of walkability for research and planning in the Sydney Metropolitan Region of New South Wales, Australia: an ecological study

PubMed Central

2013-01-01

Background Walkability describes the capacity of the built environment to support walking for various purposes. This paper describes the construction and validation of two objective walkability indexes for Sydney, Australia. Methods Walkability indexes using residential density, intersection density, land use mix, with and without retail floor area ratio were calculated for 5,858 Sydney Census Collection Districts in a geographical information system. Associations between variables were evaluated using Spearman’s rho (ρ). Internal consistency and factor structure of indexes were estimated with Cronbach’s alpha and principal components analysis; convergent and predictive validity were measured using weighted kappa (κw) and by comparison with reported walking to work at the 2006 Australian Census using logistic regression. Spatial variation in walkability was assessed using choropleth maps and Moran’s I. Results A three-attribute abridged Sydney Walkability Index comprising residential density, intersection density and land use mix was constructed for all Sydney as retail floor area was only available for 5.3% of Census Collection Districts. A four-attribute full index including retail floor area ratio was calculated for 263 Census Collection Districts in the Sydney Central Business District. Abridged and full walkability index scores for these 263 areas were strongly correlated (ρ=0.93) and there was good agreement between walkability quartiles (κw=0.73). Internal consistency ranged from 0.60 to 0.71, and all index variables loaded highly on a single factor. The percentage of employed persons who walked to work increased with increasing walkability: 3.0% in low income-low walkability areas versus 7.9% in low income-high walkability areas; and 2.1% in high income-low walkability areas versus 11% in high income-high walkability areas. The adjusted odds of walking to work were 1.05 (0.96–1.15), 1.58 (1.45–1.71) and 3.02 (2.76–3.30) times higher in

Polish Version of the Neighbourhood Environment Walkability Scale (NEWS-Poland).

PubMed

Jaśkiewicz, Michał; Besta, Tomasz

2016-11-04

The characteristics of built environments are the subject of intense consideration in the search for solutions to promote wellbeing and a higher quality of life among the inhabitants of cities. Walkability, defined as the extent to which the built environment is friendly to living and fulfilling the needs of the area, has become an important concept in sustainable urban design, public health and environmental psychology. This study systematically adapted the Neighbourhood Environment Walkability Scale (NEWS) for Poland, and evaluated the construct validity aspects of the adapted version among Polish adults. A total sample of 783 participants from a TriCity (Trójmiasto) agglomeration completed the adapted version of the NEWS. Smaller extracted samples of the participants also completed wellbeing related scales, including self-efficacy, local identity and distance to city centre measures. It was expected that various districts of Gdańsk would differ in terms of walkability. The confirmatory factor analysis showed satisfactory goodness-of-fit statistics and factor loadings corresponding to the proposed original factor structure. According to the predictions, the NEWS subscales correlated with the self-efficacy, local identity and wellbeing related measures. In addition, the comparisons between the neighbourhoods of Gdańsk also showed a predictable pattern of results. Overall, the NEWS demonstrated satisfactory measurement properties, and may be useful in the evaluation of the built environment in Poland.

Developing a research and practice tool to measure walkability: a demonstration project.

PubMed

Giles-Corti, Billie; Macaulay, Gus; Middleton, Nick; Boruff, Bryan; Bull, Fiona; Butterworth, Iain; Badland, Hannah; Mavoa, Suzanne; Roberts, Rebecca; Christian, Hayley

2014-12-01

Growing evidence shows that higher-density, mixed-use, pedestrian-friendly neighbourhoods encourage active transport, including transport-related walking. Despite widespread recognition of the benefits of creating more walkable neighbourhoods, there remains a gap between the rhetoric of the need for walkability and the creation of walkable neighbourhoods. Moreover, there is little objective data to benchmark the walkability of neighbourhoods within and between Australian cities in order to monitor planning and design intervention progress and to assess built environment and urban policy interventions required to achieve increased walkability. This paper describes a demonstration project that aimed to develop, trial and validate a 'Walkability Index Tool' that could be used by policy makers and practitioners to assess the walkability of local areas; or by researchers to access geospatial data assessing walkability. The overall aim of the project was to develop an automated geospatial tool capable of creating walkability indices for neighbourhoods at user-specified scales. The tool is based on open-source software architecture, within the Australian Urban Research Infrastructure Network (AURIN) framework, and incorporates key sub-component spatial measures of walkability (street connectivity, density and land use mix). Using state-based data, we demonstrated it was possible to create an automated walkability index. However, due to the lack of availability of consistent of national data measuring land use mix, at this stage it has not been possible to create a national walkability measure. The next stage of the project is to increase useability of the tool within the AURIN portal and to explore options for alternative spatial data sources that will enable the development of a valid national walkability index. AURIN's open-source Walkability Index Tool is a first step in demonstrating the potential benefit of a tool that could measure walkability across Australia. It

Walking to Work: The Roles of Neighborhood Walkability and Socioeconomic Deprivation.

PubMed

Kelly, Cheryl M; Lian, Min; Struthers, Jim; Kammrath, Anna

2015-06-16

There are few studies that aimed to find a relationship between transportation-related physical activity and neighborhood socioeconomic condition using a composite deprivation index. The purpose of this study is to assess the relationship of neighborhood walkability and socioeconomic deprivation with percentage of adults walking to work. A walkability index and a socioeconomic deprivation index were created at block group-level. The outcome variable, percentage of adults who walk to work was dichotomized as < 5% of the block group walking to work low and ≥ 5% of the block group walking to work as high and applied logistic regression to examine the association of walkability and socioeconomic deprivation with walking to work. Individuals in the most walkable neighborhoods are almost 5 times more likely to walk to work than individuals in the least walkable neighborhoods (OR = 4.90, 95% CI = 2.80-8.59). After adjusting for neighborhood socioeconomic deprivation, individuals in the most walkable neighborhoods are almost 3 times more likely to walk to work than individuals in the least walkable neighborhoods (OR = 2.98, 95% CI = 1.62-5.49). Walkability (as measured by the walkability index) is a very strong indicator of walking to work even after controlling for neighborhood socioeconomic disadvantage.

Are residents of high-walkable areas satisfied with their neighbourhood?

PubMed

Grasser, Gerlinde; Titze, Sylvia; Stronegger, Willibald J

2016-01-01

While the association between walkability and walking for transport has been well established, less is known about the association between walkability and neighbourhood satisfaction. This study aims to examine the direction and strength of the association between objective measures of residential walkability and neighbourhood satisfaction, as well as the differences by sex. Using a cross-sectional study design, outcome data were derived from the representative cross-sectional survey (n = 843) 'Bicycle-friendly City' of adults in the city of Graz (Austria). Walkability was measured as gross population density, household unit density, entropy index, proportion of mixed land use, three-way intersection density, four-way intersection density and walkability indices. The outcomes were measured as general neighbourhood satisfaction and neighbourhood satisfaction with the general socio-environmental quality, social cohesion and local infrastructure. Logistic regression analyses were conducted, including age, socio-economic status and place of residence. Walkability was negatively associated with general neighbourhood satisfaction, neighbourhood satisfaction with general socio-environmental quality and social cohesion. It was positively associated with neighbourhood satisfaction with local infrastructure. Connectivity and the entropy index showed the weakest or no association with the outcomes. The strongest association was between walkability and neighbourhood satisfaction with socio-environmental quality. There were no differences by sex. These results contribute to the current limited understanding of the association between walkability and neighbourhood satisfaction, especially in a European context. More comparable, longitudinal research would be helpful to determine what impact walkability has on neighbourhood satisfaction and to identify the important mediating factors.

Neighbourhood Walkability and Daily Steps in Adults with Type 2 Diabetes.

PubMed

Hajna, Samantha; Ross, Nancy A; Joseph, Lawrence; Harper, Sam; Dasgupta, Kaberi

2016-01-01

There is evidence that greater neighbourhood walkability (i.e., neighbourhoods with more amenities and well-connected streets) is associated with higher levels of total walking in Europe and in Asia, but it remains unclear if this association holds in the Canadian context and in chronic disease populations. We examined the relationships of different walkability measures to biosensor-assessed total walking (i.e., steps/day) in adults with type 2 diabetes living in Montreal (QC, Canada). Participants (60.5±10.4 years; 48.1% women) were recruited through McGill University-affiliated clinics (June 2006 to May 2008). Steps/day were assessed once per season for one year with pedometers. Neighbourhood walkability was evaluated through participant reports, in-field audits, Geographic Information Systems (GIS)-derived measures, and the Walk Score®. Relationships between walkability and daily steps were estimated using Bayesian longitudinal hierarchical linear regression models (n = 131). Participants who reported living in the most compared to the least walkable neighbourhoods completed 1345 more steps/day (95% Credible Interval: 718, 1976; Quartiles 4 versus 1). Those living in the most compared to the least walkable neighbourhoods (based on GIS-derived walkability) completed 606 more steps per day (95% CrI: 8, 1203). No statistically significant associations with steps were observed for audit-assessed walkability or the Walk Score®. Adults with type 2 diabetes who perceived their neighbourhoods as more walkable accumulated more daily steps. This suggests that knowledge of local neighborhood features that enhance walking is a meaningful predictor of higher levels of walking and an important component of neighbourhood walkability.

Snow and Rain Modify Neighbourhood Walkability for Older Adults.

PubMed

Clarke, Philippa; Hirsch, Jana A; Melendez, Robert; Winters, Meghan; Sims Gould, Joanie; Ashe, Maureen; Furst, Sarah; McKay, Heather

2017-06-01

The literature has documented a positive relationship between walkable built environments and outdoor mobility in older adults. Yet, surprisingly absent is any consideration of how weather conditions modify the impact of neighbourhood walkability. Using archived weather data linked to survey data collected from a sample of older adults in Vancouver, Canada, we found that car-dependent neighbourhoods (featuring longer block lengths, fewer intersections, and greater distance to amenities) became inaccessible in snow. Even older adults who lived in very walkable neighbourhoods walked to 25 per cent fewer destinations in snow. It is crucial to consider the impact of weather in the relationship between neighbourhood walkability and older adult mobility.

Neighbourhood Walkability and Daily Steps in Adults with Type 2 Diabetes

PubMed Central

Hajna, Samantha; Ross, Nancy A.; Joseph, Lawrence; Harper, Sam; Dasgupta, Kaberi

2016-01-01

Introduction There is evidence that greater neighbourhood walkability (i.e., neighbourhoods with more amenities and well-connected streets) is associated with higher levels of total walking in Europe and in Asia, but it remains unclear if this association holds in the Canadian context and in chronic disease populations. We examined the relationships of different walkability measures to biosensor-assessed total walking (i.e., steps/day) in adults with type 2 diabetes living in Montreal (QC, Canada). Materials and Methods Participants (60.5±10.4 years; 48.1% women) were recruited through McGill University-affiliated clinics (June 2006 to May 2008). Steps/day were assessed once per season for one year with pedometers. Neighbourhood walkability was evaluated through participant reports, in-field audits, Geographic Information Systems (GIS)-derived measures, and the Walk Score®. Relationships between walkability and daily steps were estimated using Bayesian longitudinal hierarchical linear regression models (n = 131). Results Participants who reported living in the most compared to the least walkable neighbourhoods completed 1345 more steps/day (95% Credible Interval: 718, 1976; Quartiles 4 versus 1). Those living in the most compared to the least walkable neighbourhoods (based on GIS-derived walkability) completed 606 more steps per day (95% CrI: 8, 1203). No statistically significant associations with steps were observed for audit-assessed walkability or the Walk Score®. Conclusions Adults with type 2 diabetes who perceived their neighbourhoods as more walkable accumulated more daily steps. This suggests that knowledge of local neighborhood features that enhance walking is a meaningful predictor of higher levels of walking and an important component of neighbourhood walkability. PMID:26991308

Space, race, and poverty: Spatial inequalities in walkable neighborhood amenities?

PubMed Central

Aldstadt, Jared; Whalen, John; White, Kellee; Castro, Marcia C.; Williams, David R.

2017-01-01

BACKGROUND Multiple and varied benefits have been suggested for increased neighborhood walkability. However, spatial inequalities in neighborhood walkability likely exist and may be attributable, in part, to residential segregation. OBJECTIVE Utilizing a spatial demographic perspective, we evaluated potential spatial inequalities in walkable neighborhood amenities across census tracts in Boston, MA (US). METHODS The independent variables included minority racial/ethnic population percentages and percent of families in poverty. Walkable neighborhood amenities were assessed with a composite measure. Spatial autocorrelation in key study variables were first calculated with the Global Moran’s I statistic. Then, Spearman correlations between neighborhood socio-demographic characteristics and walkable neighborhood amenities were calculated as well as Spearman correlations accounting for spatial autocorrelation. We fit ordinary least squares (OLS) regression and spatial autoregressive models, when appropriate, as a final step. RESULTS Significant positive spatial autocorrelation was found in neighborhood socio-demographic characteristics (e.g. census tract percent Black), but not walkable neighborhood amenities or in the OLS regression residuals. Spearman correlations between neighborhood socio-demographic characteristics and walkable neighborhood amenities were not statistically significant, nor were neighborhood socio-demographic characteristics significantly associated with walkable neighborhood amenities in OLS regression models. CONCLUSIONS Our results suggest that there is residential segregation in Boston and that spatial inequalities do not necessarily show up using a composite measure. COMMENTS Future research in other geographic areas (including international contexts) and using different definitions of neighborhoods (including small-area definitions) should evaluate if spatial inequalities are found using composite measures but also should use measures of

Rural Neighborhood Walkability: Implications for Assessment.

PubMed

Kegler, Michelle C; Alcantara, Iris; Haardörfer, Regine; Gemma, Alexandra; Ballard, Denise; Gazmararian, Julie

2015-06-16

Physical activity levels, including walking, are lower in the southern U.S., particularly in rural areas. This study investigated the concept of rural neighborhood walkability to aid in developing tools for assessing walkability and to identify intervention targets in rural communities. Semi-structured interviews were conducted with physically active adults (n = 29) in rural Georgia. Mean age of participants was 55.9 years; 66% were male, 76% were white, and 24% were African American. Participants drew maps of their neighborhoods and discussed the relevance of typical domains of walkability to their decisions to exercise. Comparative analyses were conducted to identify major themes. The majority felt the concept of neighborhood was applicable and viewed their neighborhood as small geographically (less than 0.5 square miles). Sidewalks were not viewed as essential for neighborhood-based physical activity and typical destinations for walking were largely absent. Destinations within walking distance included neighbors' homes and bodies of water. Views were mixed on whether shade, safety, dogs, and aesthetics affected decisions to exercise in their neighborhoods. Measures of neighborhood walkability in rural areas should acknowledge the small size of self-defined neighborhoods, that walking in rural areas is likely for leisure time exercise, and that some domains may not be relevant.

ATTRIBUTES OF FORM IN THE BUILT ENVIRONMENT THAT INFLUENCE PERCEIVED WALKABILITY.

PubMed

Oreskovic, Nicolas M; Charles, Pablina Roth Suzanne Lanyi; Shepherd, Dido Tsigaridi Kathrine; Nelson, Kerrie P; Bar, Moshe

2014-01-01

A recent focus of design and building regulations, including form-based codes and the Leadership in Energy and Environmental Design for Neighborhood Development rating system, has been on promoting pedestrian activity. This study assessed perceptions of walkability for residential and commercial streetscapes with different design attributes in order to inform form-based regulations and codes that aim to impact walkability. We scored 424 images on four design attributes purported to influence walkability: variation in building height, variation in building plane, presence of ground-floor windows, and presence of a street focal point. We then presented the images to 45 adults, who were asked to rate the images for walkability. The results showed that perceived walkability varied according to the degree to which a particular design attribute was present, with the presence of ground-floor windows and a street focal point most consistently associated with a space's perceived walkability. Understanding if and which design attributes are most related to walkability could allow planners and developers to focus on the most salient built-environment features influencing physical activity, as well as provide empirical scientific evidence for form-based regulations and zoning codes aimed at impacting walkabilit.

Residents’ Perceptions of Walkability Attributes in Mainland China: Reliability and Validity

NASA Astrophysics Data System (ADS)

Ye, Yang; Fei, Teng; Mei, Hongyuan

2017-12-01

To test the influence of urban built environment on walkability in mainland Chinese cities, this study developed a questionnaire to perceive the residents’ perception of walkability around their neighborhood, which was based on the Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A), and modified to reflect the characteristics of mainland Chinese built environment and people’s behavior mode. To perceive the final version of Neighborhood Environment Walkability Scale for Mainland China (NEWS-MC), We made a pilot study which include 50 samples, then interview 350 residents from 4 selected residential districts in Harbin which were different in walkability attributes and economic status. The final version of the NEWS-MC included 8 subscales and 5 single items (81 items in total). Test-retest reliability showed moderate to high except 1 subscale. In total, the NEWS-MC could illustrate residents’ perceptions of walkability attributes in mainland Chinese cities and could be use in other Chinese urban attributes studies related to walking.

['Walkability' and physical activity - results of empirical studies based on the 'Neighbourhood Environment Walkability Scale (NEWS)'].

PubMed

Rottmann, M; Mielck, A

2014-02-01

'Walkability' is mainly assessed by the NEWS questionnaire (Neighbourhood Environment Walkability Scale); in Germany this questionnaire is widely unknown. We now try to fill this gap by providing a systematic overview of empirical studies based on the NEWS. A systematic review was conducted concerning original papers including empirical analyses based on the NEWS. The results are summarised and presented in tables. Altogether 31 publications could be identified. Most of them focus on associations with the variable 'physical activity', and they often report significant associations with at least some of the scales included in the NEWS. Due to methodological differences between the studies it is difficult to compare the results. The concept of 'walkability' should also be established in the German public health discussion. A number of methodological challenges remain to be solved, such as the identification of those scales and items in the NEWS that show the strongest associations with individual health behaviours. © Georg Thieme Verlag KG Stuttgart · New York.

Neighborhood walkability and hospital treatment costs: A first assessment.

PubMed

Yu, Yan; Davey, Rachel; Cochrane, Tom; Learnihan, Vincent; Hanigan, Ivan C; Bagheri, Nasser

2017-06-01

Health system expenditure is a global concern, with hospital cost a major component. Built environment has been found to affect physical activity and health outcomes. The purpose of the study was a first assessment of the relationship between neighborhood walkability and hospital treatment costs. For 88 neighborhoods in the Australian Capital Territory (ACT), 2011-2013, a total of 30,690 public hospital admissions for the treatment of four diagnostic groups (cancers, endocrine, nutritional and metabolic diseases, circulatory diseases and respiratory diseases) were extracted from the ACT admitted patient care database and analyzed in relation to the Walk Score® index as a measure of walkability. Hospital cost was calculated according to the cost weight of the diagnosis related group assigned to each admission. Linear regressions were used to analyze the associations of walkability with hospital cost per person, admissions per person and cost per admission at the neighborhood level. An inverse association with neighborhood walkability was found for cost per person and admissions per person, but not cost per admission. After adjusting for age, sex and socioeconomic status, a 20-unit increase in walkability was associated with 12.1% (95% CI: 7.1-17.0%) lower cost and 12.5% (8.1-17.0%) fewer admissions. These associations did not vary by neighborhood socioeconomic status. This exploratory analysis suggests the potential for improved population health and reduced hospital cost with greater neighborhood walkability. Further research should replicate the analysis with data from other urban settings, and focus on the behavioral mechanisms underlying the inverse walkability-hospital cost association. Copyright © 2017 Elsevier Inc. All rights reserved.

Walk Score(TM), Perceived Neighborhood Walkability, and walking in the US.

PubMed

Tuckel, Peter; Milczarski, William

2015-03-01

To investigate both the Walk Score(TM) and a self-reported measure of neighborhood walkability ("Perceived Neighborhood Walkability") as estimators of transport and recreational walking among Americans. The study is based upon a survey of a nationally-representative sample of 1224 American adults. The survey gauged walking for both transport and recreation and included a self-reported measure of neighborhood walkability and each respondent's Walk Score(TM). Binary logistic and linear regression analyses were performed on the data. The Walk Score(TM) is associated with walking for transport, but not recreational walking nor total walking. Perceived Neighborhood Walkability is associated with transport, recreational and total walking. Perceived Neighborhood Walkability captures the experiential nature of walking more than the Walk Score(TM).

An Australian Version of the Neighborhood Environment Walkability Scale: Validity Evidence

ERIC Educational Resources Information Center

Cerin, Ester; Leslie, Eva; Owen, Neville; Bauman, Adrian

2008-01-01

This study examined validity evidence for the Australian version of the Neighborhood Environment Walkability Scale (NEWS-AU). A stratified two-stage cluster sampling design was used to recruit 2,650 adults from Adelaide (Australia). The sample was drawn from residential addresses within eight high-walkable and eight low-walkable suburbs matched…

Walkability and walking for transport: characterizing the built environment using space syntax.

PubMed

Koohsari, Mohammad Javad; Owen, Neville; Cerin, Ester; Giles-Corti, Billie; Sugiyama, Takemi

2016-11-24

Neighborhood walkability has been shown to be associated with walking behavior. However, the availability of geographical data necessary to construct it remains a limitation. Building on the concept of space syntax, we propose an alternative walkability index, space syntax walkability (SSW). This study examined associations of the full walkability index and SSW with walking for transport (WT). Data were collected in 2003-2004 from 2544 adults living in 154 Census Collection Districts (CCD) in Adelaide, Australia. Participants reported past week WT frequency. Full walkability (consisting of net residential density, intersection density, land use mix, and net retail area ratio) and SSW (consisting of gross population density and a space syntax measure of street integration) were calculated for each CCD using geographic information systems and space syntax software. Generalized linear models with negative binomial variance and logarithmic link functions were employed to examine the associations of each walkability index with WT frequency, adjusting for socio-demographic variables. Two walkability indices were closely correlated (ρ = 0.76, p < 0.01). The associations of full walkability and SSW with WT frequency were positive, with regression coefficients of 1.12 (95% CI: 1.08, 1.17) and 1.14 (95% CI: 1.10, 1.19), respectively. SSW employs readily-available geographic data, yet is comparable to full walkability in its association with WT. The concept and methods of space syntax provide a novel approach to further understanding how urban design influences walking behaviors.

Neighborhood walkability: field validation of geographic information system measures.

PubMed

Hajna, Samantha; Dasgupta, Kaberi; Halparin, Max; Ross, Nancy A

2013-06-01

Given the health benefits of walking, there is interest in understanding how physical environments favor walking. Although GIS-derived measures of land-use mix, street connectivity, and residential density are commonly combined into indices to assess how conducive neighborhoods are to walking, field validation of these measures is limited. To assess the relationship between audit- and GIS-derived measures of overall neighborhood walkability and between objective (audit- and GIS-derived) and participant-reported measures of walkability. Walkability assessments were conducted in 2009. Street-level audits were conducted using a modified version of the Pedestrian Environmental Data Scan. GIS analyses were used to derive land-use mix, street connectivity, and residential density. Participant perceptions were assessed using a self-administered questionnaire. Audit, GIS, and participant-reported indices of walkability were calculated. Spearman correlation coefficients were used to assess the relationships between measures. All analyses were conducted in 2012. The correlation between audit- and GIS-derived measures of overall walkability was high (R=0.7 [95% CI=0.6, 0.8]); the correlations between objective (audit and GIS-derived) and participant-reported measures were low (R=0.2 [95% CI=0.06, 0.3]; R=0.2 [95% CI=0.04, 0.3], respectively). For comparable audit and participant-reported items, correlations were higher for items that appeared more objective (e.g., sidewalk presence, R=0.4 [95% CI=0.3, 0.5], versus safety, R=0.1 [95% CI=0.003, 0.3]). The GIS-derived measure of walkability correlated well with the in-field audit, suggesting that it is reasonable to use GIS-derived measures in place of more labor-intensive audits. Interestingly, neither audit- nor GIS-derived measures correlated well with participants' perceptions of walkability. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Stepping towards causation: do built environments or neighborhood and travel preferences explain physical activity, driving, and obesity?

PubMed

Frank, Lawrence Douglas; Saelens, Brian E; Powell, Ken E; Chapman, James E

2007-11-01

Evidence documents associations between neighborhood design and active and sedentary forms of travel. Most studies compare travel patterns for people located in different types of neighborhoods at one point in time adjusting for demographics. Most fail to account for either underlying neighborhood selection factors (reasons for choosing a neighborhood) or preferences (neighborhoods that are preferred) that impact neighborhood selection and behavior. Known as self-selection, this issue makes it difficult to evaluate causation among built form, behavior, and associated outcomes and to know how much more walking and less driving could occur through creating environments conducive to active transport. The current study controls for neighborhood selection and preference and isolates the effect of the built environment on walking, car use, and obesity. Separate analyses were conducted among 2056 persons in the Atlanta, USA based Strategies for Metropolitan Atlanta's Regional Transportation and Air Quality (SMARTRAQ) travel survey on selection factors and 1466 persons in the SMARTRAQ community preference sub-survey. A significant proportion of the population are "mismatched" and do not live in their preferred neighborhood type. Factors influencing neighborhood selection and individual preferences, and current neighborhood walkability explained vehicle travel distance after controlling for demographic variables. Individuals who preferred and lived in a walkable neighborhood walked most (33.9% walked) and drove 25.8 miles per day on average. Individuals that preferred and lived in car dependent neighborhoods drove the most (43 miles per day) and walked the least (3.3%). Individuals that do not prefer a walkable environment walked little and show no change in obesity prevalence regardless of where they live. About half as many participants were obese (11.7%) who prefer and live in walkable environments than participants who prefer car dependent environments (21.6%). Findings

Active living neighborhoods: is neighborhood walkability a key element for Belgian adolescents?

PubMed

De Meester, Femke; Van Dyck, Delfien; De Bourdeaudhuij, Ilse; Deforche, Benedicte; Sallis, James F; Cardon, Greet

2012-01-04

In adult research, neighborhood walkability has been acknowledged as an important construct among the built environmental correlates of physical activity. Research into this association has only recently been extended to adolescents and the current empirical evidence is not consistent. This study investigated whether neighborhood walkability and neighborhood socioeconomic status (SES) are associated with physical activity among Belgian adolescents and whether the association between neighborhood walkability and physical activity is moderated by neighborhood SES and gender. In Ghent (Belgium), 32 neighborhoods were selected based on GIS-based walkability and SES derived from census data. In total, 637 adolescents (aged 13-15 year, 49.6% male) participated in the study. Physical activity was assessed using accelerometers and the Flemish Physical Activity Questionnaire. To analyze the associations between neighborhood walkability, neighborhood SES and individual physical activity, multivariate multi-level regression analyses were conducted. Only in low-SES neighborhoods, neighborhood walkability was positively associated with accelerometer-based moderate to vigorous physical activity and the average activity level expressed in counts/minute. For active transport to and from school, cycling for transport during leisure time and sport during leisure time no association with neighborhood walkability nor, with neighborhood SES was found. For walking for transport during leisure time a negative association with neighborhood SES was found. Gender did not moderate the associations of neighborhood walkability and SES with adolescent physical activity. Neighborhood walkability was related to accelerometer-based physical activity only among adolescent boys and girls living in low-SES neighborhoods. The relation of built environment to adolescent physical activity may depend on the context.

Using GPS Data to Study Neighborhood Walkability and Physical Activity.

PubMed

Rundle, Andrew G; Sheehan, Daniel M; Quinn, James W; Bartley, Katherine; Eisenhower, Donna; Bader, Michael M D; Lovasi, Gina S; Neckerman, Kathryn M

2016-03-01

Urban form characteristics intended to support pedestrian activity, collectively referred to as neighborhood walkability, are thought to increase total physical activity. However, little is known about how neighborhood walkability influences utilization of neighborhood space by residents and their overall physical activity. Sociodemographic information and data on mobility and physical activity over 1-week periods measured by GPS loggers and accelerometers were collected from 803 residents of New York City between November 2010 and November 2011. Potentially accessible neighborhood areas were defined as land area within a 1-kilometer distance of the subject's home (radial buffer) and within a 1-kilometer journey on the street network from the home (network buffer). To define actual areas utilized by subjects, a minimum convex polygon was plotted around GPS waypoints falling within 1 kilometer of the home. A neighborhood walkability scale was calculated for each neighborhood area. Data were analyzed in 2014. Total residential neighborhood space utilized by subjects was significantly associated with street intersection density and was significantly negatively associated with residential density and subway stop density within 1 kilometer of the home. Walkability scale scores were significantly higher within utilized as compared with non-utilized neighborhood areas. Neighborhood walkability in the utilized neighborhood area was positively associated with total weekly physical activity (32% [95% CI=17%, 49%] more minutes of moderate-equivalent physical activity across the interquartile range of walkability). Neighborhood walkability is associated with neighborhood spaces utilized by residents and total weekly physical activity. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Active living neighborhoods: is neighborhood walkability a key element for Belgian adolescents?

PubMed Central

2012-01-01

Background In adult research, neighborhood walkability has been acknowledged as an important construct among the built environmental correlates of physical activity. Research into this association has only recently been extended to adolescents and the current empirical evidence is not consistent. This study investigated whether neighborhood walkability and neighborhood socioeconomic status (SES) are associated with physical activity among Belgian adolescents and whether the association between neighborhood walkability and physical activity is moderated by neighborhood SES and gender. Methods In Ghent (Belgium), 32 neighborhoods were selected based on GIS-based walkability and SES derived from census data. In total, 637 adolescents (aged 13-15 year, 49.6% male) participated in the study. Physical activity was assessed using accelerometers and the Flemish Physical Activity Questionnaire. To analyze the associations between neighborhood walkability, neighborhood SES and individual physical activity, multivariate multi-level regression analyses were conducted. Results Only in low-SES neighborhoods, neighborhood walkability was positively associated with accelerometer-based moderate to vigorous physical activity and the average activity level expressed in counts/minute. For active transport to and from school, cycling for transport during leisure time and sport during leisure time no association with neighborhood walkability nor, with neighborhood SES was found. For walking for transport during leisure time a negative association with neighborhood SES was found. Gender did not moderate the associations of neighborhood walkability and SES with adolescent physical activity. Conclusions Neighborhood walkability was related to accelerometer-based physical activity only among adolescent boys and girls living in low-SES neighborhoods. The relation of built environment to adolescent physical activity may depend on the context. PMID:22216923

Physical Limitations, Walkability, Perceived Environmental Facilitators and Physical Activity of Older Adults in Finland

PubMed Central

Portegijs, Erja; Keskinen, Kirsi E.; Tsai, Li-Tang; Rantanen, Taina; Rantakokko, Merja

2017-01-01

The aim was to study objectively assessed walkability of the environment and participant perceived environmental facilitators for outdoor mobility as predictors of physical activity in older adults with and without physical limitations. 75–90-year-old adults living independently in Central Finland were interviewed (n = 839) and reassessed for self-reported physical activity one or two years later (n = 787). Lower-extremity physical limitations were defined as Short Physical Performance Battery score ≤9. Number of perceived environmental facilitators was calculated from a 16-item checklist. Walkability index (land use mix, street connectivity, population density) of the home environment was calculated from geographic information and categorized into tertiles. Accelerometer-based step counts were registered for one week (n = 174). Better walkability was associated with higher numbers of perceived environmental facilitators (p < 0.001) and higher physical activity (self-reported p = 0.021, step count p = 0.010). Especially among those with physical limitations, reporting more environmental facilitators was associated with higher odds for reporting at least moderate physical activity (p < 0.001), but not step counts. Perceived environmental facilitators only predicted self-reported physical activity at follow-up. To conclude, high walkability of the living environment provides opportunities for physical activity in old age, but among those with physical limitations especially, awareness of environmental facilitators may be needed to promote physical activity. PMID:28327543

Physical Limitations, Walkability, Perceived Environmental Facilitators and Physical Activity of Older Adults in Finland.

PubMed

Portegijs, Erja; Keskinen, Kirsi E; Tsai, Li-Tang; Rantanen, Taina; Rantakokko, Merja

2017-03-22

The aim was to study objectively assessed walkability of the environment and participant perceived environmental facilitators for outdoor mobility as predictors of physical activity in older adults with and without physical limitations. 75-90-year-old adults living independently in Central Finland were interviewed ( n = 839) and reassessed for self-reported physical activity one or two years later ( n = 787). Lower-extremity physical limitations were defined as Short Physical Performance Battery score ≤9. Number of perceived environmental facilitators was calculated from a 16-item checklist. Walkability index (land use mix, street connectivity, population density) of the home environment was calculated from geographic information and categorized into tertiles. Accelerometer-based step counts were registered for one week ( n = 174). Better walkability was associated with higher numbers of perceived environmental facilitators ( p < 0.001) and higher physical activity (self-reported p = 0.021, step count p = 0.010). Especially among those with physical limitations, reporting more environmental facilitators was associated with higher odds for reporting at least moderate physical activity ( p < 0.001), but not step counts. Perceived environmental facilitators only predicted self-reported physical activity at follow-up. To conclude, high walkability of the living environment provides opportunities for physical activity in old age, but among those with physical limitations especially, awareness of environmental facilitators may be needed to promote physical activity.

Dynamic model predicting overweight, obesity, and extreme obesity prevalence trends.

PubMed

Thomas, Diana M; Weedermann, Marion; Fuemmeler, Bernard F; Martin, Corby K; Dhurandhar, Nikhil V; Bredlau, Carl; Heymsfield, Steven B; Ravussin, Eric; Bouchard, Claude

2014-02-01

Obesity prevalence in the United States appears to be leveling, but the reasons behind the plateau remain unknown. Mechanistic insights can be provided from a mathematical model. The objective of this study is to model known multiple population parameters associated with changes in body mass index (BMI) classes and to establish conditions under which obesity prevalence will plateau. A differential equation system was developed that predicts population-wide obesity prevalence trends. The model considers both social and nonsocial influences on weight gain, incorporates other known parameters affecting obesity trends, and allows for country specific population growth. The dynamic model predicts that: obesity prevalence is a function of birthrate and the probability of being born in an obesogenic environment; obesity prevalence will plateau independent of current prevention strategies; and the US prevalence of overweight, obesity, and extreme obesity will plateau by about 2030 at 28%, 32%, and 9% respectively. The US prevalence of obesity is stabilizing and will plateau, independent of current preventative strategies. This trend has important implications in accurately evaluating the impact of various anti-obesity strategies aimed at reducing obesity prevalence. Copyright © 2013 The Obesity Society.

Neighborhood Walkability and Body Mass Index Trajectories: Longitudinal Study of Canadians.

PubMed

Wasfi, Rania A; Dasgupta, Kaberi; Orpana, Heather; Ross, Nancy A

2016-05-01

To assess the impact of neighborhood walkability on body mass index (BMI) trajectories of urban Canadians. Data are from Canada's National Population Health Survey (n = 2935; biannual assessments 1994-2006). We measured walkability with the Walk Score. We modeled body mass index (BMI, defined as weight in kilograms divided by the square of height in meters [kg/m(2)]) trajectories as a function of Walk Score and sociodemographic and behavioral covariates with growth curve models and fixed-effects regression models. In men, BMI increased annually by an average of 0.13 kg/m(2) (95% confidence interval [CI] = 0.11, 0.14) over the 12 years of follow-up. Moving to a high-walkable neighborhood (2 or more Walk Score quartiles higher) decreased BMI trajectories for men by approximately 1 kg/m(2) (95% CI = -1.16, -0.17). Moving to a low-walkable neighborhood increased BMI for men by approximately 0.45 kg/m(2) (95% CI = 0.01, 0.89). There was no detectable influence of neighborhood walkability on body weight for women. Our study of a large sample of urban Canadians followed for 12 years confirms that neighborhood walkability influences BMI trajectories for men, and may be influential in curtailing male age-related weight gain.

Neighborhood walkability and walking behavior: the moderating role of action orientation.

PubMed

Friederichs, Stijn A H; Kremers, Stef P J; Lechner, Lilian; de Vries, Nanne K

2013-05-01

In promoting physical activity, it is important to gain insight into environmental factors that facilitate or hinder physical activity and factors that may influence this environment-behavior relationship. As the personality factor of action orientation reflects an individual's capacity to regulate behavior it may act as a moderator in the environment-behavior relationship. The current study addressed the relationship between neighborhood walkability and walking behavior and the influence of action orientation on this relationship. Three hundred and forty-seven Dutch inhabitants [mean age 43.1 (SD 17.1)] completed a web based questionnaire assessing demographic variables, neighborhood walkability (Neighborhood Environment Walkability Scale), variables of the Theory of Planned Behavior, action orientation, and walking behavior. The results show that high levels of neighborhood walkability are positively associated with walking behavior and that this influence is largely unmediated by cognitive processes. A positive influence of neighborhood walkability on walking behavior was identified in the action-oriented subpopulation, whereas in the state-oriented part of the population, this influence was absent. The findings suggest that the influence of neighborhood environment on walking behavior has a relatively large unconscious, automatic component. In addition, the results suggest that the walkability-walking relationship is moderated by action orientation.

Dynamic Model Predicting Overweight, Obesity, and Extreme Obesity Prevalence Trends

PubMed Central

Thomas, Diana M.; Weedermann, Marion; Fuemmeler, Bernard F.; Martin, Corby K.; Dhurandhar, Nikhil V.; Bredlau, Carl; Heymsfield, Steven B.; Ravussin, Eric; Bouchard, Claude

2013-01-01

Objective Obesity prevalence in the United States (US) appears to be leveling, but the reasons behind the plateau remain unknown. Mechanistic insights can be provided from a mathematical model. The objective of this study is to model known multiple population parameters associated with changes in body mass index (BMI) classes and to establish conditions under which obesity prevalence will plateau. Design and Methods A differential equation system was developed that predicts population-wide obesity prevalence trends. The model considers both social and non-social influences on weight gain, incorporates other known parameters affecting obesity trends, and allows for country specific population growth. Results The dynamic model predicts that: obesity prevalence is a function of birth rate and the probability of being born in an obesogenic environment; obesity prevalence will plateau independent of current prevention strategies; and the US prevalence of obesity, overweight, and extreme obesity will plateau by about 2030 at 28%, 32%, and 9%, respectively. Conclusions The US prevalence of obesity is stabilizing and will plateau, independent of current preventative strategies. This trend has important implications in accurately evaluating the impact of various anti-obesity strategies aimed at reducing obesity prevalence. PMID:23804487

One size doesn't fit all: cross-sectional associations between neighborhood walkability, crime and physical activity depends on age and sex of residents.

PubMed

Richardson, Andrea S; Troxel, Wendy M; Ghosh-Dastidar, Madhumita B; Beckman, Robin; Hunter, Gerald P; DeSantis, Amy S; Colabianchi, Natalie; Dubowitz, Tamara

2017-01-19

Low-income African American adults are disproportionately affected by obesity and are also least likely to engage in recommended levels of physical activity (Flegal et al. JAMA 303(3):235-41, 2010; Tucker et al. Am J Prev Med 40(4):454-61, 2011). Moderate-to-vigorous physical activity (MVPA) is an important factor for weight management and control, as well as for reducing disease risk (Andersen et al. Lancet 368(9532):299-304, 2006; Boreham and Riddoch J Sports Sci 19(12):915-29, 2001; Carson et al. PLoS One 8(8):e71417, 2013). While neighborhood greenspace and walkability have been associated with increased MVPA, evidence also suggests that living in areas with high rates of crime limits MVPA. Few studies have examined to what extent the confluence of neighborhood greenspace, walkability and crime might impact MVPA in low-income African American adults nor how associations may vary by age and sex. In 2013 we collected self-reported data on demographics, functional limitations, objective measures of MVPA (accelerometry), neighborhood greenspace (geographic information system), and walkability (street audit) in 791 predominantly African-American adults (mean age 56 years) living in two United States (U.S.) low-income neighborhoods. We also acquired data from the City of Pittsburgh on all crime events within both neighborhoods. To examine cross-sectional associations of neighborhood-related variables (i.e., neighborhood greenspace, walkability and crime) with MVPA, we used zero-inflated negative binomial regression models. Additionally, we examined potential interactions by age (over 65 years) and sex on relationships between neighborhood variables and MVPA. Overall, residents engaged in very little to no MVPA regardless of where they lived. However, for women, but not men, under the age of 65 years, living in more walkable neighborhoods was associated with more time engaged in MVPA in (β = 0.55, p = 0.007) as compared to their counterparts living in less

Neighbourhood walkability, leisure-time and transport-related physical activity in a mixed urban-rural area.

PubMed

de Sa, Eric; Ardern, Chris I

2014-01-01

Objectives. To develop a walkability index specific to mixed rural/suburban areas, and to explore the relationship between walkability scores and leisure time physical activity. Methods. Respondents were geocoded with 500 m and 1,000 m buffer zones around each address. A walkability index was derived from intersections, residential density, and land-use mix according to built environment measures. Multivariable logistic regression models were used to quantify the association between the index and physical activity levels. Analyses used cross-sectional data from the 2007-2008 Canadian Community Health Survey (n = 1158; ≥18 y). Results. Respondents living in highly walkable 500 m buffer zones (upper quartiles of the walkability index) were more likely to walk or cycle for leisure than those living in low-walkable buffer zones (quartile 1). When a 1,000 m buffer zone was applied, respondents in more walkable neighbourhoods were more likely to walk or cycle for both leisure-time and transport-related purposes. Conclusion. Developing a walkability index can assist in exploring the associations between measures of the built environment and physical activity to prioritize neighborhood change.

Walkable Route Perceptions and Physical Features: Converging Evidence for En Route Walking Experiences

ERIC Educational Resources Information Center

Brown, Barbara B.; Werner, Carol M.; Amburgey, Jonathan W.; Szalay, Caitlin

2007-01-01

Guided walks near a light rail stop in downtown Salt Lake City, Utah, were examined using a 2 (gender) x 3 (route walkability: low-mixed-, or high-walkability features) design. Trained raters confirmed that more walkable segments had more traffic, environmental, and social safety; pleasing aesthetics; natural features; pedestrian amenities; and…

Neighborhood Walkability and Body Mass Index Trajectories: Longitudinal Study of Canadians

PubMed Central

Dasgupta, Kaberi; Orpana, Heather; Ross, Nancy A.

2016-01-01

Objectives. To assess the impact of neighborhood walkability on body mass index (BMI) trajectories of urban Canadians. Methods. Data are from Canada’s National Population Health Survey (n = 2935; biannual assessments 1994–2006). We measured walkability with the Walk Score. We modeled body mass index (BMI, defined as weight in kilograms divided by the square of height in meters [kg/m2]) trajectories as a function of Walk Score and sociodemographic and behavioral covariates with growth curve models and fixed-effects regression models. Results. In men, BMI increased annually by an average of 0.13 kg/m2 (95% confidence interval [CI] = 0.11, 0.14) over the 12 years of follow-up. Moving to a high-walkable neighborhood (2 or more Walk Score quartiles higher) decreased BMI trajectories for men by approximately 1 kg/m2 (95% CI = −1.16, −0.17). Moving to a low-walkable neighborhood increased BMI for men by approximately 0.45 kg/m2 (95% CI = 0.01, 0.89). There was no detectable influence of neighborhood walkability on body weight for women. Conclusions. Our study of a large sample of urban Canadians followed for 12 years confirms that neighborhood walkability influences BMI trajectories for men, and may be influential in curtailing male age-related weight gain. PMID:26985612

Does neighbourhood walkability moderate the effects of mass media communication strategies to promote regular physical activity?

PubMed

Barnes, R; Giles-Corti, B; Bauman, A; Rosenberg, M; Bull, F C; Leavy, J E

2013-02-01

Mass media campaigns are widely used in Australia and elsewhere to promote physical activity among adults. Neighbourhood walkability is consistently shown to be associated with walking and total activity. Campaigns may have different effects on individuals living in high and low walkable neighbourhoods. The purpose of this study is to compare pre- and post-campaign cognitive and behavioural impacts of the Heart Foundation's Find Thirty every day® campaign, in respondents living in high and lower walkable neighbourhoods. Pre- and post-campaign cross-sectional survey data were linked with objectively measured neighbourhood walkability. Cognitive and behavioural impacts were assessed using logistic regression stratified by walkability. Cognitive impacts were significantly higher post-campaign and consistently higher in respondents in high compared with lower walkable neighbourhoods. Post campaign sufficient activity was significantly higher and transport walking significantly lower, but only in residents of lower walkable areas. Cognitive impacts of mass media physical activity campaigns may be enhanced by living in a more walkable neighbourhood.

Neighborhood walkability and particulate air pollution in a nationwide cohort of women.

PubMed

James, Peter; Hart, Jaime E; Laden, Francine

2015-10-01

Features of neighborhoods associated with walkability (i.e., connectivity, accessibility, and density) may also be correlated with levels of ambient air pollution, which would attenuate the health benefits of walkability. We examined the relationship between neighborhood walkability and ambient air pollution in a cross-sectional analysis of a cohort study spanning the entire United States using residence-level exposure assessment for ambient air pollution and the built environment. Using data from the Nurses' Health Study, we used linear regression to estimate the association between a neighborhood walkability index, combining neighborhood intersection count, business count, and population density (defined from Census data, infoUSA business data, and StreetMap USA data), and air pollution, defined from a GIS-based spatiotemporal PM2.5 model. After adjustment for Census tract median income, median home value, and percent with no high school education, the highest tertile of walkability index, intersection count, business count, and population density was associated with a with 1.58 (95% CI 1.54, 1.62), 1.20 (95% CI 1.16, 1.24), 1.31 (95% CI 1.27, 1.35), and 1.84 (95% CI 1.80, 1.88) µg/m(3) higher level of PM2.5 respectively, compared to the lowest tertile. Results varied somewhat by neighborhood socioeconomic status and greatly by region. This nationwide analysis showed a positive relationship between neighborhood walkability and modeled air pollution levels, which were consistent after adjustment for neighborhood-level socioeconomic status. Regional differences in the air pollution-walkability relationship demonstrate that there are factors that vary from region to region that allow for walkable neighborhoods with low levels of air pollution. Copyright © 2015 Elsevier Inc. All rights reserved.

Neighborhood Design, Physical Activity, and Wellbeing: Applying the Walkability Model

PubMed Central

Zuniga-Teran, Adriana A.; Orr, Barron J.; Gimblett, Randy H.; Chalfoun, Nader V.; Guertin, David P.; Marsh, Stuart E.

2017-01-01

Neighborhood design affects lifestyle physical activity, and ultimately human wellbeing. There are, however, a limited number of studies that examine neighborhood design types. In this research, we examine four types of neighborhood designs: traditional development, suburban development, enclosed community, and cluster housing development, and assess their level of walkability and their effects on physical activity and wellbeing. We examine significant associations through a questionnaire (n = 486) distributed in Tucson, Arizona using the Walkability Model. Among the tested neighborhood design types, traditional development showed significant associations and the highest value for walkability, as well as for each of the two types of walking (recreation and transportation) representing physical activity. Suburban development showed significant associations and the highest mean values for mental health and wellbeing. Cluster housing showed significant associations and the highest mean value for social interactions with neighbors and for perceived safety from crime. Enclosed community did not obtain the highest means for any wellbeing benefit. The Walkability Model proved useful in identifying the walkability categories associated with physical activity and perceived crime. For example, the experience category was strongly and inversely associated with perceived crime. This study provides empirical evidence of the importance of including vegetation, particularly trees, throughout neighborhoods in order to increase physical activity and wellbeing. Likewise, the results suggest that regular maintenance is an important strategy to improve mental health and overall wellbeing in cities. PMID:28098785

Neighborhood Design, Physical Activity, and Wellbeing: Applying the Walkability Model.

PubMed

Zuniga-Teran, Adriana A; Orr, Barron J; Gimblett, Randy H; Chalfoun, Nader V; Guertin, David P; Marsh, Stuart E

2017-01-13

Neighborhood design affects lifestyle physical activity, and ultimately human wellbeing. There are, however, a limited number of studies that examine neighborhood design types. In this research, we examine four types of neighborhood designs: traditional development, suburban development, enclosed community, and cluster housing development, and assess their level of walkability and their effects on physical activity and wellbeing. We examine significant associations through a questionnaire ( n = 486) distributed in Tucson, Arizona using the Walkability Model. Among the tested neighborhood design types, traditional development showed significant associations and the highest value for walkability, as well as for each of the two types of walking (recreation and transportation) representing physical activity. Suburban development showed significant associations and the highest mean values for mental health and wellbeing. Cluster housing showed significant associations and the highest mean value for social interactions with neighbors and for perceived safety from crime. Enclosed community did not obtain the highest means for any wellbeing benefit. The Walkability Model proved useful in identifying the walkability categories associated with physical activity and perceived crime. For example, the experience category was strongly and inversely associated with perceived crime. This study provides empirical evidence of the importance of including vegetation, particularly trees, throughout neighborhoods in order to increase physical activity and wellbeing. Likewise, the results suggest that regular maintenance is an important strategy to improve mental health and overall wellbeing in cities.

Exposures to Walkability and Particulate Air Pollution in a Nationwide Cohort of Women

PubMed Central

James, Peter; Hart, Jaime E.; Laden, Francine

2015-01-01

Background Features of neighborhoods associated with walkability (i.e., connectivity, accessibility, and density) may also be correlated with levels of ambient air pollution, which would attenuate the health benefits of walkability. Objectives We examined the relationship between neighborhood walkability and ambient air pollution in a cross-sectional analysis of a cohort study spanning the entire United States using residence-level exposure assessment for ambient air pollution and the built environment. Methods Using data from the Nurses’ Health Study, we used linear regression to estimate the association between a neighborhood walkability index, combining neighborhood intersection count, business count, and population density (defined from Census data, infoUSA business data, and StreetMap USA data), and air pollution, defined from a GIS-based spatiotemporal PM2.5 model. Results After adjustment for Census tract median income, median home value, and percent with no high school education, the highest tertile of walkability index, intersection count, business count, and population density was associated with a with 1.58 (95% CI 1.54, 1.62), 1.20 (95% CI 1.16, 1.24), 1.31 (95% CI 1.27, 1.35), and 1.84 (95% CI 1.80, 1.88) μg/m3 higher level of PM2.5 respectively, compared to the lowest tertile. Results varied somewhat by neighborhood socioeconomic status and greatly by region. Conclusions This nationwide analysis showed a positive relationship between neighborhood walkability and modeled air pollution levels, which were consistent after adjustment for neighborhood-level socioeconomic status. Regional differences in the air pollution-walkability relationship demonstrate that there are factors that vary across region that allow for walkable neighborhoods with low levels of air pollution. PMID:26397775

Development of a pedestrian audit tool to assess rural neighborhood walkability.

PubMed

Scanlin, Kathleen; Haardoerfer, Regine; Kegler, Michelle C; Glanz, Karen

2014-08-01

Recently, investigators have begun to refine audit instruments for use in rural areas. However, no studies have developed a walkability summary score or have correlated built environment characteristics with physical activity behavior. The Rural Pedestrian Environmental Audit Instrument was developed specifically for use in rural areas. Segments surrounding participant's homes were selected to represent neighborhood streets (N = 116). Interrater reliability was conducted on a subset of streets (N = 42). Rural-specific domain and walkability scores were developed and correlated with individual-level data on perceptions of the neighborhood and self-reported physical activity behavior. Interrater reliability for the instrument was substantial and all domains had high agreement. Walkability in the audited area was low with even the best segments demonstrating only moderate support for walking. There were no significant correlations between the neighborhood walkability score and self-reported neighborhood walkability, time spent walking, sedentary behavior, or BMI; however, a few correlations within the social/dynamic domain were significant. This study expands recent research refining audit instruments for rural areas. Findings suggest the usefulness of summarizing environmental data at the domain level and linking it to physical activity behavior to identify aspects of the neighborhood environment that are most strongly correlated with actual behavior.

Neighbourhood walkability, daily steps and utilitarian walking in Canadian adults.

PubMed

Hajna, Samantha; Ross, Nancy A; Joseph, Lawrence; Harper, Sam; Dasgupta, Kaberi

2015-11-24

To estimate the associations of neighbourhood walkability (based on Geographic Information System (GIS)-derived measures of street connectivity, land use mix, and population density and the Walk Score) with self-reported utilitarian walking and accelerometer-assessed daily steps in Canadian adults. A cross-sectional analysis of data collected as part of the Canadian Health Measures Survey (2007-2009). Home neighbourhoods (500 m polygonal street network buffers around the centroid of the participant's postal code) located in Atlantic Canada, Québec, Ontario, the Prairies and British Columbia. 5605 individuals participated in the survey. 3727 adults (≥18 years) completed a computer-assisted interview and attended a mobile clinic assessment. Analyses were based on those who had complete exposure, outcome and covariate data (n=2949). GIS-derived walkability (based on land use mix, street connectivity and population density); Walk Score. Self-reported utilitarian walking; accelerometer-assessed daily steps. No important relationship was observed between neighbourhood walkability and daily steps. Participants who reported more utilitarian walking, however, accumulated more steps (<1 h/week: 6613 steps/day, 95% CI 6251 to 6975; 1 to 5 h/week: 6768 steps/day, 95% CI 6420 to 7117; ≥6 h/week: 7391 steps/day, 95% CI 6972 to 7811). There was a positive graded association between walkability and odds of walking ≥1 h/week for utilitarian purposes (eg, Q4 vs Q1 of GIS-derived walkability: OR=1.66, 95% CI 1.31 to 2.11; Q3 vs Q1: OR=1.41, 95% CI 1.14 to 1.76; Q2 vs Q1: OR=1.13, 95% CI 0.91 to 1.39) independent of age, sex, body mass index, married/common law status, annual household income, having children in the household, immigrant status, mood disorder, perceived health, ever smoker and season. Contrary to expectations, living in more walkable Canadian neighbourhoods was not associated with more total walking. Utilitarian walking and daily steps were, however

Neighbourhood walkability, daily steps and utilitarian walking in Canadian adults

PubMed Central

Hajna, Samantha; Ross, Nancy A; Joseph, Lawrence; Harper, Sam; Dasgupta, Kaberi

2015-01-01

Objectives To estimate the associations of neighbourhood walkability (based on Geographic Information System (GIS)-derived measures of street connectivity, land use mix, and population density and the Walk Score) with self-reported utilitarian walking and accelerometer-assessed daily steps in Canadian adults. Design A cross-sectional analysis of data collected as part of the Canadian Health Measures Survey (2007–2009). Setting Home neighbourhoods (500 m polygonal street network buffers around the centroid of the participant's postal code) located in Atlantic Canada, Québec, Ontario, the Prairies and British Columbia. Participants 5605 individuals participated in the survey. 3727 adults (≥18 years) completed a computer-assisted interview and attended a mobile clinic assessment. Analyses were based on those who had complete exposure, outcome and covariate data (n=2949). Main exposure measures GIS-derived walkability (based on land use mix, street connectivity and population density); Walk Score. Main outcome measures Self-reported utilitarian walking; accelerometer-assessed daily steps. Results No important relationship was observed between neighbourhood walkability and daily steps. Participants who reported more utilitarian walking, however, accumulated more steps (<1 h/week: 6613 steps/day, 95% CI 6251 to 6975; 1 to 5 h/week: 6768 steps/day, 95% CI 6420 to 7117; ≥6 h/week: 7391 steps/day, 95% CI 6972 to 7811). There was a positive graded association between walkability and odds of walking ≥1 h/week for utilitarian purposes (eg, Q4 vs Q1 of GIS-derived walkability: OR=1.66, 95% CI 1.31 to 2.11; Q3 vs Q1: OR=1.41, 95% CI 1.14 to 1.76; Q2 vs Q1: OR=1.13, 95% CI 0.91 to 1.39) independent of age, sex, body mass index, married/common law status, annual household income, having children in the household, immigrant status, mood disorder, perceived health, ever smoker and season. Conclusions Contrary to expectations, living in more walkable Canadian

Neighborhood walkability, income, and hour-by-hour physical activity patterns.

PubMed

Arvidsson, Daniel; Eriksson, Ulf; Lönn, Sara Larsson; Sundquist, Kristina

2013-04-01

This study aimed to investigate both the mean daily physical activity and the hour-by-hour physical activity patterns across the day using accelerometry and how they are associated with neighborhood walkability and individual income. Moderate physical activity (MPA) was assessed by accelerometry in 2252 adults in the city of Stockholm, Sweden. Neighborhood walkability (residential density, street connectivity, and land use mix) was objectively assessed within 1000m network buffers around the participants' residence and individual income was self-reported. Living in a high walkability neighborhood was associated with more mean daily MPA compared with living in a low walkability neighborhood on weekdays and weekend days. Hour-by-hour analyses showed that this association appeared mainly in the afternoon/early evening during weekdays, whereas it appeared across the middle of the day during weekend days. Individual income was associated with mean daily MPA on weekend days. On weekdays, the hour-by-hour analyses showed that high income was associated with more MPA around noon and in late afternoon/early evening, whereas low income was associated with more MPA at the hours before noon and in the early afternoon. During the weekend, high income was more consistently associated with higher MPA. Hour-by-hour accelerometry physical activity patterns provides a more comprehensive picture of the associations between neighborhood walkability and individual income and physical activity and the variability of these associations across the day.

Relationship between objectively measured walkability and exercise walking among adults with diabetes.

PubMed

Hosler, Akiko S; Gallant, Mary P; Riley-Jacome, Mary; Rajulu, Deepa T

2014-01-01

Little is known about the relationship between objectively measured walkability and walking for exercise among adults with diabetes. Information regarding walking behavior of adults with diabetes residing in 3 Upstate New York counties was collected through an interview survey. Walkability measures were collected through an environmental audit of a sample of street segments. Overall walkability and 4 subgroup measures of walkability were aggregated at the ZIP level. Multivariate logistic regression was used for analysis. Study participants (n = 208) were 61.0% female, 56.7% non-Hispanic White, and 35.1% African-American, with a mean age of 62.0 years. 108 participants (51.9%) walked for exercise on community streets, and 62 (29.8%) met the expert-recommended level of walking for ≥150 minutes/week. After adjustment for age, gender, race/ethnicity, education, BMI, physical impairment, and social support for exercise, walking any minutes/week was associated with traffic safety (OR 1.34, 95% CI 1.15-1.65). Walking ≥150 minutes/week was associated with overall walkability of the community (2.65, 1.22, and 5.74), as well as sidewalks (1.73, 1.12-2.67), street amenity (2.04, 1.12-3.71), and traffic safety (1.92, 1.02-3.72). This study suggests that walkability of the community should be an integral part of the socioecologic approach to increase physical activity among adults with diabetes.

Physical activity as a mediator of the associations between neighborhood walkability and adiposity in Belgian adults.

PubMed

Van Dyck, Delfien; Cerin, Ester; Cardon, Greet; Deforche, Benedicte; Sallis, James F; Owen, Neville; de Bourdeaudhuij, Ilse

2010-09-01

This study examined whether physical activity (PA) and sedentary behavior mediated the relationship of neighborhood walkability with two measures of adiposity: body mass index (BMI) and waist-to-height ratio (WHTR). Twenty-four neighborhoods in Ghent, Belgium were selected, stratified by objectively assessed walkability and by socio-economic status. Participants (1200 adults aged 20-65 years) completed the International Physical Activity Questionnaire and wore an accelerometer for 7 days. Weight and height were self-reported and waist circumference was objectively measured. Accelerometer-assessed moderate-to-vigorous PA and self-reported cycling for transport mediated the associations of walkability with BMI and WHTR. Moreover, walking for transport and recreational walking significantly mediated the relationship between walkability and BMI. Sedentary behavior did not mediate associations of walkability with BMI or WHTR. These findings suggest that PA, but not sedentary behavior, is a mechanism by which walkability may affect adults' adiposity. Planning for neighborhoods to be high in walkability could have favorable effects on physical activity and weight status. Copyright 2010 Elsevier Ltd. All rights reserved.

Associations of leisure-time sitting in cars with neighborhood walkability.

PubMed

Koohsari, Mohammad Javad; Sugiyama, Takemi; Kaczynski, Andrew T; Owen, Neville

2014-08-01

Too much sitting, including time spent sitting in cars, is associated with poor health outcomes. Identifying the built-environment attributes that may reduce vehicular sitting time can inform future initiatives linking the public health, urban design, and transportation sectors. Data collected in 2003-2004 from adult residents (n = 2521) of Adelaide, Australia were used. Logistic regression analyses examined associations of prolonged time spent sitting in cars during leisure time (30 min/day or more) with neighborhood walkability and its components (dwelling density; intersection density; land use mix; net retail area ratio). Lower overall walkability was significantly associated with a higher odds (OR = 1.43, 95% CI: 1.21-1.70) of spending prolonged time in cars. For analyses with walkability components, lower net retail area ratio, lower residential density, and lower intersection density were significantly associated with prolonged sitting in cars. This study found that residents of high walkable neighborhoods tended to spend less time sitting in cars. In particular, higher net retail area ratio, an indicator of tightly spaced commercial areas, was strongly associated with less time in cars. Policy and planning initiatives to reduce car use require further evidence, particularly on the influence of neighborhood retail areas.

Promoting walking in older adults: Perceived neighborhood walkability influences the effectiveness of motivational messages.

PubMed

Notthoff, Nanna; Carstensen, Laura L

2017-06-01

Positively framed messages seem to promote walking in older adults better than negatively framed messages. This study targeted elderly people in communities unfavorable to walking. Walking was measured with pedometers during baseline (1 week) and intervention (4 weeks). Participants ( n = 74) were informed about either the benefits of walking or the negative consequences of not walking. Perceived neighborhood walkability was assessed with a modified version of the Neighborhood Walkability Scale. When perceived walkability was high, positively framed messages were more effective than negatively framed messages in promoting walking; when perceived walkability was low, negatively framed messages were comparably effective to positively framed messages.

Promoting walking in older adults: Perceived neighborhood walkability influences the effectiveness of motivational messages

PubMed Central

Notthoff, Nanna; Carstensen, Laura L.

2015-01-01

Positively-framed messages seem to promote walking in older adults better than negatively-framed messages. This study targeted elderly people in communities unfavorable to walking. Walking was measured with pedometers during baseline (one week) and intervention (four weeks). Participants (n = 74) were either informed about the benefits of walking or the negative consequences of not walking. Perceived neighborhood walkability was assessed with a modified version of the Neighborhood Walkability Scale. When perceived walkability was high positively-framed messages were more effective than negatively-framed messages in promoting walking; when perceived walkability was low negatively-framed messages were comparably effective to positively-framed messages. PMID:26604128

Does perceived neighborhood walkability and safety mediate the association between education and meeting physical activity guidelines?

PubMed

Pratt, Michael; Yin, Shaoman; Soler, Robin; Njai, Rashid; Siegel, Paul Z; Liao, Youlian

2015-04-09

The role of neighborhood walkability and safety in mediating the association between education and physical activity has not been quantified. We used data from the 2010 and 2012 Communities Putting Prevention to Work Behavioral Risk Factor Surveillance System and structural equation modeling to estimate how much of the effect of education level on physical activity was mediated by perceived neighborhood walkability and safety. Neighborhood walkability accounts for 11.3% and neighborhood safety accounts for 6.8% of the effect. A modest proportion of the important association between education and physical activity is mediated by perceived neighborhood walkability and safety, suggesting that interventions focused on enhancing walkability and safety could reduce the disparity in physical activity associated with education level.

Impact of walkability with regard to physical activity in the prevention of diabetes.

PubMed

Mena, Carlos; Sepúlveda, César; Ormazábal, Yony; Fuentes, Eduardo; Palomo, Iván

2017-11-03

Walkability, a component of urban design intended to facilitate pedestrian traffic, depends on parameters associated with the connectivity of routes, population density and availability of destinations in the neighbourhood. The aim is to achieve levels of physical activity related to the prevention of risk factors associated with diseases, such as diabetes and the improvement of glycaemia control. It is important to consider that the effects of walkability depend on its relation with other variables present in the neighbourhood, e.g., environmental and socioeconomic factors. Considering this, improving walkability levels could be an effective strategy to reduce disease, the prevalence of diabetes in particular, in the population and thus reduce public spending. To investigate these relationships, PUBMED and ScienceDirect databases were searched using the following key words: Diabetes, Walkability and Physical activity.

Does Perceived Neighborhood Walkability and Safety Mediate the Association Between Education and Meeting Physical Activity Guidelines?

PubMed Central

Yin, Shaoman; Soler, Robin; Njai, Rashid; Siegel, Paul Z.; Liao, Youlian

2015-01-01

The role of neighborhood walkability and safety in mediating the association between education and physical activity has not been quantified. We used data from the 2010 and 2012 Communities Putting Prevention to Work Behavioral Risk Factor Surveillance System and structural equation modeling to estimate how much of the effect of education level on physical activity was mediated by perceived neighborhood walkability and safety. Neighborhood walkability accounts for 11.3% and neighborhood safety accounts for 6.8% of the effect. A modest proportion of the important association between education and physical activity is mediated by perceived neighborhood walkability and safety, suggesting that interventions focused on enhancing walkability and safety could reduce the disparity in physical activity associated with education level. PMID:25855989

Single-Family Housing Value Resilience of Walkable Versus Unwalkable Neighborhoods During a Market Downturn: Causal Evidence and Policy Implications.

PubMed

Xu, Minjie; Yu, Chia-Yuan; Lee, Chanam; Frank, Lawrence D

2018-01-01

This study investigated the resilience of single-family housing values in walkable versus unwalkable neighborhoods during the economic downturn from 2008 to 2012 in Dallas, Texas. Using propensity score matching and difference in differences methods, this study established a natural experimental design to compare before-and-after value changes of single-family (SF) homes in walkable neighborhoods with unwalkable neighborhoods during the Great Recession. Two thousand seven hundred ninety-nine SF homes within 18 Tax Increment Financing (TIF) districts were categorized into walkable (Walk Score ≥50) and unwalkable (<50) groups. Six hundred twenty-four dwellings in walkable neighborhoods were matched with the most identical ones in the unwalkable neighborhoods by controlling for the selected structural and residential location variables. Relative average treatment effects were examined for SF values in walkable and unwalkable neighborhoods. On average, the SF homes in walkable neighborhoods held $4566 (2.08%) more value than their how walkable counterparts. This study aims to help planners and decision-makers by documenting the unmet demand for walkable communities and their sustained economic benefit. Increased awareness of the sustained value of walkable communities can be used by lenders who finance and by policy makers who regulate placemaking. Results from this study can be integrated with research that demonstrates health-care cost savings of walkable environments to create an even more comprehensive set of evidence-based interventions to increase their supply.

The association between objective walkability, neighborhood socio-economic status, and physical activity in Belgian children.

PubMed

D'Haese, Sara; Van Dyck, Delfien; De Bourdeaudhuij, Ilse; Deforche, Benedicte; Cardon, Greet

2014-08-23

Objective walkability is an important correlate of adults' physical activity. Studies investigating the relation between walkability and children's physical activity are scarce. However, in order to develop effective environmental interventions, a profound investigation of this relation is needed in all age groups. The aim of this study was to investigate the association between objective walkability and different domains of children's physical activity, and to investigate the moderating effect of neighborhood socio-economic status in this relation. Data were collected between December 2011 and May 2013 as part of the Belgian Environmental Physical Activity Study in children. Children (9-12 years old; n = 606) were recruited from 18 elementary schools in Ghent (Belgium). Children together with one of their parents completed the Flemish Physical Activity Questionnaire and wore an accelerometer for 7 consecutive days. Children's neighborhood walkability was calculated using geographical information systems. Multilevel cross-classified modeling was used to determine the relationship between children's PA and objectively measured walkability and the moderating effect of neighborhood SES in this relation. In low SES neighborhoods walkability was positively related to walking for transportation during leisure time (β = 0.381 ± 0.124; 95% CI = 0.138, 0.624) and was negatively related to sports during leisure time (β = -0.245 ± 0.121; 95% CI = -0.482, -0.008). In high socio-economic status neighborhoods, walkability was unrelated to children's physical activity. No relations of neighborhood walkability and neighborhood socio-economic status with cycling during leisure time, active commuting to school and objectively measured moderate- to vigorous-intensity physical activity were found. No univocal relation between neighborhood walkability and physical activity was found in 9-12 year old children. Results from international adult studies

Development of a novel walkability index for London, United Kingdom: cross-sectional application to the Whitehall II Study.

PubMed

Stockton, Jemima C; Duke-Williams, Oliver; Stamatakis, Emmanuel; Mindell, Jennifer S; Brunner, Eric J; Shelton, Nicola J

2016-05-18

Physical activity is essential for health; walking is the easiest way to incorporate activity into everyday life. Previous studies report positive associations between neighbourhood walkability and walking but most focused on cities in North America and Australasia. Urban form with respect to street connectivity, residential density and land use mix-common components of walkability indices-differs in European cities. The objective of this study was to develop a walkability index for London and test the index using walking data from the Whitehall II Study. A neighbourhood walkability index for London was constructed, comprising factors associated with walking behaviours: residential dwelling density, street connectivity and land use mix. Three models were produced that differed in the land uses included. Neighbourhoods were operationalised at three levels of administrative geography: (i) 21,140 output areas, (ii) 633 wards and (iii) 33 local authorities. A neighbourhood walkability score was assigned to each London-dwelling Whitehall II Study participant (2003-04, N = 3020, mean ± SD age = 61.0 years ± 6.0) based on residential postcode. The effect of changing the model specification and the units of enumeration on spatial variation in walkability was examined. There was a radial decay in walkability from the centre to the periphery of London. There was high inter-model correlation in walkability scores for any given neighbourhood operationalisation (0.92-0.98), and moderate-high correlation between neighbourhood operationalisations for any given model (0.39-0.70). After adjustment for individual level factors and area deprivation, individuals in the most walkable neighbourhoods operationalised as wards were more likely to walk >6 h/week (OR = 1.4; 95 % CI: 1.1-1.9) than those in the least walkable. Walkability was associated with walking time in adults. This walkability index could help urban planners identify and design neighbourhoods in

Association between neighborhood walkability and GPS-measured walking, bicycling and vehicle time in adolescents.

PubMed

Carlson, Jordan A; Saelens, Brian E; Kerr, Jacqueline; Schipperijn, Jasper; Conway, Terry L; Frank, Lawrence D; Chapman, Jim E; Glanz, Karen; Cain, Kelli L; Sallis, James F

2015-03-01

To investigate relations of walking, bicycling and vehicle time to neighborhood walkability and total physical activity in youth. Participants (N=690) were from 380 census block groups of high/low walkability and income in two US regions. Home neighborhood residential density, intersection density, retail density, entertainment density and walkability were derived using GIS. Minutes/day of walking, bicycling and vehicle time were derived from processing algorithms applied to GPS. Accelerometers estimated total daily moderate-to-vigorous physical activity (MVPA). Models were adjusted for nesting of days (N=2987) within participants within block groups. Walking occurred on 33%, active travel on 43%, and vehicle time on 91% of the days observed. Intersection density and neighborhood walkability were positively related to walking and bicycling and negatively related to vehicle time. Residential density was positively related to walking. Increasing walking in youth could be effective in increasing total physical activity. Built environment findings suggest potential for increasing walking in youth through improving neighborhood walkability. Copyright © 2014 Elsevier Ltd. All rights reserved.

Intersection of neighborhood dynamics and socioeconomic status in small-area walkability: the Heart Healthy Hoods project.

PubMed

Gullón, Pedro; Bilal, Usama; Cebrecos, Alba; Badland, Hannah M; Galán, Iñaki; Franco, Manuel

2017-06-06

Previous studies found a complex relationship between area-level socioeconomic status (SES) and walkability. These studies did not include neighborhood dynamics. Our aim was to study the association between area-level SES and walkability in the city of Madrid (Spain) evaluating the potential effect modification of neighborhood dynamics. All census sections of the city of Madrid (n = 2415) were included. Area-level SES was measured using a composite index of 7 indicators in 4 domains (education, wealth, occupation and living conditions). Two neighborhood dynamics factors were computed: gentrification, proxied by change in education levels in the previous 10 years, and neighborhood age, proxied by median year of construction of housing units in the area. Walkability was measured using a composite index of 4 indicators (Residential Density, Population Density, Retail Destinations and Street Connectivity). We modeled the association using linear mixed models with random intercepts. Area-level SES and walkability were inversely and significantly associated. Areas with lower SES showed the highest walkability. This pattern did not hold for areas with an increase in education level, where the association was flat (no decrease in walkability with higher SES). Moreover, the association was attenuated in newly built areas: the association was stronger in areas built before 1975, weaker in areas built between 1975 and 1990 and flat in areas built from 1990 on. Areas with higher neighborhood socioeconomic status had lower walkability in Madrid. This disadvantage in walkability was not present in recently built or gentrified areas.

Walkability is only part of the story: walking for transportation in Stuttgart, Germany.

PubMed

Reyer, Maren; Fina, Stefan; Siedentop, Stefan; Schlicht, Wolfgang

2014-05-30

In modern Western societies people often lead inactive and sedentary lifestyles, even though there is no doubt that physical activity and health are related. From an urban planning point of view it would be highly desirable to develop built environments in a way that supports people in leading more active and healthy lifestyles. Within this context there are several methods, predominantly used in the US, to measure the suitability of built environments for walking and cycling. Empirical studies show that people living in highly walkable areas are more physically active (for example, walk more or cycle more). The question is, however, whether these results are also valid for European cities given their different urban planning characteristics and infrastructure standards. To answer this question we used the Walkability-Index and the Walk Score to empirically investigate the associations between walkability and active transportation in the city of Stuttgart, Germany. In a sample of household survey data (n = 1.871) we found a noticeable relationship between walkability and active transportation-the more walkable an area was, the more active residents were. Although the statistical effect is small, the health impact might be of relevance. Being physically active is multi-determined and not only affected by the walkability of an area. We highlight these points with an excursion into research that the health and exercise sciences contribute to the topic. We propose to strengthen interdisciplinary research between the disciplines and to specifically collect data that captures the influence of the environment on physical activity in the future.

Walkability is Only Part of the Story: Walking for Transportation in Stuttgart, Germany

PubMed Central

Reyer, Maren; Fina, Stefan; Siedentop, Stefan; Schlicht, Wolfgang

2014-01-01

In modern Western societies people often lead inactive and sedentary lifestyles, even though there is no doubt that physical activity and health are related. From an urban planning point of view it would be highly desirable to develop built environments in a way that supports people in leading more active and healthy lifestyles. Within this context there are several methods, predominantly used in the US, to measure the suitability of built environments for walking and cycling. Empirical studies show that people living in highly walkable areas are more physically active (for example, walk more or cycle more). The question is, however, whether these results are also valid for European cities given their different urban planning characteristics and infrastructure standards. To answer this question we used the Walkability-Index and the Walk Score to empirically investigate the associations between walkability and active transportation in the city of Stuttgart, Germany. In a sample of household survey data (n = 1.871) we found a noticeable relationship between walkability and active transportation—the more walkable an area was, the more active residents were. Although the statistical effect is small, the health impact might be of relevance. Being physically active is multi-determined and not only affected by the walkability of an area. We highlight these points with an excursion into research that the health and exercise sciences contribute to the topic. We propose to strengthen interdisciplinary research between the disciplines and to specifically collect data that captures the influence of the environment on physical activity in the future. PMID:24886755

Relationships between Neighborhood Walkability and Objectively Measured Physical Activity Levels in Hemodialysis Patients.

PubMed

Han, Maggie; Ye, Xiaoling; Preciado, Priscila; Williams, Schantel; Campos, Israel; Bonner, Marcee; Young, Candace; Marsh, Daniel; Larkin, John W; Usvyat, Len A; Maddux, Franklin W; Pecoits-Filho, Roberto; Kotanko, Peter

2018-01-01

Neighborhood walkability is associated with indicators of health in the general population. We explored the association between neighborhood walkability and daily steps in hemodialysis (HD) patients. We measured daily steps over 5 weeks using Fitbit Flex (Fitbit, San Francisco, CA, USA) and retrieved Walk Score® (WS) data by patient's home ZIP code (www.walkscore.com; 0 = poorest walkability; 100 = greatest walkability). HD patients took a mean of 6,393 ± 3,550 steps/day (n = 46). Median WS of the neighborhood where they resided was 28. Patients in an above-median WS (n = 27) neighborhood took significantly more daily steps compared to those (n = 19) in a below-median WS neighborhood (7,514 ± 3,900 vs. 4,800 ± 2,228 steps/day; p < 0.001, t test). Daily steps and WS were directly correlated (R = 0.425; p = 0.0032, parametric test; R = 0.359, p = 0.0143, non-parametric test). This is the first study conducted among HD patients to indicate a direct relationship between neighborhood walkability and the actual steps taken. These results should be considered when designing initiatives to increase and improvise exercise routines in HD populations. © 2018 S. Karger AG, Basel.

Neighborhood walkability moderates the association between low back pain and physical activity: A co-twin control study.

PubMed

Zadro, J R; Shirley, D; Pinheiro, M B; Bauman, A; Duncan, G E; Ferreira, P H

2017-06-01

The aim of this study was to investigate whether neighborhood walkability moderates the association between low back pain (LBP) and physical activity (PA), using a co-twin design to control for genetics and shared environmental factors. A cross-sectional analysis was performed on 10,228 twins from the Washington State Twin Registry with available data on LBP from recruitment surveys between 2009 and 2013. LBP within the past 3months was our exposure variable. Our outcome variables were sufficient moderate or vigorous-intensity PA (MVPA, defined as at least 75min of vigorous-intensity PA, or 150min of moderate-intensity PA per week), and walking (≥150min per week). Neighborhood walkability, estimated using the commercially available Walk Score®, was our moderator variable. After controlling for the influence of genetics and shared environment, individuals reporting LBP were significantly less likely to engage in sufficient MVPA if they lived in a neighborhood with high walkability (OR=0.59, 95%CI: 0.36-0.96). There was no association between LBP and sufficient MVPA for individuals living in a neighborhood with low walkability (OR=1.27, 95%CI: 0.93-1.72), demonstrating that walkability is a significant moderator of the association between LBP and PA (interaction p=0.013). These findings were similar for the association between LBP and walking (high walkability OR=0.42, 95%CI: 0.22-0.78; low walkability OR=0.71, 95%CI: 0.46-1.12), although the interaction was not significant (p=0.700). Neighborhood walkability moderates the association between LBP and PA. Our results highlight the importance of targeting interventions promoting PA towards individuals with LBP living in a neighborhood with good walkable access to amenities. Copyright © 2017 Elsevier Inc. All rights reserved.

Moving to a Highly Walkable Neighborhood and Incidence of Hypertension: A Propensity-Score Matched Cohort Study.

PubMed

Chiu, Maria; Rezai, Mohammad-Reza; Maclagan, Laura C; Austin, Peter C; Shah, Baiju R; Redelmeier, Donald A; Tu, Jack V

2016-06-01

The impact of moving to a neighborhood more conducive to utilitarian walking on the risk of incident hypertension is uncertain. Our study aimed to examine the effect of moving to a highly walkable neighborhood on the risk of incident hypertension. A population-based propensity-score matched cohort study design was used based on the Ontario population from the Canadian Community Health Survey (2001-2010). Participants were adults ≥ 20 years of age who moved from a low-walkability neighborhood (defined as any neighborhood with a Walk Score < 90) to either a high- (Walk Score ≥ 90) or another low-walkability neighborhood. The incidence of hypertension was assessed by linking the cohort to administrative health databases using a validated algorithm. Propensity-score matched Cox proportional hazard models were used. Annual health examination was used as a control event. Among the 1,057 propensity-score matched pairs there was a significantly lower risk of incident hypertension in the low to high vs. the low to low-walkability groups [hazard ratio = 0.46; 95% CI, 0.26, 0.81, p < 0.01]. The crude hypertension incidence rates were 18.0 per 1,000 person-years (95% CI: 11.6, 24.8) among the low- to low-walkability movers compared with 8.6 per 1,000 person-years (95% CI: 5.3, 12.7) among the low- to high-walkability movers (p < 0.001). There were no significant differences in the hazard of annual health examination between the two mover groups. Moving to a highly walkable neighborhood was associated with a significantly lower risk of incident hypertension. Future research should assess whether specific attributes of walkable neighborhoods (e.g., amenities, density, land-use mix) may be driving this relationship. Chiu M, Rezai MR, Maclagan LC, Austin PC, Shah BR, Redelmeier DA, Tu JV. 2016. Moving to a highly walkable neighborhood and incidence of hypertension: a propensity-score matched cohort study. Environ Health Perspect 124:754-760; http://dx.doi.org/10.1289/ehp

Food Reinforcement and Parental Obesity Predict Future Weight Gain in Non-Obese Adolescents

PubMed Central

Epstein, Leonard H.; Yokum, Sonja; Feda, Denise M.; Stice, Eric

2014-01-01

Background Food reinforcement, the extent to which people are willing to work to earn a preferred snack food, and parental obesity are risk factors for weight gain, but there is no research comparing the predictive effects of these factors for adolescent weight gain. Methods 130 non-obese adolescents (M age = 15.2 ± 1.0; M BMI = 20.7 ± 2.0; M zBMI = 0.16 ± 0.64) at differential risk for weight gain based on parental obesity completed baseline food and money reinforcement tasks, and provided zBMI data over 2-yr follow-up. Results The number of obese (BMI ≥ 30) parents (p = 0.007) and high food reinforcement (p = 0.046) were both significant independent predictors of greater zBMI increases, controlling for age, sex, parent education and minority status. Having no obese parents or being low or average in food reinforcement was associated with reductions in zBMI, but those high in food reinforcement showed larger zBMI increases (0.102) than having one obese parent (0.025) but less than having two obese parents (0.177). Discussion Food reinforcement and parental obesity independently predict future weight gain among adolescents. It might be fruitful for obesity prevention programs to target both high risk groups. PMID:25045864

Audit of workplace walkability in an Irish healthcare setting.

PubMed

Cronin, Judy

2016-12-01

Recent studies suggest that time spent sitting is associated with greater risks of all causes of mortality and cardiovascular disease even for those who live a healthy lifestyle. As part of a healthier worksite initiative, we conducted a worksite walkability audit and staff survey of a large hospital-based administrative campus with a high proportion of health staff working in largely office-based roles. The US Centre for Disease Control (CDC) Healthier Worksite Initiative Walkability Audit Tool was used to audit 20 walking segments. The audit further examined the walkability of segments most likely to be used by outpatients and the families of residents visiting and attending the campus. The second phase of this research involved an employee electronic survey to understand staff requirements from a workplace physical activity initiative. Overall, the campus scored a medium risk to walkability on the CDC audit tool. This means that with some key minor alterations the walking route could be made safe and attractive for walking. There was a 20% (n = 151) response rate to the staff survey with 66% of respondents sitting at their desk for most of the day with the majority spending 5-7 h a day sitting at work. Evidence suggests that reducing sedentary time may be important to public health. The worksite is an ideal location for targeting a large number of individuals. Key public health messages that promote daily recommended physical activity targets should also carry additional messages about reducing occupational sitting time. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Talking the talk, walking the walk: examining the effect of neighbourhood walkability and social connectedness on physical activity.

PubMed

Kaczynski, Andrew T; Glover, Troy D

2012-08-01

Few studies have considered the joint effects of social and physical environments on physical activity (PA). The primary purpose of this study was to examine the compounding effects of neighbourhood walkability and social connectedness on PA. Data were collected from adults (n = 380) in Waterloo, Ontario, Canada. Perceptions of neighbourhood social connectedness and walkability were measured via survey. Minutes of neighbourhood PA for recreation and transportation were captured with a detailed 7-day log booklet. Four groups were created (e.g. high walkability/low social connectedness) and two factorial ANOVAs examined group differences in minutes of recreational and transport-related PA. There were significant differences across the four walkability/social connectedness groups for both recreational (F = 11.36, P < 0.01) and transport-related PA (F = 8.12, P < 0.01). Participants perceiving both high walkability and social connectedness displayed the greatest levels of both recreational (130.6 min) and transport-related PA (24.5 min). The high walkability/low social connectedness group had greater transport-related PA than the two low walkability groups, while the high social connectedness/low walkability group had greater recreational PA than the two low social connectedness groups. These findings underscore the relationship between physical and social dimensions of urban form and their association with health behaviours. PA promotion efforts should take into account both physical (e.g. land-use planning) and social (e.g. walking group) environments.

Neighborhood walkability and active travel (walking and cycling) in New York City.

PubMed

Freeman, Lance; Neckerman, Kathryn; Schwartz-Soicher, Ofira; Quinn, James; Richards, Catherine; Bader, Michael D M; Lovasi, Gina; Jack, Darby; Weiss, Christopher; Konty, Kevin; Arno, Peter; Viola, Deborah; Kerker, Bonnie; Rundle, Andrew G

2013-08-01

Urban planners have suggested that built environment characteristics can support active travel (walking and cycling) and reduce sedentary behavior. This study assessed whether engagement in active travel is associated with neighborhood walkability measured for zip codes in New York City. Data were analyzed on engagement in active travel and the frequency of walking or biking ten blocks or more in the past month, from 8,064 respondents to the New York City 2003 Community Health Survey (CHS). A neighborhood walkability scale that measures: residential, intersection, and subway stop density; land use mix; and the ratio of retail building floor area to retail land area was calculated for each zip code. Data were analyzed using zero-inflated negative binomial regression incorporating survey sample weights and adjusting for respondents' sociodemographic characteristics. Overall, 44 % of respondents reported no episodes of active travel and among those who reported any episode, the mean number was 43.2 episodes per month. Comparing the 75th to the 25th percentile of zip code walkability, the odds ratio for reporting zero episodes of active travel was 0.71 (95 % CI 0.61, 0.83) and the exponentiated beta coefficient for the count of episodes of active travel was 1.13 (95 % CI 1.06, 1.21). Associations between lower walkability and reporting zero episodes of active travel were significantly stronger for non-Hispanic Whites as compared to non-Hispanic Blacks and to Hispanics and for those living in higher income zip codes. The results suggest that neighborhood walkability is associated with higher engagement in active travel.

Associations between Perceived Neighborhood Walkability and Walking Time, Wellbeing, and Loneliness in Community-Dwelling Older Chinese People in Hong Kong

PubMed Central

Yu, Ruby; Cheung, Osbert; Lau, Kevin

2017-01-01

This study examined the cross-sectional associations between perceived neighborhood walkability and walking time, physical activity, wellbeing, and loneliness, and examined which components of walkability were most strongly associated with better wellbeing and less loneliness in older adults. Participants were community-dwelling Chinese adults aged 60+ (n = 181). Walkability was measured using nine items selected from the Chinese version of the abbreviated Neighborhood Environment Walkability Scales (NEWS) and NEWS for Chinese Seniors. Outcomes were walking time, physical activity, wellbeing (life satisfaction, happiness, sense of purpose and meaning in life), and loneliness. The mean age of the participants was 71.7 ± 7.8 years. Walkability was positively associated with walking time (p = 0.001, p for trend <0.001) but not with physical activity. After adjusting for socio-demographic characteristics, health conditions, lifestyle, and negative life events, those who perceived their neighborhoods as walkable had higher scores for life satisfaction (p = 0.002) and happiness (p = 0.002), and lower scores for loneliness (p = 0.019), compared with those who perceived their neighborhoods as less walkable. However, perceived neighborhood walkability was not associated with sense of purpose and meaning in life. Among components of walkability, land use mix-access, infrastructure and safety for walking, and traffic safety showed the strongest associations with the measures of wellbeing. The results of this study support the importance of neighborhood walkability for health behavior and wellbeing of older adults. The wellbeing of older adults may be enhanced through the improvement of land use mix-access, infrastructure for walking, and traffic safety. PMID:28991205

Associations between Perceived Neighborhood Walkability and Walking Time, Wellbeing, and Loneliness in Community-Dwelling Older Chinese People in Hong Kong.

PubMed

Yu, Ruby; Cheung, Osbert; Lau, Kevin; Woo, Jean

2017-10-09

This study examined the cross-sectional associations between perceived neighborhood walkability and walking time, physical activity, wellbeing, and loneliness, and examined which components of walkability were most strongly associated with better wellbeing and less loneliness in older adults. Participants were community-dwelling Chinese adults aged 60+ ( n = 181). Walkability was measured using nine items selected from the Chinese version of the abbreviated Neighborhood Environment Walkability Scales (NEWS) and NEWS for Chinese Seniors. Outcomes were walking time, physical activity, wellbeing (life satisfaction, happiness, sense of purpose and meaning in life), and loneliness. The mean age of the participants was 71.7 ± 7.8 years. Walkability was positively associated with walking time ( p = 0.001, p for trend <0.001) but not with physical activity. After adjusting for socio-demographic characteristics, health conditions, lifestyle, and negative life events, those who perceived their neighborhoods as walkable had higher scores for life satisfaction ( p = 0.002) and happiness ( p = 0.002), and lower scores for loneliness ( p = 0.019), compared with those who perceived their neighborhoods as less walkable. However, perceived neighborhood walkability was not associated with sense of purpose and meaning in life. Among components of walkability, land use mix-access, infrastructure and safety for walking, and traffic safety showed the strongest associations with the measures of wellbeing. The results of this study support the importance of neighborhood walkability for health behavior and wellbeing of older adults. The wellbeing of older adults may be enhanced through the improvement of land use mix-access, infrastructure for walking, and traffic safety.

Walkable new urban LEED_Neighborhood-Development (LEED-ND) community design and children's physical activity: selection, environmental, or catalyst effects?

PubMed

Stevens, Robert B; Brown, Barbara B

2011-12-20

Interest is growing in physical activity-friendly community designs, but few tests exist of communities explicitly designed to be walkable. We test whether students living in a new urbanist community that is also a pilot LEED_ND (Leadership in Energy and Environmental Design-Neighborhood Development) community have greater accelerometer-measured moderate-to-vigorous physical activity (MVPA) across particular time periods compared to students from other communities. We test various time/place periods to see if the data best conform to one of three explanations for MVPA. Environmental effects suggest that MVPA occurs when individuals are exposed to activity-friendly settings; selection effects suggest that walkable community residents prefer MVPA, which leads to both their choice of a walkable community and their high levels of MVPA; catalyst effects occur when walking to school creates more MVPA, beyond the school commute, on schooldays but not weekends. Fifth graders (n = 187) were sampled from two schools representing three communities: (1) a walkable community, Daybreak, designed with new urbanist and LEED-ND pilot design standards; (2) a mixed community (where students lived in a less walkable community but attended the walkable school so that part of the route to school was walkable), and (3) a less walkable community. Selection threats were addressed through controlling for parental preferences for their child to walk to school as well as comparing in-school MVPA for the walkable and mixed groups. Minutes of MVPA were tested with 3 × 2 (Community by Gender) analyses of covariance (ANCOVAs). Community walkability related to more MVPA during the half hour before and after school and, among boys only, more MVPA after school. Boys were more active than girls, except during the half hour after school. Students from the mixed and walkable communities--who attended the same school--had similar in-school MVPA levels, and community groups did not differ in weekend

Predicting adult obesity from childhood obesity: a systematic review and meta-analysis.

PubMed

Simmonds, M; Llewellyn, A; Owen, C G; Woolacott, N

2016-02-01

A systematic review and meta-analysis was performed to investigate the ability of simple measures of childhood obesity such as body mass index (BMI) to predict future obesity in adolescence and adulthood. Large cohort studies, which measured obesity both in childhood and in later adolescence or adulthood, using any recognized measure of obesity were sought. Study quality was assessed. Studies were pooled using diagnostic meta-analysis methods. Fifteen prospective cohort studies were included in the meta-analysis. BMI was the only measure of obesity reported in any study, with 200,777 participants followed up. Obese children and adolescents were around five times more likely to be obese in adulthood than those who were not obese. Around 55% of obese children go on to be obese in adolescence, around 80% of obese adolescents will still be obese in adulthood and around 70% will be obese over age 30. Therefore, action to reduce and prevent obesity in these adolescents is needed. However, 70% of obese adults were not obese in childhood or adolescence, so targeting obesity reduction solely at obese or overweight children needs to be considered carefully as this may not substantially reduce the overall burden of adult obesity. © 2015 World Obesity.

Patterns of Walkability, Transit, and Recreation Environment for Physical Activity.

PubMed

Adams, Marc A; Todd, Michael; Kurka, Jonathan; Conway, Terry L; Cain, Kelli L; Frank, Lawrence D; Sallis, James F

2015-12-01

Diverse combinations of built environment (BE) features for physical activity (PA) are understudied. This study explored whether patterns of GIS-derived BE features explained objective and self-reported PA, sedentary behavior, and BMI. Neighborhood Quality of Life Study participants (N=2,199, aged 20-65 years, 48.2% female, 26% ethnic minority) were sampled in 2001-2005 from Seattle / King County WA and Baltimore MD / Washington DC regions. Their addresses were geocoded to compute net residential density, land use mix, retail floor area ratio, intersection density, public transit, and public park and private recreation facility densities using a 1-km network buffer. Latent profile analyses (LPAs) were estimated from these variables. Multilevel regression models compared profiles on accelerometer-measured moderate to vigorous PA (MVPA) and self-reported PA, adjusting for covariates and clustering. Analyses were conducted in 2013-2014. Seattle region LPAs yielded four profiles, including low walkability/transit/recreation (L-L-L); mean walkability/transit/recreation (M-M-M); moderately high walkability/transit/recreation (MH-MH-MH); and high walkability/transit/recreation (H-HH). All measures were higher in the HHH than the LLL profile (difference of 17.1 minutes/day for MVPA, 146.5 minutes/week for walking for transportation, 58.2 minutes/week for leisure-time PA, and 2.2 BMI points; all p<0.05). Baltimore region LPAs yielded four profiles, including L-L-L; M-M-M; high land use mix, transit, and recreation (HLU-HT-HRA); and high intersection density, high retail floor area ratio (HID-HRFAR). HLU-HT-HRA and L-L-L differed by 12.3 MVPA minutes/day; HID-HRFAR and L-L-L differed by 157.4 minutes/week for walking for transportation (all p<0.05). Patterns of environmental features explain greater differences in adults' PA than the four-component walkability index. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The impact of neighbourhood walkability on the effectiveness of a structured education programme to increase objectively measured walking.

PubMed

Carter, P; Bodicoat, D H; Jones, A; Khunti, K; Davies, M J; Edwardson, C L; Henson, J; Yates, T; Coombes, E

2018-03-01

Incorporating physical activity into daily activities is key for the effectiveness of lifestyle education interventions aimed at improving health outcomes; however, consideration of the environmental context in which individuals live is not always made. Walkability is a characteristic of the physical environment, and may be a potential facilitator to changing physical activity levels. Using data collected during the Walking Away from Diabetes randomized controlled trial, we examined the association between the walkability of the home neighbourhood and physical activity of participants. We also determined whether home neighbourhood walkability of participants was associated with the intervention effect of the education programme. Data from 706 participants were available for analysis. Neighbourhood walkability was not significantly associated with any of the physical activity measures at baseline, or at 12, 24 or 36 months following the intervention (P > 0.05 for all). There was no association between walkability and change in purposeful steps/day from baseline to 36 months in the usual care or intervention arm; 25.77 (-99.04, 150.58) and 42.97 (-327.63, 413.45), respectively. Neighbourhood walkability appeared to have no association with objectively measured physical activity in this population. Furthermore, the walkability of participant's neighbourhood did not influence the effectiveness of a lifestyle programme.

Associations between neighbourhood walkability and daily steps in adults: a systematic review and meta-analysis.

PubMed

Hajna, Samantha; Ross, Nancy A; Brazeau, Anne-Sophie; Bélisle, Patrick; Joseph, Lawrence; Dasgupta, Kaberi

2015-08-11

Higher street connectivity, land use mix and residential density (collectively referred to as neighbourhood walkability) have been linked to higher levels of walking. The objective of our study was to summarize the current body of knowledge on the association between neighbourhood walkability and biosensor-assessed daily steps in adults. We conducted a systematic search of PubMed, SCOPUS, and Embase (Ovid) for articles published prior to May 2014 on the association between walkability (based on Geographic Information Systems-derived street connectivity, land use mix, and/or residential density) and daily steps (pedometer or accelerometer-assessed) in adults. The mean differences in daily steps between adults living in high versus low walkable neighbourhoods were pooled across studies using a Bayesian hierarchical model. The search strategy yielded 8,744 unique abstracts. Thirty of these underwent full article review of which six met the inclusion criteria. Four of these studies were conducted in Europe and two were conducted in Asia. A meta-analysis of four of these six studies indicates that participants living in high compared to low walkable neighbourhoods accumulate 766 more steps per day (95 % credible interval 250, 1271). This accounts for approximately 8 % of recommended daily steps. The results of European and Asian studies support the hypothesis that higher neighbourhood walkability is associated with higher levels of biosensor-assessed walking in adults. More studies on this association are needed in North America.

Neighborhood Contributions to Racial and Ethnic Disparities in Obesity Among New York City Adults.

PubMed

Lim, Sungwoo; Harris, Tiffany G

2015-01-01

Objectives. We assessed neighborhood confounding on racial/ethnic obesity disparities among adults in New York City after accounting for complex sampling, and how much neighborhood factors (walkability, percentage Black or Hispanic, poverty) contributed to this effect. Methods. We combined New York City Community Health Survey 2002-2004 data with Census 2000 zip code-level data. We estimated odds ratios (ORs) for obesity with 2 sets of regression analyses. First, we used the method incorporating the conditional pseudolikelihood into complex sample adjustment. Second, we compared ORs for race/ethnicity from a conventional multilevel model for each neighborhood factor with those from a hybrid fixed-effect model. Results. The weighted estimate for obesity for Blacks versus Whites (OR = 1.8; 95% confidence interval = 1.6, 2.0) was attenuated when we controlled neighborhood confounding (OR = 1.4; 95% confidence interval = 1.2, 1.6; first analysis). Percentage of Blacks in the neighborhood made a large contribution whereas the walkability contribution was minimal (second analysis). Conclusions. Percentage of Blacks in New York City neighborhoods explained a large portion of the disparity in obesity between Blacks and Whites. The study highlights the importance of estimating valid neighborhood effects for public health surveillance and intervention.

Perceived and Objective Measures of Neighborhood Walkability and Physical Activity among Adults in Japan: A Multilevel Analysis of a Nationally Representative Sample.

PubMed

Hanibuchi, Tomoya; Nakaya, Tomoki; Yonejima, Mayuko; Honjo, Kaori

2015-10-23

Although associations between a person's neighborhood and their health have been studied internationally, most studies have been limited to a few cities or towns. Therefore, we used a nationally representative sample to explore whether perceived and objective neighborhood walkability was associated with the physical activity of residents. Data were analyzed from the Japanese General Social Surveys of 2010 (n = 2395; 1114 men and 1281 women). Perceived walkability was scored using factor analysis for the respondents' perceptions of neighborhood conditions, while objective walkability was measured using the geographic information system approach. Finally, multilevel logistic regression analysis was performed to examine whether neighborhood walkability was associated with the frequency of leisure-time physical activity (LTPA) among respondents. We found that perceived walkability was positively associated with the frequency of LTPA (odds ratio of the highest quartile was 1.53 (1.14-2.05) compared with the lowest quartile); however, objective walkability showed no association. When stratified by gender, an association between perceived walkability and LTPA was observed among women, but only a marginally significant association was present between objective walkability and LTPA among men. We conclude that the association between neighborhood walkability and LTPA can be partially generalized across Japan.

Neighbourhood walkability and home neighbourhood-based physical activity: an observational study of adults with type 2 diabetes.

PubMed

Hajna, Samantha; Kestens, Yan; Daskalopoulou, Stella S; Joseph, Lawrence; Thierry, Benoit; Sherman, Mark; Trudeau, Luc; Rabasa-Lhoret, Rémi; Meissner, Leslie; Bacon, Simon L; Gauvin, Lise; Ross, Nancy A; Dasgupta, Kaberi

2016-09-09

Converging international evidence suggests that diabetes incidence is lower among adults living in more walkable neighbourhoods. The association between walkability and physical activity (PA), the presumed mediator of this relationship, has not been carefully examined in adults with type 2 diabetes. We investigated the associations of walkability with total PA occurring within home neighbourhoods and overall PA, irrespective of location. Participants (n = 97; 59.5 ± 10.5 years) were recruited through clinics in Montreal (QC, Canada) and wore a GPS-accelerometer device for 7 days. Total PA was expressed as the total Vector of the Dynamic Body Acceleration. PA location was determined using a Global Positioning System (GPS) device (SIRF IV chip). Walkability (street connectivity, land use mix, population density) was assessed using Geographical Information Systems software. The cross-sectional associations between walkability and location-based PA were estimated using robust linear regressions adjusted for age, body mass index, sex, university education, season, car access, residential self-selection, and wear-time. A one standard deviation (SD) increment in walkability was associated with 10.4 % of a SD increment in neighbourhood-based PA (95 % confidence interval (CI) 1.2, 19.7) - equivalent to 165 more steps/day (95 % 19, 312). Car access emerged as an important predictor of neighbourhood-based PA (Not having car access: 38.6 % of a SD increment in neighbourhood-based PA, 95 % CI 17.9, 59.3). Neither walkability nor car access were conclusively associated with overall PA. Higher neighbourhood walkability is associated with higher home neighbourhood-based PA but not with higher overall PA. Other factors will need to be leveraged to facilitate meaningful increases in overall PA among adults with type 2 diabetes.

The moderating effect of psychosocial factors in the relation between neighborhood walkability and children's physical activity.

PubMed

D'Haese, Sara; Gheysen, Freja; De Bourdeaudhuij, Ilse; Deforche, Benedicte; Van Dyck, Delfien; Cardon, Greet

2016-12-09

The study aimed to investigate if psychosocial factors moderate the association between objective walkability and different domains of children's physical activity (PA). A second aim of the study was to investigate the direct associations between psychosocial factors and children's PA. Based on previous literature, it was hypothesized that walkability would be more strongly related to PA among children with negative psychosocial profiles. Data were collected between December 2011 and May 2013 as part of the Belgian Environmental Physical Activity Study in children (BEPAS-child). In total, data from 494 children and one of their parents were included in the study. Children wore an accelerometer for 7 consecutive days and together with one of their parents, they completed the Flemish Physical Activity Questionnaire. Parents filled out a questionnaire concerning their child's psychosocial factors toward PA (i.e. parental attitude toward their child's PA, parental social norm toward their child's PA, parental support, friend support, children's self-efficacy, and perceived benefits and barriers toward sports and PA). Neighborhood walkability was calculated using geographical information systems (GIS). Multilevel cross-classified analyses were conducted. Of the 42 investigated interactions between neighborhood walkability and psychosocial factors in relation to PA among children, only 7 significant interactions were found of which 3 were only significant among children from low-income neighborhoods. Parental support and self-efficacy were positive correlates of children's PA in high- and low-income neighborhoods independent of the level of walkability, but effect sizes were small. The hypothesis that walkability would be more strongly related to PA among children with negative psychosocial profiles could not be confirmed and in general, psychosocial factors and objective walkability did not interact in relation to children's PA. Focusing on parental support and self

Perceived and Objective Measures of Neighborhood Walkability and Physical Activity among Adults in Japan: A Multilevel Analysis of a Nationally Representative Sample

PubMed Central

Hanibuchi, Tomoya; Nakaya, Tomoki; Yonejima, Mayuko; Honjo, Kaori

2015-01-01

Although associations between a person’s neighborhood and their health have been studied internationally, most studies have been limited to a few cities or towns. Therefore, we used a nationally representative sample to explore whether perceived and objective neighborhood walkability was associated with the physical activity of residents. Data were analyzed from the Japanese General Social Surveys of 2010 (n = 2395; 1114 men and 1281 women). Perceived walkability was scored using factor analysis for the respondents’ perceptions of neighborhood conditions, while objective walkability was measured using the geographic information system approach. Finally, multilevel logistic regression analysis was performed to examine whether neighborhood walkability was associated with the frequency of leisure-time physical activity (LTPA) among respondents. We found that perceived walkability was positively associated with the frequency of LTPA (odds ratio of the highest quartile was 1.53 (1.14–2.05) compared with the lowest quartile); however, objective walkability showed no association. When stratified by gender, an association between perceived walkability and LTPA was observed among women, but only a marginally significant association was present between objective walkability and LTPA among men. We conclude that the association between neighborhood walkability and LTPA can be partially generalized across Japan. PMID:26512682

Neighborhood Walkability and Walking for Transport Among South Asians in the MASALA Study.

PubMed

Kelley, Elizabeth A; Kandula, Namratha R; Kanaya, Alka M; Yen, Irene H

2016-05-01

The neighborhood built environment can have a strong influence on physical activity levels, particularly walking for transport. In examining racial/ethnic differences in physical activity, one important and understudied group is South Asians. This study aims to describe the association between neighborhood walkability and walking for transport among South Asian men and women in the United States in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. A cross-sectional study was conducted in 2014 using the baseline dataset of the MASALA study (N = 906). Mean age was 55 years old and 54% of the sample was male. Weekly minutes spent walking for transport was assessed using a questionnaire adapted from the Cross-Cultural Activity Participation Study. Neighborhood walkability was measured using Walk Score, a composite index of walkability. After adjusting for covariates, with each 10-point increase in Walk Score, South Asian American men engaged in 13 additional minutes per week of walking for transport (P = .008). No association was observed between walkability and walking for transport in South Asian American women. Results provide new evidence for how the effects of environmental influences on walking for transport may vary between South Asian men and women.

Validity of Walk Score® as a measure of neighborhood walkability in Japan.

PubMed

Koohsari, Mohammad Javad; Sugiyama, Takemi; Hanibuchi, Tomoya; Shibata, Ai; Ishii, Kaori; Liao, Yung; Oka, Koichiro

2018-03-01

Objective measures of environmental attributes have been used to understand how neighborhood environments relate to physical activity. However, this method relies on detailed spatial data, which are often not easily available. Walk Score® is a free, publicly available web-based tool that shows how walkable a given location is based on objectively-derived proximity to several types of local destinations and street connectivity. To date, several studies have tested the concurrent validity of Walk Score as a measure of neighborhood walkability in the USA and Canada. However, it is unknown whether Walk Score is a valid measure in other regions. The current study examined how Walk Score is correlated with objectively-derived attributes of neighborhood walkability, for residential addresses in Japan. Walk Scores were obtained for 1072 residential addresses in urban and rural areas in Japan. Five environmental attributes (residential density, intersection density, number of local destinations, sidewalk availability, and access to public transportation) were calculated using geographic information systems for each address. Pearson's correlation coefficients between Walk Score and these environmental attributes were calculated (conducted in May 2017). Significant positive correlations were observed between Walk Score and environmental attributes relevant to walking. Walk Score was most closely associated with intersection density ( r  = 0.82) and with the number of local destinations ( r  = 0.77). Walk Score appears to be a valid measure of neighborhood walkability in Japan. Walk Score will allow urban designers and public health practitioners to identify walkability of local areas without relying on detailed geographic data.

Neighbourhood walkability and incidence of hypertension: Findings from the study of 429,334 UK Biobank participants.

PubMed

Sarkar, Chinmoy; Webster, Chris; Gallacher, John

2018-04-01

With an estimated one billion hypertension cases worldwide, the role of the built environment in its prevention and control is still uncertain. The present study aims to examine the associations between neighbourhood walkability and hypertension in a large and diverse population-based cohort. We examined the association between neighbourhood walkability and blood pressure outcomes for N = 429,334 participants drawn from the UK Biobank and aged 38-73 years. Neighbourhood walkability was objectively modelled from detailed building footprint-level data within multi-scale functional neighbourhoods (1.0-, 1.5- and 2.0-kilometer street catchments of geocoded dwelling). A series of linear and modified Poisson regression models were employed to examine the association between walkability and outcomes of diastolic blood pressure (DBP in mmHg), systolic blood pressure (SBP in mmHg) and prevalent hypertension adjusting for socio-demographic, lifestyle and related physical environmental covariates. We also examined the relationship between walkability and change in blood pressure for a sub-sample of participants with follow-up data and tested for interaction effects of age, sex, employment status, neighbourhood SES, residential density and green exposure. Neighbourhood walkability within one-kilometer street catchment was beneficially associated with all the three blood pressure outcomes, independent of all other factors. Each interquartile increment in walkability was associated with the lower blood pressure outcomes of DBP (β = -0.358, 95% CI: -0.42, -0.29 mmHg), SBP (β = -0.833, 95% CI: -0.95, -0.72 mmHg) as well as reduced hypertension risk (RR = 0.970, 95% CI: 0.96, 0.98). The results remained consistent across spatial and temporal scales and were sensitive to sub-groups, with pronounced protective effects among female participants, those aged between 50 and 60 years, in employment, residing in deprived, high density and greener areas. This large

The use of measures of obesity in childhood for predicting obesity and the development of obesity-related diseases in adulthood: a systematic review and meta-analysis.

PubMed

Simmonds, Mark; Burch, Jane; Llewellyn, Alexis; Griffiths, Claire; Yang, Huiqin; Owen, Christopher; Duffy, Steven; Woolacott, Nerys

2015-06-01

It is uncertain which simple measures of childhood obesity are best for predicting future obesity-related health problems and the persistence of obesity into adolescence and adulthood. To investigate the ability of simple measures, such as body mass index (BMI), to predict the persistence of obesity from childhood into adulthood and to predict obesity-related adult morbidities. To investigate how accurately simple measures diagnose obesity in children, and how acceptable these measures are to children, carers and health professionals. Multiple sources including MEDLINE, EMBASE and The Cochrane Library were searched from 2008 to 2013. Systematic reviews and a meta-analysis were carried out of large cohort studies on the association between childhood obesity and adult obesity; the association between childhood obesity and obesity-related morbidities in adulthood; and the diagnostic accuracy of simple childhood obesity measures. Study quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and a modified version of the Quality in Prognosis Studies (QUIPS) tool. A systematic review and an elicitation exercise were conducted on the acceptability of the simple measures. Thirty-seven studies (22 cohorts) were included in the review of prediction of adult morbidities. Twenty-three studies (16 cohorts) were included in the tracking review. All studies included BMI. There were very few studies of other measures. There was a strong positive association between high childhood BMI and adult obesity [odds ratio 5.21, 95% confidence interval (CI) 4.50 to 6.02]. A positive association was found between high childhood BMI and adult coronary heart disease, diabetes and a range of cancers, but not stroke or breast cancer. The predictive accuracy of childhood BMI to predict any adult morbidity was very low, with most morbidities occurring in adults who were of healthy weight in childhood. Predictive accuracy of childhood obesity was moderate for

Modelling obesity trends in Australia: unravelling the past and predicting the future.

PubMed

Hayes, A J; Lung, T W C; Bauman, A; Howard, K

2017-01-01

Modelling is increasingly being used to predict the epidemiology of obesity progression and its consequences. The aims of this study were: (a) to present and validate a model for prediction of obesity among Australian adults and (b) to use the model to project the prevalence of obesity and severe obesity by 2025. Individual level simulation combined with survey estimation techniques to model changing population body mass index (BMI) distribution over time. The model input population was derived from a nationally representative survey in 1995, representing over 12 million adults. Simulations were run for 30 years. The model was validated retrospectively and then used to predict obesity and severe obesity by 2025 among different aged cohorts and at a whole population level. The changing BMI distribution over time was well predicted by the model and projected prevalence of weight status groups agreed with population level data in 2008, 2012 and 2014.The model predicts more growth in obesity among younger than older adult cohorts. Projections at a whole population level, were that healthy weight will decline, overweight will remain steady, but obesity and severe obesity prevalence will continue to increase beyond 2016. Adult obesity prevalence was projected to increase from 19% in 1995 to 35% by 2025. Severe obesity (BMI>35), which was only around 5% in 1995, was projected to be 13% by 2025, two to three times the 1995 levels. The projected rise in obesity severe obesity will have more substantial cost and healthcare system implications than in previous decades. Having a robust epidemiological model is key to predicting these long-term costs and health outcomes into the future.

Promoting Active Urban Aging: A Measurement Approach to Neighborhood Walkability for Older Adults

PubMed Central

Weiss, Rachael L.; Maantay, Juliana A.; Fahs, Marianne

2011-01-01

Understanding the role of the built environment on physical activity behavior among older adults is an important public health goal, but evaluating these relationships remains complicated due to the difficulty of measuring specific attributes of the environment. As a result, there is conflicting evidence regarding the association between perceived and objectively measured walkability and physical activity among urban-dwelling older adults. This suggests that both actual environmental features and perceptions of these attributes influence walking behavior. The purpose of this pilot project is to create an Objective Walkability Index (OWI) by census block using a Geographic Information System (GIS) and supplement the results with resident perceptions thus more accurately characterizing the context of walkability. Computerized Neighborhood Environment Tracking (ComNET) was used to systematically assess environmental risks impacting activity patterns of older adults in two New York City neighborhoods. In addition, the Senior Center Evaluation of the Neighborhood Environment (SCENE) survey was administered to older adults attending two senior centers located within the target neighborhoods. The results indicate that there is substantial variation in OWI score both between and within the neighborhoods suggesting that residence in some communities may increase the risk of inactivity among older adults. Also, low walkability census blocks were clustered within each neighborhood providing an opportunity for targeted investigation into localized threats to walkability. A lack of consensus regarding the association between the built environment and physical activity among older adults is a consequence of the problems inherent in measuring these determinants. Further empirical evidence evaluating the complex relationships between the built environment and physical activity is an essential step towards creating active communities. PMID:21874149

Neighborhood Walkability and Walking for Transport Among South Asians in the MASALA Study

PubMed Central

Kelley, Elizabeth A.; Kandula, Namratha R.; Kanaya, Alka M.; Yen, Irene H.

2016-01-01

Background The neighborhood built environment can have a strong influence on physical activity levels, particularly walking for transport. In examining racial/ethnic differences in physical activity, one important and understudied group is South Asians. This study aims to describe the association between neighborhood walkability and walking for transport among South Asian men and women in the United States in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. Methods A cross-sectional study was conducted in 2014 using the baseline dataset of the MASALA study (N = 906). Mean age was 55 years old and 54% of the sample was male. Weekly minutes spent walking for transport was assessed using a questionnaire adapted from the Cross-Cultural Activity Participation Study. Neighborhood walkability was measured using Walk Score, a composite index of walkability. Results After adjusting for covariates, with each 10-point increase in Walk Score, South Asian American men engaged in 13 additional minutes per week of walking for transport (P = .008). No association was observed between walkability and walking for transport in South Asian American women. Conclusions Results provide new evidence for how the effects of environmental influences on walking for transport may vary between South Asian men and women. PMID:26529292

Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trial.

PubMed

Merom, D; Gebel, K; Fahey, P; Astell-Burt, T; Voukelatos, A; Rissel, C; Sherrington, C

2015-01-01

In older adults the relationships between health, fall-related risk factors, perceived neighborhood walkability, walking behavior and intervention impacts are poorly understood. To determine whether: i) health and fall-related risk factors were associated with perceptions of neighborhood walkability; ii) perceived environmental attributes, and fall-related risk factors predicted change in walking behavior at 12 months; and iii) perceived environmental attributes and fall-related risk factors moderated the effect of a self-paced walking program on walking behavior. Randomized trial on walking and falls conducted between 2009 and 2012 involving 315 community-dwelling inactive adults ≥ 65 years living in Sydney, Australia. Measures were: mobility status, fall history, injurious fall and fear of falling (i.e., fall-related risk factors), health status, walking self-efficacy and 11 items from the neighborhood walkability scale and planned walking ≥ 150 min/week at 12 months. Participants with poorer mobility, fear of falling, and poor health perceived their surroundings as less walkable. Walking at 12 months was significantly greater in "less greenery" (AOR = 3.3, 95% CI: 1.11-9.98) and "high traffic" (AOR = 1.98, 95% CI: 1.00-3.91) neighborhoods. The intervention had greater effects in neighborhoods perceived to have poorer pedestrian infrastructure (p for interaction = 0.036). Low perceived walkability was shaped by health status and did not appear to be a barrier to walking behavior. There appears to be a greater impact of, and thus, need for, interventions to encourage walking in environments perceived not to have supportive walking infrastructure. Future studies on built environments and walking should gather information on fall-related risk factors to better understand how these characteristics interact.

Quasi-causal associations of physical activity and neighborhood walkability with body mass index: a twin study.

PubMed

Duncan, Glen E; Cash, Stephanie Whisnant; Horn, Erin E; Turkheimer, Eric

2015-01-01

Physical activity, neighborhood walkability, and body mass index (BMI, kg/m(2)) associations were tested using quasi-experimental twin methods. We hypothesized that physical activity and walkability were independently associated with BMI within twin pairs, controlling for genetic and environmental background shared between them. Data were from 6376 (64% female; 58% identical) same-sex pairs, University of Washington Twin Registry, 2008-2013. Neighborhood walking, moderate-to-vigorous physical activity (MVPA), and BMI were self-reported. Residential address was used to calculate walkability. Phenotypic (non-genetically informed) and biometric (genetically informed) regression was employed, controlling for age, sex, and race. Walking and MVPA were associated with BMI in phenotypic analyses; associations were attenuated but significant in biometric analyses (Ps<0.05). Walkability was not associated with BMI, however, was associated with walking (but not MVPA) in both phenotypic and biometric analyses (Ps<0.05), with no attenuation accounting for shared genetic and environmental background. The association between activity and BMI is largely due to shared genetic and environmental factors, but a significant causal relationship remains accounting for shared background. Although walkability is not associated with BMI, it is associated with neighborhood walking (but not MVPA) accounting for shared background, suggesting a causal relationship between them. Copyright © 2014 Elsevier Inc. All rights reserved.

A disadvantaged advantage in walkability: findings from socioeconomic and geographical analysis of national built environment data in the United States.

PubMed

King, Katherine E; Clarke, Philippa J

2015-01-01

Urban form-the structure of the built environment-can influence physical activity, yet little is known about how walkable design differs according to neighborhood sociodemographic composition. We studied how walkable urban form varies by neighborhood sociodemographic composition, region, and urbanicity across the United States. Using linear regression models and 2000-2001 US Census data, we investigated the relationship between 5 neighborhood census characteristics (income, education, racial/ethnic composition, age distribution, and sex) and 5 walkability indicators in almost 65,000 census tracts in 48 states and the District of Columbia. Data on the built environment were obtained from the RAND Corporation's (Santa Monica, California) Center for Population Health and Health Disparities (median block length, street segment, and node density) and the US Geological Survey's National Land Cover Database (proportion open space and proportion highly developed). Disadvantaged neighborhoods and those with more educated residents were more walkable (i.e., shorter block length, greater street node density, more developed land use, and higher density of street segments). However, tracts with a higher proportion of children and older adults were less walkable (fewer street nodes and lower density of street segments), after adjustment for region and level of urbanicity. Research and policy on the walkability-health link should give nuanced attention to the gap between persons living in walkable areas and those for whom walkability has the most to offer. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Changes in Objectively-Determined Walkability and Physical Activity in Adults: A Quasi-Longitudinal Residential Relocation Study

PubMed Central

McCormack, Gavin R.; McLaren, Lindsay; Salvo, Grazia; Blackstaffe, Anita

2017-01-01

Causal evidence for the built environment’s role in supporting physical activity is needed to inform land use and transportation policies. This quasi-longitudinal residential relocation study compared within-person changes in self-reported transportation walking, transportation cycling, and overall physical activity during the past 12 months among adults who did and did not move to a different neighbourhood. In 2014, a random sample of adults from 12 neighbourhoods (Calgary, AB, Canada) with varying urban form and socioeconomic status provided complete self-administered questionnaire data (n = 915). Participants, some of whom moved neighbourhood during the past 12 months (n = 95), reported their perceived change in transportation walking and cycling, and overall physical activity during that period. The questionnaire also captured residential self-selection, and sociodemographic and health characteristics. Walk Scores® were linked to each participant’s current and previous neighbourhood and three groups identified: walkability “improvers” (n = 48); “decliners” (n = 47), and; “maintainers” (n = 820). Perceived change in physical activity was compared between the three groups using propensity score covariate-adjusted Firth logistic regression (odds ratios: OR). Compared with walkability maintainers, walkability decliners (OR 4.37) and improvers (OR 4.14) were more likely (p < 0.05) to report an increase in their transportation walking since moving neighbourhood, while walkability decliners were also more likely (OR 3.17) to report decreasing their transportation walking since moving. Walkability improvers were more likely than maintainers to increase their transportation cycling since moving neighbourhood (OR 4.22). Temporal changes in neighbourhood walkability resulting from residential relocation appear to be associated with reported temporal changes in transportation walking and cycling in adults. PMID:28531149

Changes in Objectively-Determined Walkability and Physical Activity in Adults: A Quasi-Longitudinal Residential Relocation Study.

PubMed

McCormack, Gavin R; McLaren, Lindsay; Salvo, Grazia; Blackstaffe, Anita

2017-05-22

Causal evidence for the built environment's role in supporting physical activity is needed to inform land use and transportation policies. This quasi-longitudinal residential relocation study compared within-person changes in self-reported transportation walking, transportation cycling, and overall physical activity during the past 12 months among adults who did and did not move to a different neighbourhood. In 2014, a random sample of adults from 12 neighbourhoods (Calgary, AB, Canada) with varying urban form and socioeconomic status provided complete self-administered questionnaire data ( n = 915). Participants, some of whom moved neighbourhood during the past 12 months ( n = 95), reported their perceived change in transportation walking and cycling, and overall physical activity during that period. The questionnaire also captured residential self-selection, and sociodemographic and health characteristics. Walk Scores ® were linked to each participant's current and previous neighbourhood and three groups identified: walkability "improvers" ( n = 48); "decliners" ( n = 47), and; "maintainers" ( n = 820). Perceived change in physical activity was compared between the three groups using propensity score covariate-adjusted Firth logistic regression (odds ratios: OR). Compared with walkability maintainers, walkability decliners (OR 4.37) and improvers (OR 4.14) were more likely ( p < 0.05) to report an increase in their transportation walking since moving neighbourhood, while walkability decliners were also more likely (OR 3.17) to report decreasing their transportation walking since moving. Walkability improvers were more likely than maintainers to increase their transportation cycling since moving neighbourhood (OR 4.22). Temporal changes in neighbourhood walkability resulting from residential relocation appear to be associated with reported temporal changes in transportation walking and cycling in adults.

Designing healthy communities: creating evidence on metrics for built environment features associated with walkable neighbourhood activity centres.

PubMed

Gunn, Lucy Dubrelle; Mavoa, Suzanne; Boulangé, Claire; Hooper, Paula; Kavanagh, Anne; Giles-Corti, Billie

2017-12-04

Evidence-based metrics are needed to inform urban policy to create healthy walkable communities. Most active living research has developed metrics of the environment around residential addresses, ignoring other important walking locations. Therefore, this study examined: metrics for built environment features surrounding local shopping centres, (known in Melbourne, Australia as neighbourhood activity centres (NACs) which are typically anchored by a supermarket); the association between NACs and transport walking; and, policy compliance for supermarket provision. In this observational study, cluster analysis was used to categorize 534 NACs in Melbourne, Australia by their built environment features. The NACS were linked to eligible Victorian Integrated Survey of Travel Activity 2009-2010 (VISTA) survey participants (n=19,984). Adjusted multilevel logistic regressions estimated associations between each cluster typology and two outcomes of daily walking: any transport walking; and, any 'neighbourhood' transport walking. Distance between residential dwellings and closest NAC was assessed to evaluate compliance with local planning policy on supermarket locations. Metrics for 19 built environment features were estimated and three NAC clusters associated with walkability were identified. NACs with significantly higher street connectivity (mean:161, SD:20), destination diversity (mean:16, SD:0.4); and net residential density (mean:77, SD:65) were interpreted as being 'highly walkable' when compared with 'low walkable' NACs, which had lower street connectivity (mean:57, SD:15); destination diversity (mean:11, SD:3); and net residential density (mean:10, SD:3). The odds of any daily transport walking was 5.85 times higher (95% CI: 4.22, 8.11), and for any 'neighborhood' transport walking 8.66 (95% CI: 5.89, 12.72) times higher, for residents whose closest NAC was highly walkable compared with those living near low walkable NACs. Only highly walkable NACs met the policy

Machine Learning Techniques for Prediction of Early Childhood Obesity.

PubMed

Dugan, T M; Mukhopadhyay, S; Carroll, A; Downs, S

2015-01-01

This paper aims to predict childhood obesity after age two, using only data collected prior to the second birthday by a clinical decision support system called CHICA. Analyses of six different machine learning methods: RandomTree, RandomForest, J48, ID3, Naïve Bayes, and Bayes trained on CHICA data show that an accurate, sensitive model can be created. Of the methods analyzed, the ID3 model trained on the CHICA dataset proved the best overall performance with accuracy of 85% and sensitivity of 89%. Additionally, the ID3 model had a positive predictive value of 84% and a negative predictive value of 88%. The structure of the tree also gives insight into the strongest predictors of future obesity in children. Many of the strongest predictors seen in the ID3 modeling of the CHICA dataset have been independently validated in the literature as correlated with obesity, thereby supporting the validity of the model. This study demonstrated that data from a production clinical decision support system can be used to build an accurate machine learning model to predict obesity in children after age two.

Achieving walkable city in Indonesia: Policy and responsive design through public participation

NASA Astrophysics Data System (ADS)

Tanan, Natalia; Darmoyono, Laksmi

2017-11-01

This paper discusses approaches to policy and planning of pedestrian facility that facilitate walking in cities in Indonesia. It applies quantitative and qualitative methods to analyze walkability in some cities. The new perspective in policy and planning are focusing on improving non-motorized mobility; it encourages walking and put the provision of the pedestrian facility as an integral part of built environmental planning and development. The policy perceives pedestrian facility in broad, not only about physical development, but also benefit to socioeconomic activity and environmental quality. It is expected that the implementation of policies and walkability concept could upgrade the pedestrian facility, as a walkable city delivers green atmosphere of the urban environment. A design competition of pedestrian facility was held to test the policy and accommodate input from the public. Public participation through competition also enriches the design of pedestrian facility that responsive to local condition. Implementation is still a challenge due to limited budget; however, there are tendencies that few cities improve pedestrian facilities to encourage people walking in order to make the city livable and environmentally friendly.

New body fat prediction equations for severely obese patients.

PubMed

Horie, Lilian Mika; Barbosa-Silva, Maria Cristina Gonzalez; Torrinhas, Raquel Susana; de Mello, Marco Túlio; Cecconello, Ivan; Waitzberg, Dan Linetzky

2008-06-01

Severe obesity imposes physical limitations to body composition assessment. Our aim was to compare body fat (BF) estimations of severely obese patients obtained by bioelectrical impedance (BIA) and air displacement plethysmography (ADP) for development of new equations for BF prediction. Severely obese subjects (83 female/36 male, mean age=41.6+/-11.6 years) had BF estimated by BIA and ADP. The agreement of the data was evaluated using Bland-Altman's graphic and concordance correlation coefficient (CCC). A multivariate regression analysis was performed to develop and validate new predictive equations. BF estimations from BIA (64.8+/-15 kg) and ADP (65.6+/-16.4 kg) did not differ (p>0.05, with good accuracy, precision, and CCC), but the Bland- Altman graphic showed a wide limit of agreement (-10.4; 8.8). The standard BIA equation overestimated BF in women (-1.3 kg) and underestimated BF in men (5.6 kg; p<0.05). Two BF new predictive equations were generated after BIA measurement, which predicted BF with higher accuracy, precision, CCC, and limits of agreement than the standard BIA equation. Standard BIA equations were inadequate for estimating BF in severely obese patients. Equations developed especially for this population provide more accurate BF assessment.

Perceived neighborhood walkability and physical exercise: An examination of casual communication in a social process.

PubMed

Yamamoto, Masahiro; Jo, Hyerim

2018-05-01

Despite the accumulated evidence for the environmental correlates of physical activity, social processes underlying this association are not entirely clear. This study positions communication characterized by weak ties as a social mechanism linking neighborhood walkability with physical exercise. Data from a survey of Chicago residents show that perceived neighborhood walkability is positively related to frequency of weak-tie communication. Frequency of weak-tie communication is related positively to perceived social cohesion and negatively to anonymity, both of which are significantly related to frequency of physical exercise in the neighborhood. Data also show a sequential indirect relationship involving perceived neighborhood walkability, weak-tie communication, anonymity, and physical exercise. Implications are discussed in terms of the role of communication in promoting locality-based physical exercise. Copyright © 2018 Elsevier Ltd. All rights reserved.

Place matters: A longitudinal analysis measuring the association between neighbourhood walkability and walking by age group and population center size in Canada.

PubMed

Wasfi, Rania; Steinmetz-Wood, Madeleine; Kestens, Yan

2017-01-01

This study examined the influence of walkability on walking behaviour and assessed whether associations varied according to life-stage and population center (PC) size. Walkability scores were obtained for the six-digit postal codes of residential neighbourhoods of 11,200 Canadians, who participated in biennial assessments of the National Population Health Survey from 1994 to 2010. Participants were stratified by age-group. Mixed-effects logistic regression models were used to estimate the influence of cumulative exposure to neighborhood walkability on utilitarian and exercise walking by PC size and life-stage. Associations of neighbourhood walkability with utilitarian and exercise walking varied according to age-group and PC size. Exposure to high walkable neighborhoods was associated with utilitarian walking in younger and older adults in all PC sizes, except for older adults living in a medium PC. Living in a highly walkable neighborhood in a large PC was associated with walking for exercise in younger (OR: 1.42; 95%CI: 1.20-1.67) and older adults (OR: 2.09; 95%CI: 1.51-2.89). Living in highly walkable neighbourhood in a medium PC was associated with walking for exercise in older adults (OR: 1.62; 95%CI: 1.15-2.29). These results emphasize the need to consider the size and nature of every community, and the age-group of a population when implementing strategies to promote walking.

Neighborhood walkability, deprivation and incidence of type 2 diabetes: a population-based study on 512,061 Swedish adults

PubMed Central

Sundquist, Kristina; Eriksson, Ulf; Mezuk, Briana; Ohlsson, Henrik

2014-01-01

Neighborhood walkability has been associated with increased physical activity, but only a few studies have explored the association between walkability and health outcomes related to physical activity, such as type 2 diabetes. The aim of this study was to investigate the association between objectively assessed neighborhood walkability and the 4-year incidence of type 2 diabetes in a sample of 512,061 Swedish adults aged 18 years and older. Neighborhoods were defined by 408 administratively defined geographical areas in the city of Stockholm. We found a negative association between walkability and type 2 diabetes (OR=1.33, 95% CI=1.13–1.55) that remained significant after adjusting for neighborhood deprivation. This association, however, no longer remained statistically significant after adjusting for individual socio-demographic factors. These results were also confirmed using a co-sibling design. Future studies are encouraged to further explore the potential effect of a broader array of the neighborhood built environment on health outcomes related to physical activity. PMID:25463914

An artificial neural network to predict resting energy expenditure in obesity.

PubMed

Disse, Emmanuel; Ledoux, Séverine; Bétry, Cécile; Caussy, Cyrielle; Maitrepierre, Christine; Coupaye, Muriel; Laville, Martine; Simon, Chantal

2017-09-01

The resting energy expenditure (REE) determination is important in nutrition for adequate dietary prescription. The gold standard i.e. indirect calorimetry is not available in clinical settings. Thus, several predictive equations have been developed, but they lack of accuracy in subjects with extreme weight including obese populations. Artificial neural networks (ANN) are useful predictive tools in the area of artificial intelligence, used in numerous clinical fields. The aim of this study was to determine the relevance of ANN in predicting REE in obesity. A Multi-Layer Perceptron (MLP) feed-forward neural network with a back propagation algorithm was created and cross-validated in a cohort of 565 obese subjects (BMI within 30-50 kg m -2 ) with weight, height, sex and age as clinical inputs and REE measured by indirect calorimetry as output. The predictive performances of ANN were compared to those of 23 predictive REE equations in the training set and in two independent sets of 100 and 237 obese subjects for external validation. Among the 23 established prediction equations for REE evaluated, the Harris & Benedict equations recalculated by Roza were the most accurate for the obese population, followed by the USA DRI, Müller and the original Harris & Benedict equations. The final 5-fold cross-validated three-layer 4-3-1 feed-forward back propagation ANN model developed in that study improved precision and accuracy of REE prediction over linear equations (precision = 68.1%, MAPE = 8.6% and RMSPE = 210 kcal/d), independently from BMI subgroups within 30-50 kg m -2 . External validation confirmed the better predictive performances of ANN model (precision = 73% and 65%, MAPE = 7.7% and 8.6%, RMSPE = 187 kcal/d and 200 kcal/d in the 2 independent datasets) for the prediction of REE in obese subjects. We developed and validated an ANN model for the prediction of REE in obese subjects that is more precise and accurate than established REE predictive

Walkability and cardiometabolic risk factors: Cross-sectional and longitudinal associations from the Multi-Ethnic Study of Atherosclerosis.

PubMed

Braun, Lindsay M; Rodríguez, Daniel A; Evenson, Kelly R; Hirsch, Jana A; Moore, Kari A; Diez Roux, Ana V

2016-05-01

We used data from 3227 older adults in the Multi-Ethnic Study of Atherosclerosis (2004-2012) to explore cross-sectional and longitudinal associations between walkability and cardiometabolic risk factors. In cross-sectional analyses, linear regression was used to estimate associations of Street Smart Walk Score® with glucose, triglycerides, HDL and LDL cholesterol, systolic and diastolic blood pressure, and waist circumference, while logistic regression was used to estimate associations with odds of metabolic syndrome. Econometric fixed effects models were used to estimate longitudinal associations of changes in walkability with changes in each risk factor among participants who moved residential locations between 2004 and 2012 (n=583). Most cross-sectional and longitudinal associations were small and statistically non-significant. We found limited evidence that higher walkability was cross-sectionally associated with lower blood pressure but that increases in walkability were associated with increases in triglycerides and blood pressure over time. Further research over longer time periods is needed to understand the potential for built environment interventions to improve cardiometabolic health. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relationship between neighborhood walkability and older adults' physical activity: results from the Belgian Environmental Physical Activity Study in Seniors (BEPAS Seniors).

PubMed

Van Holle, Veerle; Van Cauwenberg, Jelle; Van Dyck, Delfien; Deforche, Benedicte; Van de Weghe, Nico; De Bourdeaudhuij, Ilse

2014-08-23

Adequate knowledge on environmental correlates of physical activity (PA) in older adults is needed to develop effective health promotion initiatives. However, research in this age group is scarce and most existing studies were conducted in North America. The present study aimed to examine relationships between GIS-based neighborhood walkability and objective and self-reported PA in community-dwelling Belgian older adults. Furthermore, moderating effects of neighborhood income levels were investigated. The Belgian Environmental Physical Activity Study (BEPAS) for Seniors is a cross-sectional study in older adults (≥65 yrs) and was conducted between October 2010 and September 2012. Data from 438 older adults living in 20 neighborhoods across Ghent (Belgium) were analyzed. Stratification of selected neighborhoods was based upon objective walkability and neighborhood income. Participants wore an accelerometer during seven consecutive days to obtain objective levels of moderate-to-vigorous physical activity (MVPA). Self-reported levels of transportation walking/cycling and recreational walking/cycling were assessed using the International Physical Activity Questionnaire (long, last 7 days version) adapted for the elderly. Multi-level regression analyses were conducted. Findings showed a positive relationship between neighborhood walkability and weekly minutes of older adults' self-reported walking for transportation (B = 4.63 ± 1.05;p < 0.001) and a negative relationship between walkability and accelerometer-derived low-light PA (B = -1.38 ± 0.62;p = 0.025). Walkability was not related to any measure of recreational PA. A walkability x income interaction was found for accelerometer-derived MVPA (B = -1.826 ± 1.03;p = 0.075), showing only a positive association between walkability and MVPA in low-income neighborhood residents. This was the first European study to examine walkability-PA relationships in older adults. These Belgian findings suggest that a high

Place matters: A longitudinal analysis measuring the association between neighbourhood walkability and walking by age group and population center size in Canada

PubMed Central

Steinmetz-Wood, Madeleine; Kestens, Yan

2017-01-01

This study examined the influence of walkability on walking behaviour and assessed whether associations varied according to life-stage and population center (PC) size. Walkability scores were obtained for the six-digit postal codes of residential neighbourhoods of 11,200 Canadians, who participated in biennial assessments of the National Population Health Survey from 1994 to 2010. Participants were stratified by age-group. Mixed-effects logistic regression models were used to estimate the influence of cumulative exposure to neighborhood walkability on utilitarian and exercise walking by PC size and life-stage. Associations of neighbourhood walkability with utilitarian and exercise walking varied according to age-group and PC size. Exposure to high walkable neighborhoods was associated with utilitarian walking in younger and older adults in all PC sizes, except for older adults living in a medium PC. Living in a highly walkable neighborhood in a large PC was associated with walking for exercise in younger (OR: 1.42; 95%CI: 1.20–1.67) and older adults (OR: 2.09; 95%CI: 1.51–2.89). Living in highly walkable neighbourhood in a medium PC was associated with walking for exercise in older adults (OR: 1.62; 95%CI: 1.15–2.29). These results emphasize the need to consider the size and nature of every community, and the age-group of a population when implementing strategies to promote walking. PMID:29261706

A Disadvantaged Advantage in Walkability: Findings from Socioeconomic and Geographic Analysis of National Built Environment Data in the United States.

EPA Science Inventory

Urban form-the structure of the built environment-can influence physical activity, yet little is known about how walkable design differs according to neighborhood sociodemographic composition. We studied how walkable urban form varies by neighborhood sociodemographic composition,...

Prediction Equations Overestimate the Energy Requirements More for Obesity-Susceptible Individuals.

PubMed

McLay-Cooke, Rebecca T; Gray, Andrew R; Jones, Lynnette M; Taylor, Rachael W; Skidmore, Paula M L; Brown, Rachel C

2017-09-13

Predictive equations to estimate resting metabolic rate (RMR) are often used in dietary counseling and by online apps to set energy intake goals for weight loss. It is critical to know whether such equations are appropriate for those susceptible to obesity. We measured RMR by indirect calorimetry after an overnight fast in 26 obesity susceptible (OSI) and 30 obesity resistant (ORI) individuals, identified using a simple 6-item screening tool. Predicted RMR was calculated using the FAO/WHO/UNU (Food and Agricultural Organisation/World Health Organisation/United Nations University), Oxford and Miflin-St Jeor equations. Absolute measured RMR did not differ significantly between OSI versus ORI (6339 vs. 5893 kJ·d -1 , p = 0.313). All three prediction equations over-estimated RMR for both OSI and ORI when measured RMR was ≤5000 kJ·d -1 . For measured RMR ≤7000 kJ·d -1 there was statistically significant evidence that the equations overestimate RMR to a greater extent for those classified as obesity susceptible with biases ranging between around 10% to nearly 30% depending on the equation. The use of prediction equations may overestimate RMR and energy requirements particularly in those who self-identify as being susceptible to obesity, which has implications for effective weight management.

Do Inequalities in Neighborhood Walkability Drive Disparities in Older Adults' Outdoor Walking?

PubMed

Zandieh, Razieh; Flacke, Johannes; Martinez, Javier; Jones, Phil; van Maarseveen, Martin

2017-07-07

Older residents of high-deprivation areas walk less than those of low-deprivation areas. Previous research has shown that neighborhood built environment may support and encourage outdoor walking. The extent to which the built environment supports and encourages walking is called "walkability". This study examines inequalities in neighborhood walkability in high- versus low-deprivation areas and their possible influences on disparities in older adults' outdoor walking levels. For this purpose, it focuses on specific neighborhood built environment attributes (residential density, land-use mix and intensity, street connectivity, and retail density) relevant to neighborhood walkability. It applied a mixed-method approach, included 173 participants (≥65 years), and used a Geographic Information System (GIS) and walking interviews (with a sub-sample) to objectively and subjectively measure neighborhood built environment attributes. Outdoor walking levels were measured by using the Geographic Positioning System (GPS) technology. Data on personal characteristics was collected by completing a questionnaire. The results show that inequalities in certain land-use intensity (i.e., green spaces, recreation centers, schools and industries) in high- versus low-deprivation areas may influence disparities in older adults' outdoor walking levels. Modifying neighborhood land use intensity may help to encourage outdoor walking in high-deprivation areas.

Evaluation of the walkable neighborhoods for seniors project in Sacramento County.

PubMed

Hooker, Steven P; Cirill, Lisa A; Geraghty, Anne

2009-07-01

The Walkable Neighborhoods for Seniors project was implemented to foster the creation and promotion of safe and accessible neighborhood walking routes for seniors. This article describes a case study of the efforts put forth by a local task force jointly managed by the Sacramento County Department of Health Services and WALK Sacramento. To facilitate environmental and policy changes that would enable and encourage walking by older adults, these local lead agencies implemented several strategies including organizing a community task force with broad professional and civic representation, conducting environmental audits of selected walking routes, creating walking groups, and advocating for environmental and policy change. Evaluation processes yield information on successes, challenges, and lessons learned that could be applied to similar efforts undertaken by community organizations to improve the walkability of neighborhoods for older adults.

Neighborhood walkability, deprivation and incidence of type 2 diabetes: a population-based study on 512,061 Swedish adults.

PubMed

Sundquist, Kristina; Eriksson, Ulf; Mezuk, Briana; Ohlsson, Henrik

2015-01-01

Neighborhood walkability has been associated with increased physical activity, but only a few studies have explored the association between walkability and health outcomes related to physical activity, such as type 2 diabetes. The aim of this study was to investigate the association between objectively assessed neighborhood walkability and the 4-year incidence of type 2 diabetes in a sample of 512,061 Swedish adults aged 18 years and older. Neighborhoods were defined by 408 administratively defined geographical areas in the city of Stockholm. We found a negative association between walkability and type 2 diabetes (OR=1.33, 95% CI=1.13-1.55) that remained significant after adjusting for neighborhood deprivation. This association, however, no longer remained statistically significant after adjusting for individual socio-demographic factors. These results were also confirmed using a co-sibling design. Future studies are encouraged to further explore the potential effect of a broader array of the neighborhood built environment on health outcomes related to physical activity. Copyright © 2014 Elsevier Ltd. All rights reserved.

Association between neighbourhood walkability and metabolic risk factors influenced by physical activity: a cross-sectional study of adults in Toronto, Canada.

PubMed

Loo, C K Jennifer; Greiver, Michelle; Aliarzadeh, Babak; Lewis, Daniel

2017-04-08

To determine whether neighbourhood walkability is associated with clinical measures of obesity, hypertension, diabetes and dyslipidaemia in an urban adult population. Observational cross-sectional study. Urban primary care patients. 78 023 Toronto residents, aged 18 years and over, who were formally rostered or had at least 2 visits between 2012 and 2014 with a primary care physician participating in the University of Toronto Practice Based Research Network (UTOPIAN), within the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). Differences in average body mass index (BMI), systolic and diastolic blood pressure, fasting blood glucose, haemoglobin A1c (HbA1C), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and triglyceride between residents in the highest versus the lowest quartile of neighbourhood walkability, as estimated using multivariable linear regression models and stratified by age. Outcomes were objectively measured and were retrieved from primary care electronic medical records. Models adjusted for age, sex, smoking, medications, medical comorbidities and indices of neighbourhood safety and marginalisation. Compared with those in the lowest walkability quartile, individuals in the highest quartile had lower mean BMI (-2.64 kg/m 2 , 95% CI -2.98 to -2.30; p<0.001), systolic blood pressure (-1.35 mm Hg, 95% CI -2.01 to -0.70; p<0.001), diastolic blood pressure (-0.60 mm Hg, 95% CI 1.06 to -0.14; p=0.010) and HbA1c (-0.063%, 95% CI -0.11 to -0.021; p=0.003) and higher mean HDL (0.052 mmol/L, 95% CI 0.029 to 0.075; p<0.001). In age-stratified analyses, differences in the mean BMI were consistently observed for adults aged 18 to under 40 (-4.44 kg/m 2 , 95% CI -5.09 to -3.79; p<0.001), adults aged 40-65 (-2.74 kg/m 2 , 95% CI -3.24 to -2.23; p<0.001) and adults aged over 65 (-0.87 kg/m 2 , 95% CI -1.48 to -0.26; p=0.005). There was a clinically meaningful association between living in the most

Association between neighbourhood walkability and metabolic risk factors influenced by physical activity: a cross-sectional study of adults in Toronto, Canada

PubMed Central

Loo, C K Jennifer; Greiver, Michelle; Aliarzadeh, Babak; Lewis, Daniel

2017-01-01

Objective To determine whether neighbourhood walkability is associated with clinical measures of obesity, hypertension, diabetes and dyslipidaemia in an urban adult population. Design Observational cross-sectional study. Setting Urban primary care patients. Participants 78 023 Toronto residents, aged 18 years and over, who were formally rostered or had at least 2 visits between 2012 and 2014 with a primary care physician participating in the University of Toronto Practice Based Research Network (UTOPIAN), within the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). Main outcome measures Differences in average body mass index (BMI), systolic and diastolic blood pressure, fasting blood glucose, haemoglobin A1c (HbA1C), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and triglyceride between residents in the highest versus the lowest quartile of neighbourhood walkability, as estimated using multivariable linear regression models and stratified by age. Outcomes were objectively measured and were retrieved from primary care electronic medical records. Models adjusted for age, sex, smoking, medications, medical comorbidities and indices of neighbourhood safety and marginalisation. Results Compared with those in the lowest walkability quartile, individuals in the highest quartile had lower mean BMI (−2.64 kg/m2, 95% CI −2.98 to −2.30; p<0.001), systolic blood pressure (−1.35 mm Hg, 95% CI −2.01 to −0.70; p<0.001), diastolic blood pressure (−0.60 mm Hg, 95% CI 1.06 to −0.14; p=0.010) and HbA1c (−0.063%, 95% CI −0.11 to −0.021; p=0.003) and higher mean HDL (0.052 mmol/L, 95% CI 0.029 to 0.075; p<0.001). In age-stratified analyses, differences in the mean BMI were consistently observed for adults aged 18 to under 40 (−4.44 kg/m2, 95% CI −5.09 to −3.79; p<0.001), adults aged 40–65 (−2.74 kg/m2, 95% CI −3.24 to −2.23; p<0.001) and adults aged over 65 (−0.87 kg/m2, 95% CI −1

Polygenic risk predicts obesity in both white and black young adults.

PubMed

Domingue, Benjamin W; Belsky, Daniel W; Harris, Kathleen Mullan; Smolen, Andrew; McQueen, Matthew B; Boardman, Jason D

2014-01-01

To test transethnic replication of a genetic risk score for obesity in white and black young adults using a national sample with longitudinal data. A prospective longitudinal study using the National Longitudinal Study of Adolescent Health Sibling Pairs (n = 1,303). Obesity phenotypes were measured from anthropometric assessments when study members were aged 18-26 and again when they were 24-32. Genetic risk scores were computed based on published genome-wide association study discoveries for obesity. Analyses tested genetic associations with body-mass index (BMI), waist-height ratio, obesity, and change in BMI over time. White and black young adults with higher genetic risk scores had higher BMI and waist-height ratio and were more likely to be obese compared to lower genetic risk age-peers. Sibling analyses revealed that the genetic risk score was predictive of BMI net of risk factors shared by siblings. In white young adults only, higher genetic risk predicted increased risk of becoming obese during the study period. In black young adults, genetic risk scores constructed using loci identified in European and African American samples had similar predictive power. Cumulative information across the human genome can be used to characterize individual level risk for obesity. Measured genetic risk accounts for only a small amount of total variation in BMI among white and black young adults. Future research is needed to identify modifiable environmental exposures that amplify or mitigate genetic risk for elevated BMI.

Walkability of local communities: using geographic information systems to objectively assess relevant environmental attributes.

PubMed

Leslie, Eva; Coffee, Neil; Frank, Lawrence; Owen, Neville; Bauman, Adrian; Hugo, Graeme

2007-03-01

Geographic Information Systems (GIS) can be used to objectively measure features of the built environment that may influence adults' physical activity, which is an important determinant of chronic disease. We describe how a previously developed index of walkability was operationalised in an Australian context, using available spatial data. The index was used to generate a stratified sampling frame for the selection of households from 32 communities for the PLACE (Physical Activity in Localities and Community Environments) study. GIS data have the potential to be used to construct measures of environmental attributes and to develop indices of walkability for cities, regions or local communities.

Path Analysis of Campus Walkability/Bikeability and College Students' Physical Activity Attitudes, Behaviors, and Body Mass Index.

PubMed

Horacek, Tanya M; Dede Yildirim, E; Kattelmann, K; Brown, O; Byrd-Bredbenner, C; Colby, S; Greene, G; Hoerr, S; Kidd, T; Koenings, M M; Morrell, J; Olfert, M D; Phillips, B; Shelnutt, K; White, A

2018-03-01

The purpose of this study was to assess the relationship between the walkability/bikeability of college campuses and students' body mass index (BMI) with student physical activity (PA) attitudes and behaviors as potential mediators. Cross-sectional. Thirteen university campuses. A total of 1384 student participants. Walkability/bikeability environmental score (ES): 12-item audit assessed an average of 44 path segments per campus. Students were measured for height and weight and completed online surveys. Physical activity stage of change/behavior intentions were assessed using the transtheoretical model. The Cognitive Behavioral Physical Activity Questionnaire assessed outcome expectations, self-regulation, and personal barriers. International Physical Activity Questionnaire assessed walking-, moderate-, and vigorous-intensity PA. Descriptive statistics, zero-order correlations, and path analysis with maximum likelihood estimation. The overall model fit was good with χ 2 of 171.388 ( df = 18), P < .001, comparative fit index value of .95, and a root mean square of approximation of .079. After controlling for gender, there was a direct negative association between walkability/bikeability ES and BMI (β = -.085) and positive association between personal barriers and BMI (β = .134). Walkability/bikeability ES was positively associated with walking-intensity PA (β = .010). Self-regulation was positively associated with moderate-intensity PA (β = .213), which, in turn, was negatively associated with BMI (β = -.057). The ease of walking and biking on a campus was related to college students' walking behavior and their BMI. Students' PA behavioral intentions were associated with moderate PA and lower BMI. These results provide evidence to focus on policies and structural supports for walkable/bikeable environments to supplement and enhance interventions encouraging individual behavior change for PA and weight management.

Food outlet visits, physical activity and body weight: variations by gender and race-ethnicity.

PubMed

Frank, L; Kerr, J; Saelens, B; Sallis, J; Glanz, K; Chapman, J

2009-02-01

Recent evidence documents significant associations between community design, physical activity and obesity when adjusting for demographic covariates. Yet it is well understood that energy imbalance and weight gain are also a function of dietary patterns, and perhaps the degree of access to healthy food choices. The current study builds upon the Atlanta-based SMARTRAQ study of over 10,000 respondents and reports an integrated assessment of obesity impacts of physical activity and food outlet visitation. Respondents in the SMARTRAQ survey aged 25-65 provided BMI, self-reported physical activity levels (IPAQ), demographic factors, and where they went for food over a 2 day period. The relative effect of physical activity, neighbourhood walkability, and food outlet visitation on BMI differed significantly across gender and ethnicity. BMI in females increased with fast food and decreased with grocery store visitation and physical activity, but not with walkability or walking. BMI in males was not related to where they went for food but decreased with walking and overall physical activity and with walkability. Fast food visitation was associated with increased BMI in white respondents and grocery store visitation with decreased BMI in black respondents. Meeting moderate activity guidelines was associated with lower BMI in both black and white respondents, yet walking was only significant in predicting reduced BMI in white respondents. Obesity influences of physical activity, walkability, and where people go for food differ significantly across gender and ethnicity and offer important policy implications and insights for future research.

[What are the determinants of childhood obesity? : A literature review as part of the project "Nationwide Monitoring of Childhood Obesity Determinants"].

PubMed

Zeiher, Johannes; Varnaccia, Gianni; Jordan, Susanne; Lange, Cornelia

2016-11-01

Obesity can impair health even in childhood and unfold negative health consequences through an individual's lifespan. In Germany, to date, a systematic and periodically updated synopsis of the multifaceted determinants of childhood obesity is lacking. In this paper, we present the results of a systematic literature review on childhood obesity determinants, which was conducted over the course of the implementation of nationwide monitoring. The review was carried out in three steps. Initially, a search for etiological models of childhood obesity was conducted. Based on these results, a systematic review of reviews on childhood obesity determinants was carried out. Finally, the results were verified by taking international guidelines on childhood obesity into account. In total, 21 etiological models, 75 reviews and 7 guidelines were identified. Over 60 determinants were extracted from these publications and were summarized into the following categories: nutritional behavior, physical activity behavior, sleeping pattern, biological determinants and diseases, prenatal and early childhood determinants, psycho-social determinants, food environment, moveability/walkability, setting and social environment, health promotion and prevention, socioeconomic, demographic, and sociocultural determinants. This review demonstrates the complex patterns of childhood obesity determinants in correspondence with a socio-ecological approach. The review will form the basis for the monitoring-system "Nationwide Monitoring of Childhood Obesity Determinants", which will be implemented at the Robert Koch Institute by the end of 2017.

Childhood obesity: are we missing the big picture?

PubMed

Maziak, W; Ward, K D; Stockton, M B

2008-01-01

Childhood obesity is increasing worldwide, raising alarm about future trends of cardiovascular disease, diabetes and cancer. This article discusses what may underlie our failure to respond effectively to the obesity epidemic, and presents a wider perspective for future research and public health agendas. So far targeting individual-level determinants and clinical aspects of childhood obesity has produced limited success. There is growing interest in understanding the wider determinants of obesity such as the built environment (e.g. walkability), social interactions, food marketing and prices, but much needs to be learned. Particularly, we need to identify distal modifiable factors with multiple potential that would make them attractive for people and policymakers alike. For example, walking-biking-friendly cities can reduce obesity as well as energy consumption, air pollution and traffic delays. Such agenda needs to be driven by strong evidence from research involving multi-level influences on behaviour, as well as the study of wider politico-economic trends affecting people's choices. This article highlights available evidence and arguments for research and policy needed to curb the obesity epidemic. The upstream approach underlying these arguments aims to make healthy choices not only the most rational, but also the most feasible and affordable.

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

PubMed

Congdon, Peter

2017-09-07

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.

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

PubMed Central

2017-01-01

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. PMID:28880209

Does walkable neighbourhood design influence the association between objective crime and walking?

PubMed

Foster, Sarah; Knuiman, Matthew; Villanueva, Karen; Wood, Lisa; Christian, Hayley; Giles-Corti, Billie

2014-07-26

Few studies have investigated associations between objectively measured crime and walking, and findings are mixed. One explanation for null or counterintuitive findings emerges from criminology studies, which indicate that the permeable street layouts and non-residential land uses that underpin walkable neighbourhoods are also associated with more crime. This study examined associations between objective crime and walking, controlling for the characteristics of walkable neighbourhoods. A population representative sample of adults (25-65 years) (n = 3,487) completed the Western Australian Health and Wellbeing Survey (2006-2008) demographic and walking frequency items. Objective environmental measures were generated for each participant's 400 m and 1600 m neighbourhood areas, including burglary, personal crime (i.e., crimes committed against people) in public space, residential density, street connectivity and local destinations. Log-linear negative binomial regression models were used to examine associations between crime and walking frequency/week, with progressive adjustment for residential density, street connectivity and local destinations. Burglary and personal crime occurring within a participant's 400 m and 1600 m neighbourhoods were positively and significantly associated with walking frequency. For example, for every additional 10 crimes against the person/year within 400 m of a participant's home, walking frequency increased by 8% (relative change = 1.077, p = 0.017). Associations remained constant after controlling for residential density and street connectivity, but attenuated after adjusting for local destinations (e.g., for personal crime in 400 m: relative change = 1.054, p = 0.104). This pattern of attenuation was evident across both crime categories and both neighbourhood sizes. The observed positive associations between objective crime and walking appear to be a function of living in a more walkable environment, as the presence

Walkable home neighbourhood food environment and children's overweight and obesity: Proximity, density or price?

PubMed

Le, Ha; Engler-Stringer, Rachel; Muhajarine, Nazeem

2016-06-09

To identify characteristics of the food environment associated with child overweight/obesity that could, if subjected to intervention, mitigate the risk of childhood overweight/obesity. We examined whether the proximity to or density of grocery and convenience stores or fast food restaurants, or the prices of healthy food options were more strongly associated with overweight/obesity risk in children. We collected geocoded data by residential addresses for 1,469 children aged 10-14 years and conducted a census of all food outlets in Saskatoon. The Nutrition Environment Measures Survey (NEMS)-Stores and the NEMS-Restaurants were used to measure availability, quality and relative price of healthy food items in stores and restaurants. Children's weight status was calculated on the basis of measured height and weight. Logistic regression was used to test the associations between overweight/obesity and food environment variables. Within an 800 m walking distance from home, 76% of children did not have access to a grocery store; 58% and 32% had access to at least one convenience store or one fast-food restaurant respectively. A significantly lower odds of overweight/obesity was associated with lower price of healthy food items/options in grocery stores (odds ratio [OR] = 0.87, 95% confidence interval [CI] 0.77-0.99) and fast-food restaurants (OR = 0.97, 95% CI 0.95-0.99) within walking distance of home. Neither the distance to the closest food outlet nor the density of food outlets around children's homes was associated with odds of overweight/obesity. Improving economic access to healthy food in food outlets or fast-food restaurants is one strategy to counter childhood overweight/ obesity.

Using simple agent-based modeling to inform and enhance neighborhood walkability.

PubMed

Badland, Hannah; White, Marcus; Macaulay, Gus; Eagleson, Serryn; Mavoa, Suzanne; Pettit, Christopher; Giles-Corti, Billie

2013-12-11

Pedestrian-friendly neighborhoods with proximal destinations and services encourage walking and decrease car dependence, thereby contributing to more active and healthier communities. Proximity to key destinations and services is an important aspect of the urban design decision making process, particularly in areas adopting a transit-oriented development (TOD) approach to urban planning, whereby densification occurs within walking distance of transit nodes. Modeling destination access within neighborhoods has been limited to circular catchment buffers or more sophisticated network-buffers generated using geoprocessing routines within geographical information systems (GIS). Both circular and network-buffer catchment methods are problematic. Circular catchment models do not account for street networks, thus do not allow exploratory 'what-if' scenario modeling; and network-buffering functionality typically exists within proprietary GIS software, which can be costly and requires a high level of expertise to operate. This study sought to overcome these limitations by developing an open-source simple agent-based walkable catchment tool that can be used by researchers, urban designers, planners, and policy makers to test scenarios for improving neighborhood walkable catchments. A simplified version of an agent-based model was ported to a vector-based open source GIS web tool using data derived from the Australian Urban Research Infrastructure Network (AURIN). The tool was developed and tested with end-user stakeholder working group input. The resulting model has proven to be effective and flexible, allowing stakeholders to assess and optimize the walkability of neighborhood catchments around actual or potential nodes of interest (e.g., schools, public transport stops). Users can derive a range of metrics to compare different scenarios modeled. These include: catchment area versus circular buffer ratios; mean number of streets crossed; and modeling of different walking

Using simple agent-based modeling to inform and enhance neighborhood walkability

PubMed Central

2013-01-01

Background Pedestrian-friendly neighborhoods with proximal destinations and services encourage walking and decrease car dependence, thereby contributing to more active and healthier communities. Proximity to key destinations and services is an important aspect of the urban design decision making process, particularly in areas adopting a transit-oriented development (TOD) approach to urban planning, whereby densification occurs within walking distance of transit nodes. Modeling destination access within neighborhoods has been limited to circular catchment buffers or more sophisticated network-buffers generated using geoprocessing routines within geographical information systems (GIS). Both circular and network-buffer catchment methods are problematic. Circular catchment models do not account for street networks, thus do not allow exploratory ‘what-if’ scenario modeling; and network-buffering functionality typically exists within proprietary GIS software, which can be costly and requires a high level of expertise to operate. Methods This study sought to overcome these limitations by developing an open-source simple agent-based walkable catchment tool that can be used by researchers, urban designers, planners, and policy makers to test scenarios for improving neighborhood walkable catchments. A simplified version of an agent-based model was ported to a vector-based open source GIS web tool using data derived from the Australian Urban Research Infrastructure Network (AURIN). The tool was developed and tested with end-user stakeholder working group input. Results The resulting model has proven to be effective and flexible, allowing stakeholders to assess and optimize the walkability of neighborhood catchments around actual or potential nodes of interest (e.g., schools, public transport stops). Users can derive a range of metrics to compare different scenarios modeled. These include: catchment area versus circular buffer ratios; mean number of streets crossed; and

Determination of The Walkability Comfort For Urban Green Space Using GIS

NASA Astrophysics Data System (ADS)

Unal, M.; Uslu, C.; Altunkasa, M. F.

2016-12-01

Walkability relates to the ability of the places to connect people with varied destinations within a reasonable amount of time and effort, and to offer visual interest in journeys throughout the network. So, the good quality of the physical environment and arrangement of walkway and sidewalk appear to be more crucial in influencing the pedestrian route choice. Also, proximity, connectivity, and accessibility are significant factor for walkability in terms of an equal opportunity for using public spaces. As a result, there are two important points for walkability. Firstly the place should have a well-planned street network for accessible and secondly facilitate the pedestrian need for comfort. In this respect, this study aims to examine the both physical and bioclimatic comfort levels of the current condition of pedestrian route with reference to design criteria of a street to access the urban green spaces. These aspects have been identified as the main indicators for walkable streets such as continuity, materials, slope, bioclimatic condition, walkway width, greenery, and surface. Additionally, the aim was to identify the factors that need to be considered in future guidelines and policies for planning and design in urban spaces especially streets. So, a popular and most densely used neighbourhood park (Hayal Park) in Adana city were chosen as a study area. Adana is a province of Turkey located in south-central Anatolia. With a population of 2.2 million, it is the sixth most populous province in Turkey. This study workflow can be summarized in four stages: (1) environmental and physical data were collected by referred to literature and used in a weighted criteria method to determine the importance level of these data , (2) environmental characteristics of pedestrian routes gained from survey studies are evaluated to hierarchies these criteria of the collected information, (3) and then each pedestrian routes will have a score that provides comfortable access to the

Getting to Know a Place: Built Environment Walkability and Children's Spatial Representation of Their Home-School (h-s) Route.

PubMed

Moran, Mika R; Eizenberg, Efrat; Plaut, Pnina

2017-06-06

The literature on environmental walkability to date has mainly focused on walking and related health outcomes. While previous studies suggest associations between walking and spatial knowledge, the associations between environmental walkability and spatial knowledge is yet to be explored. The current study addresses this lacuna in research by exploring children's mental representations of their home-school (h-s) route, vis.

Local descriptive norms for overweight/obesity and physical inactivity, features of the built environment, and 10-year change in glycosylated haemoglobin in an Australian population-based biomedical cohort.

PubMed

Carroll, Suzanne J; Paquet, Catherine; Howard, Natasha J; Coffee, Neil T; Taylor, Anne W; Niyonsenga, Theo; Daniel, Mark

2016-10-01

Descriptive norms vary between places. Spatial variation in health-related descriptive norms may predict individual-level health outcomes. Such relationships have rarely been investigated. This study assessed 10-year change in glycosylated haemoglobin (HbA1c) in relation to local descriptive norms for overweight/obesity (n = 1890) and physical inactivity (n = 1906) in models accounting for features of the built environment. HbA1c was measured three times over 10 years for a population-based biomedical cohort of adults in Adelaide, South Australia. Environmental exposures were expressed for cohort participants using 1600 m road-network buffers centred on participants' residential address. Local descriptive norms (prevalence of overweight/obesity [body mass index ≥25 kg/m(2)] and of physical inactivity [<150 min/week]) were aggregated from responses to a separate geocoded population survey. Built environment measures were public open space (POS) availability (proportion of buffer area) and walkability. Separate sets of multilevel models analysed different predictors of 10-year change in HbA1c. Each model featured one local descriptive norm and one built environment variable with area-level education and individual-level covariates (age, sex, employment status, education, marital status, and smoking status). Interactions between local descriptive norms and built environment measures were assessed. HbA1c increased over time. POS availability and local descriptive norms for overweight/obesity and physical inactivity were each associated with greater rates of HbA1c increase. Greater walkability was associated with a reduced rate of HbA1c increase, and reduced the influence of the overweight/obesity norm on the rate of increase in HbA1c. Local descriptive health-related norms and features of the built environment predict 10-year change in HbA1c. The impact of local descriptive norms can vary according to built environment features. Little researched thus far

Walkability parameters, active transportation and objective physical activity: moderating and mediating effects of motor vehicle ownership in a cross-sectional study

PubMed Central

2012-01-01

Background Neighborhood walkability has been associated with physical activity in several studies. However, as environmental correlates of physical activity may be context specific, walkability parameters need to be investigated separately in various countries and contexts. Furthermore, the mechanisms by which walkability affects physical activity have been less investigated. Based on previous research, we hypothesized that vehicle ownership is a potential mediator. We investigated the associations between walkability parameters and physical activity, and the mediating and moderating effects of vehicle ownership on these associations in a large sample of Swedish adults. Methods Residential density, street connectivity and land use mix were assessed within polygon-based network buffers (using Geographic Information Systems) for 2,178 men and women. Time spent in moderate to vigorous physical activity was assessed by accelerometers, and walking and cycling for transportation were assessed by the International Physical Activity Questionnaire. Associations were examined by linear regression and adjusted for socio-demographic characteristics. The product of coefficients approach was used to investigate the mediating effect of vehicle ownership. Results Residential density and land use mix, but not street connectivity, were significantly associated with time spent in moderate to vigorous physical activity and walking for transportation. Cycling for transportation was not associated with any of the walkability parameters. Vehicle ownership mediated a significant proportion of the association between the walkability parameters and physical activity outcomes. For residential density, vehicle ownership mediated 25% of the association with moderate to vigorous physical activity and 20% of the association with the amount of walking for transportation. For land use mix, the corresponding proportions were 34% and 14%. Vehicle ownership did not moderate any of the associations

Walkability parameters, active transportation and objective physical activity: moderating and mediating effects of motor vehicle ownership in a cross-sectional study.

PubMed

Eriksson, Ulf; Arvidsson, Daniel; Gebel, Klaus; Ohlsson, Henrik; Sundquist, Kristina

2012-10-05

Neighborhood walkability has been associated with physical activity in several studies. However, as environmental correlates of physical activity may be context specific, walkability parameters need to be investigated separately in various countries and contexts. Furthermore, the mechanisms by which walkability affects physical activity have been less investigated. Based on previous research, we hypothesized that vehicle ownership is a potential mediator. We investigated the associations between walkability parameters and physical activity, and the mediating and moderating effects of vehicle ownership on these associations in a large sample of Swedish adults. Residential density, street connectivity and land use mix were assessed within polygon-based network buffers (using Geographic Information Systems) for 2,178 men and women. Time spent in moderate to vigorous physical activity was assessed by accelerometers, and walking and cycling for transportation were assessed by the International Physical Activity Questionnaire. Associations were examined by linear regression and adjusted for socio-demographic characteristics. The product of coefficients approach was used to investigate the mediating effect of vehicle ownership. Residential density and land use mix, but not street connectivity, were significantly associated with time spent in moderate to vigorous physical activity and walking for transportation. Cycling for transportation was not associated with any of the walkability parameters. Vehicle ownership mediated a significant proportion of the association between the walkability parameters and physical activity outcomes. For residential density, vehicle ownership mediated 25% of the association with moderate to vigorous physical activity and 20% of the association with the amount of walking for transportation. For land use mix, the corresponding proportions were 34% and 14%. Vehicle ownership did not moderate any of the associations between the walkability

The contribution of area-level walkability to geographic variation in physical activity: a spatial analysis of 95,837 participants from the 45 and Up Study living in Sydney, Australia.

PubMed

Mayne, Darren J; Morgan, Geoffrey G; Jalaludin, Bin B; Bauman, Adrian E

2017-10-03

Individual-level studies support a positive relation between walkable built environments and participation in moderate-intensity walking. However, the utility of this evidence for population-level planning is less clear as it is derived at much finer spatial scales than those used for regional programming. The aims of this study were to: evaluate if individual-level relations between walkability and walking to improve health manifest at population-level spatial scales; assess the specificity of area-level walkability for walking relative to other moderate and vigorous physical activity (MVPA); describe geographic variation in walking and other MVPA; and quantify the contribution of walkability to this variation. Data on sufficient walking, sufficient MVPA, and high MVPA to improve health were analyzed for 95,837 Sydney respondents to the baseline survey of the 45 and Up Study between January 2006 and April 2010. We used conditional autoregressive models to create smoothed MVPA "disease maps" and assess relations between sufficient MVPA to improve health and area-level walkability adjusted for individual-level demographic, socioeconomic, and health factors, and area-level relative socioeconomic disadvantage. Within-cohort prevalence of meeting recommendations for sufficient walking, sufficient MVPA, and high MVPA were 31.7 (95% CI 31.4-32.0), 69.4 (95% CI 69.1-69.7), and 56.1 (95% CI 55.8-56.4) percent. Prevalence of sufficient walking was increased by 1.20 (95% CrI 1.12-1.29) and 1.07 (95% CrI 1.01-1.13) for high and medium-high versus low walkability postal areas, and for sufficient MVPA by 1.05 (95% CrI 1.01-1.08) for high versus low walkability postal areas. Walkability was not related to high MVPA. Postal area walkability explained 65.8 and 47.4 percent of residual geographic variation in sufficient walking and sufficient MVPA not attributable to individual-level factors. Walkability is associated with area-level prevalence and geographic variation in

The impact of neighborhood walkability on walking: does it differ across adult life stage and does neighborhood buffer size matter?

PubMed

Villanueva, Karen; Knuiman, Matthew; Nathan, Andrea; Giles-Corti, Billie; Christian, Hayley; Foster, Sarah; Bull, Fiona

2014-01-01

We explored the impact of neighborhood walkability on young adults, early-middle adults, middle-aged adults, and older adults' walking across different neighborhood buffers. Participants completed the Western Australian Health and Wellbeing Surveillance System Survey (2003-2009) and were allocated a neighborhood walkability score at 200m, 400m, 800m, and 1600m around their home. We found little difference in strength of associations across neighborhood size buffers for all life stages. We conclude that neighborhood walkability supports more walking regardless of adult life stage and is relevant for small (e.g., 200m) and larger (e.g., 1600m) neighborhood buffers. © 2013 The Authors. Published by Elsevier Ltd All rights reserved.

Walking and Walkability: Is Wayfinding a Missing Link? Implications for Public Health Practice.

PubMed

Vandenberg, Ann E; Hunter, Rebecca H; Anderson, Lynda A; Bryant, Lucinda L; Hooker, Steven P; Satariano, William A

2016-02-01

Research on walking and walkability has yet to focus on wayfinding, the interactive, problem-solving process by which people use environmental information to locate themselves and navigate through various settings. We reviewed the literature on outdoor pedestrian-oriented wayfinding to examine its relationship to walking and walkability, 2 areas of importance to physical activity promotion. Our findings document that wayfinding is cognitively demanding and can compete with other functions, including walking itself. Moreover, features of the environment can either facilitate or impede wayfinding, just as environmental features can influence walking. Although there is still much to be learned about wayfinding and walking behaviors, our review helps frame the issues and lays out the importance of this area of research and practice.

Models Predictive of Metabolic Syndrome Components in Obese Pediatric Patients.

PubMed

Ortega-Cortes, Rosa; Trujillo, Xóchitl; Hurtado López, Erika Fabiola; López Beltrán, Ana Laura; Colunga Rodríguez, Cecilia; Barrera-de Leon, Juan Carlos; Tlacuilo-Parra, Alberto

2016-01-01

Components of metabolic syndrome (MetS) are complications caused by abdominal obesity and insulin resistance (IR). Diagnosis of MetS by clinical indicators could help to identify patients at risk of cardiovascular disease and type 2 diabetes. We undertook this study to propose predictive indicators of MetS in obese children and adolescents. A cross-sectional study was carried out. After obtaining informed consent and the registration of the study with an institutional research committee, 172 obese patients from an Obesity Clinic, aged 6-15 years, were included. Variables included were waist circumference (WC), glucose, high-density lipoprotein (HDL), triglycerides (TGL), blood pressure, insulin resistance (by homeostatic model assessment HOMA-index), acanthosis nigricans (AN), uric acid, serum glutamic oxaloacetic transaminase (GOT) and alanine transaminase, and hepatic sonogram. International standards for age and sex variables were used. Multivariate analysis was applied. Variables predicted components of MetS in children: HOMA-IR (insulin resistance by HOMA index) was increased by 2.4 in hepatic steatosis, by 0.6 for each unit of SUA (serum uric acid), and by 0.009 for every mg/dL of triglycerides. In adolescents, every cm of waist circumference increased systolic blood pressure by 0.6 mmHg, and each unit of SUA increased it by 2.9 mmHg. Serum uric acid and waist circumference are useful and accessible variables that can predict an increased risk of cardiovascular disease in obese pediatric patients. Copyright © 2016 IMSS. Published by Elsevier Inc. All rights reserved.

Predictive equations for central obesity via anthropometrics, stereovision imaging and MRI in adults.

PubMed

Lee, Jane J; Freeland-Graves, Jeanne H; Pepper, M Reese; Yao, Ming; Xu, Bugao

2014-03-01

Abdominal visceral adiposity is related to risks for insulin resistance and metabolic perturbations. Magnetic resonance imaging (MRI) and computed tomography are advanced instruments that quantify abdominal adiposity; yet field use is constrained by their bulkiness and costliness. The purpose of this study is to develop prediction equations for total abdominal, subcutaneous, and visceral adiposity via anthropometrics, stereovision body imaging (SBI), and MRI. Participants (67 men and 55 women) were measured for anthropometrics and abdominal adiposity volumes evaluated by MRI umbilicus scans. Body circumferences and central obesity were obtained via SBI. Prediction models were developed via multiple linear regression analysis, utilizing body measurements and demographics as independent predictors, and abdominal adiposity as a dependent variable. Cross-validation was performed by the data-splitting method. The final total abdominal adiposity prediction equation was -470.28 + 7.10 waist circumference - 91.01 gender + 5.74 sagittal diameter (R2 = 89.9%), subcutaneous adiposity was -172.37 + 8.57 waist circumference - 62.65 gender - 450.16 stereovision waist-to-hip ratio (R2 =90.4%), and visceral adiposity was -96.76 + 11.48 central obesity depth - 5.09 central obesity width + 204.74 stereovision waist-to-hip ratio - 18.59 gender (R2 = 71.7%). R2 significantly improved for predicting visceral fat when SBI variables were included, but not for total abdominal or subcutaneous adiposity. SBI is effective for predicting visceral adiposity and the prediction equations derived from SBI measurements can assess obesity. Copyright © 2013 The Obesity Society.

Evaluation of the neighborhood environment walkability scale in Nigeria.

PubMed

Oyeyemi, Adewale L; Sallis, James F; Deforche, Benedicte; Oyeyemi, Adetoyeje Y; De Bourdeaudhuij, Ilse; Van Dyck, Delfien

2013-03-21

The development of reliable and culturally sensitive measures of attributes of the built and social environment is necessary for accurate analysis of environmental correlates of physical activity in low-income countries, that can inform international evidence-based policies and interventions in the worldwide prevention of physical inactivity epidemics. This study systematically adapted the Neighborhood Environment Walkability Scale (NEWS) for Nigeria and evaluated aspects of reliability and validity of the adapted version among Nigerian adults. The adaptation of the NEWS was conducted by African and international experts, and final items were selected for NEWS-Nigeria after a cross-validation of the confirmatory factor analysis structure of the original NEWS. Participants (N = 386; female = 47.2%) from two cities in Nigeria completed the adapted NEWS surveys regarding perceived residential density, land use mix - diversity, land use mix - access, street connectivity, infrastructure and safety for walking and cycling, aesthetics, traffic safety, and safety from crime. Self-reported activity for leisure, walking for different purposes, and overall physical activity were assessed with the validated International Physical Activity Questionnaire (long version). The adapted NEWS subscales had moderate to high test-retest reliability (ICC range 0.59 -0.91). Construct validity was good, with residents of high-walkable neighborhoods reporting significantly higher residential density, more land use mix diversity, higher street connectivity, more traffic safety and more safety from crime, but lower infrastructure and safety for walking/cycling and aesthetics than residents of low-walkable neighborhoods. Concurrent validity correlations were low to moderate (r = 0.10 -0.31) with residential density, land use mix diversity, and traffic safety significantly associated with most physical activity outcomes. The NEWS-Nigeria demonstrated acceptable measurement

Urban residential environments and senior citizens' longevity in megacity areas: the importance of walkable green spaces.

PubMed

Takano, T; Nakamura, K; Watanabe, M

2002-12-01

To study the association between greenery filled public areas that are nearby a residence and easy to walk in and the longevity of senior citizens in a densely populated, developed megacity. Cohort study. The authors analysed the five year survival of 3144 people born in 1903, 1908, 1913, or 1918 who consented to a follow up survey from the records of registered Tokyo citizens in relation to baseline residential environment characteristics in 1992. The survival of 2211 and the death of 897 (98.9% follow up) were confirmed. The probability of five year survival of the senior citizens studied increased in accordance with the space for taking a stroll near the residence (p<0.01), parks and tree lined streets near the residence (p<0.05), and their preference to continue to live in their current community (p<0.01). The principal component analysis from the baseline residential environment characteristics identified two environment related factors: the factor of walkable green streets and spaces near the residence and the factor of a positive attitude to a person's own community. After controlling the effects of the residents' age, sex, marital status, and socioeconomic status, the factor of walkable green streets and spaces near the residence showed significant predictive value for the survival of the urban senior citizens over the following five years (p<0.01). Living in areas with walkable green spaces positively influenced the longevity of urban senior citizens independent of their age, sex, marital status, baseline functional status, and socioeconomic status. Greenery filled public areas that are nearby and easy to walk in should be further emphasised in urban planning for the development and re-development of densely populated areas in a megacity. Close collaboration should be undertaken among the health, construction, civil engineering, planning, and other concerned sectors in the context of the healthy urban policy, so as to promote the health of senior citizens.

Urban residential environments and senior citizens' longevity in megacity areas: the importance of walkable green spaces

PubMed Central

Takano, T; Nakamura, K; Watanabe, M

2002-01-01

Study objectives: To study the association between greenery filled public areas that are nearby a residence and easy to walk in and the longevity of senior citizens in a densely populated, developed megacity. Design: Cohort study. Methods: The authors analysed the five year survival of 3144 people born in 1903, 1908, 1913, or 1918 who consented to a follow up survey from the records of registered Tokyo citizens in relation to baseline residential environment characteristics in 1992. Main results: The survival of 2211 and the death of 897 (98.9% follow up) were confirmed. The probability of five year survival of the senior citizens studied increased in accordance with the space for taking a stroll near the residence (p<0.01), parks and tree lined streets near the residence (p<0.05), and their preference to continue to live in their current community (p<0.01). The principal component analysis from the baseline residential environment characteristics identified two environment related factors: the factor of walkable green streets and spaces near the residence and the factor of a positive attitude to a person's own community. After controlling the effects of the residents' age, sex, marital status, and socioeconomic status, the factor of walkable green streets and spaces near the residence showed significant predictive value for the survival of the urban senior citizens over the following five years (p<0.01). Conclusions: Living in areas with walkable green spaces positively influenced the longevity of urban senior citizens independent of their age, sex, marital status, baseline functional status, and socioeconomic status. Greenery filled public areas that are nearby and easy to walk in should be further emphasised in urban planning for the development and re-development of densely populated areas in a megacity. Close collaboration should be undertaken among the health, construction, civil engineering, planning, and other concerned sectors in the context of the healthy

Does walkable neighbourhood design influence the association between objective crime and walking?

PubMed Central

2014-01-01

Background Few studies have investigated associations between objectively measured crime and walking, and findings are mixed. One explanation for null or counterintuitive findings emerges from criminology studies, which indicate that the permeable street layouts and non-residential land uses that underpin walkable neighbourhoods are also associated with more crime. This study examined associations between objective crime and walking, controlling for the characteristics of walkable neighbourhoods. Methods A population representative sample of adults (25–65 years) (n = 3,487) completed the Western Australian Health and Wellbeing Survey (2006–2008) demographic and walking frequency items. Objective environmental measures were generated for each participant’s 400 m and 1600 m neighbourhood areas, including burglary, personal crime (i.e., crimes committed against people) in public space, residential density, street connectivity and local destinations. Log-linear negative binomial regression models were used to examine associations between crime and walking frequency/week, with progressive adjustment for residential density, street connectivity and local destinations. Results Burglary and personal crime occurring within a participant’s 400 m and 1600 m neighbourhoods were positively and significantly associated with walking frequency. For example, for every additional 10 crimes against the person/year within 400 m of a participant’s home, walking frequency increased by 8% (relative change = 1.077, p = 0.017). Associations remained constant after controlling for residential density and street connectivity, but attenuated after adjusting for local destinations (e.g., for personal crime in 400 m: relative change = 1.054, p = 0.104). This pattern of attenuation was evident across both crime categories and both neighbourhood sizes. Conclusions The observed positive associations between objective crime and walking appear to be a function of

Shortened Sleep Duration does not Predict Obesity in Adolescents

PubMed Central

Calamaro, Christina J.; Park, Sunhee; Mason, Thornton B. A.; Marcus, Carole L.; Weaver, Terri E.; Pack, Allan; Ratcliffe, Sarah J.

2010-01-01

Obesity continues to be a major public health issue. In adolescents, there are limited studies on the relationship between obesity and sleep duration. We hypothesied that average sleep duration of less than 6 hours in adolescents was associated with obesity. Data was from the National Longitudinal Study of Adolescent Health (ADD Health); survey of 90,000 youths, ages 12 – 18 years; surveyed in several waves. The sample population for our study was 13,568. Weighted multiple logistic regression was used to identify relationship between obesity at Wave II and sleep duration, having adjusted for skipping breakfast ≥ 2/week; race, gender, parental income, TV ≥ 2hrs/day, depression, and obesity at Wave I. At Wave I, mean age 15.96±0.11 yrs; mean sleep hours 7.91±0.04. 10.6% and 11.2% of adolescents were obese at Waves I and II, respectively. Adjusted analyses suggest that effect of shortened sleep duration in Wave I was not significantly predictive of obesity in Wave II (p<0.218).Longitudinally, depression and TV ≥ 2hrs/day at Wave I was associated with higher risk of obesity at Wave II in adjusted analyses. Depressed adolescents were almost twice as likely to be obese (OR=1.84, 95% CI=1.25–2.72); adolescents who watched TV ≥ 2hrs/day were 37% more likely to be obese (OR=1.37, 95% CI=1.09–1.72).Environmental factors including TV ≥ 2hrs/day and depression were significantly associated with obesity; shortened sleep duration was not. Future longitudinal studies in adolescents are needed to determine whether timing of television watching directly influences sleep patterns, and ultimately obesity. PMID:20545836

GPS-based exposure to greenness and walkability and accelerometry-based physical activity

PubMed Central

James, Peter; Hart, Jaime E.; Hipp, J. Aaron; Mitchell, Jonathan A.; Kerr, Jacqueline; Hurvitz, Philip M.; Glanz, Karen; Laden, Francine

2017-01-01

Background Physical inactivity is a risk factor for cancer that may be influenced by environmental factors. Indeed, dense and well-connected built environments and environments with natural vegetation may create opportunities for higher routine physical activity. However, studies have focused primarily on residential environments to define exposure and self-reported methods to estimate physical activity. The current study explores the momentary association between minute-level global positioning systems (GPS)-based greenness exposure and time-matched objectively measured physical activity. Methods Adult women were recruited from sites across the US. Participants wore a GPS device and accelerometer on the hip for 7 days to assess location and physical activity at minute-level epochs. GPS records were linked to 250m resolution satellite-based vegetation data and Census Block Group-level EPA Smart Location Database walkability data. Minute-level generalized additive mixed models were conducted to test for associations between GPS measures and accelerometer count data, accounting for repeated measures within participant and allowing for deviations from linearity using splines. Results Among 360 adult women (mean age of 55.3 ± 10.2 years), we observed positive nonlinear relationships between physical activity and both greenness and walkability. In exploratory analyses, the relationship between environmental factors and physical activity were strongest among those who were White, had higher incomes, and who were middle-aged. Conclusions Our results indicate that higher levels of physical activity occurred in areas with higher greenness and higher walkability. Impact Findings suggest that planning and design policies should focus on these environments to optimize opportunities for physical activity. PMID:28196848

Sex-specific lean body mass predictive equations are accurate in the obese paediatric population

PubMed Central

Jackson, Lanier B.; Henshaw, Melissa H.; Carter, Janet; Chowdhury, Shahryar M.

2015-01-01

Background The clinical assessment of lean body mass (LBM) is challenging in obese children. A sex-specific predictive equation for LBM derived from anthropometric data was recently validated in children. Aim The purpose of this study was to independently validate these predictive equations in the obese paediatric population. Subjects and methods Obese subjects aged 4–21 were analysed retrospectively. Predicted LBM (LBMp) was calculated using equations previously developed in children. Measured LBM (LBMm) was derived from dual-energy x-ray absorptiometry. Agreement was expressed as [(LBMm-LBMp)/LBMm] with 95% limits of agreement. Results Of 310 enrolled patients, 195 (63%) were females. The mean age was 11.8 ± 3.4 years and mean BMI Z-score was 2.3 ± 0.4. The average difference between LBMm and LBMp was −0.6% (−17.0%, 15.8%). Pearson’s correlation revealed a strong linear relationship between LBMm and LBMp (r=0.97, p<0.01). Conclusion This study validates the use of these clinically-derived sex-specific LBM predictive equations in the obese paediatric population. Future studies should use these equations to improve the ability to accurately classify LBM in obese children. PMID:26287383

Prediction of uncomplicated pregnancies in obese women: a prospective multicentre study.

PubMed

Vieira, Matias C; White, Sara L; Patel, Nashita; Seed, Paul T; Briley, Annette L; Sandall, Jane; Welsh, Paul; Sattar, Naveed; Nelson, Scott M; Lawlor, Debbie A; Poston, Lucilla; Pasupathy, Dharmintra

2017-11-03

All obese pregnant women are considered at equal high risk with respect to complications in pregnancy and birth, and are commonly managed through resource-intensive care pathways. However, the identification of maternal characteristics associated with normal pregnancy outcomes could assist in the management of these pregnancies. The present study aims to identify the factors associated with uncomplicated pregnancy and birth in obese women, and to assess their predictive performance. Data form obese women (BMI ≥ 30 kg/m 2 ) with singleton pregnancies included in the UPBEAT trial were used in this analysis. Multivariable logistic regression was used to identify sociodemographic, clinical and biochemical factors at 15 +0 to 18 +6 weeks' gestation associated with uncomplicated pregnancy and birth, defined as delivery of a term live-born infant without antenatal or labour complications. Predictive performance was assessed using area under the receiver operating characteristic curve (AUROC). Internal validation and calibration were also performed. Women were divided into fifths of risk and pregnancy outcomes were compared between groups. Sensitivity, specificity, and positive and negative predictive values were calculated using the upper fifth as the positive screening group. Amongst 1409 participants (BMI 36.4, SD 4.8 kg/m 2 ), the prevalence of uncomplicated pregnancy and birth was 36% (505/1409). Multiparity and increased plasma adiponectin, maternal age, systolic blood pressure and HbA1c were independently associated with uncomplicated pregnancy and birth. These factors achieved an AUROC of 0.72 (0.68-0.76) and the model was well calibrated. Prevalence of gestational diabetes, preeclampsia and other hypertensive disorders, preterm birth, and postpartum haemorrhage decreased whereas spontaneous vaginal delivery increased across the fifths of increasing predicted risk of uncomplicated pregnancy and birth. Sensitivity, specificity, and positive and negative

Behavior of respiratory muscle strength in morbidly obese women by using different predictive equations.

PubMed

Pazzianotto-Forti, Eli M; Peixoto-Souza, Fabiana S; Piconi-Mendes, Camila; Rasera-Junior, Irineu; Barbalho-Moulim, Marcela

2012-01-01

Studies on the behavior of respiratory muscle strength (RMS) in morbidly obese patients have found conflicting results. To evaluate RMS in morbidly obese women and to compare the results by using different predictive equations. This is a cross-sectional study that recruited 30 morbidly obese women and a control group of 30 normal-weight women. The subjects underwent anthropometric and maximal respiratory pressure measurement. Visual inspection of the Bland-Altman plots was performed to evaluate the correlation between the different equations, with a p value lower than 0.05 considered as statistically significant. The obese women showed a significant increase in maximal inspiratory pressure (MIP) values (-87.83±21.40 cmH(2)O) compared with normal-weight women (-72±15.23 cmH(2)O) and a significant reduction of MIP (-87.83±21.40 cmH(2)O) according to the values predicted by the EHarik equation (-130.71±11.98 cmH(2)O). Regarding the obtained maximal expiratory pressure (MEP), there were no between-group differences (p>0.05), and no agreeement was observed between obtained and predicted values of MEP and the ENeder and ECosta equations. Inspiratory muscle strength was greater in the morbidly obese subjects. The most appropriate equation for calculating the predicted MIP values for the morbidly obese seems to be Harik-Khan equation. There seem to be similarities between the respiratory muscle strength behavior of morbidly obese and normal-weight women, however, these findings are still inconclusive.

Influence of urban neighbourhood environment on physical activity and obesity-related diseases.

PubMed

Lee, H; Kang, H-M; Ko, Y-J; Kim, H-S; Kim, Y-J; Bae, W K; Park, S; Cho, B

2015-09-01

The impact of characteristics of neighbourhood environment on physical activity and obesity-related diseases is still the subject of debate. This study aimed to explore the impact of urban neighbourhood environment on physical activity and obesity-related diseases. Cross-sectional study. Individuals who participated in the 2009 national health-screening programme, submitted all necessary information, and had lived in Community 1 (Haengdang) or Community 2 (Ilsan) for at least 2 years (n = 16,178) were selected for inclusion in this study. Anthropometric measures were taken and physical activity was assessed using a short questionnaire. No significant difference in the trigger factors for walking, including the amount of neighbourhood park space, number of shopping malls, and distance between the community and shopping malls, was found between the two communities. However, Community 2 had a better street environment than Community 1. Participants who lived in Community 2 were more physically active [adjusted odds ratio (OR) 1.31, 95% confidence interval (CI) 1.16-1.48] and walked more regularly (adjusted OR 1.09, 95% CI 1.02-1.17) than participants who lived in Community 1, and were less likely to have abdominal obesity (adjusted OR 0.83, 95% CI 0.77-0.91), hypertension (adjusted OR 0.88, 95% CI 0.80-0.97) and diabetes (adjusted OR 0.86, 95% CI 0.75-0.99). However, the risk of dyslipidaemia, especially in terms of low-density lipoprotein cholesterol, was higher in Community 2. These results suggest that a walkable environment has a positive influence on hypertension and diabetes, and physical activity is the possible mechanism for this association. A walkable environment may function as an important tool for health promotion in urban areas. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Construct Validity of the Neighborhood Environment Walkability Scale for Africa.

PubMed

Oyeyemi, Adewale L; Conway, Terry L; Adedoyin, Rufus A; Akinroye, Kingsley K; Aryeetey, Richmond; Assah, Felix; Cain, Kelli L; Gavand, Kavita A; Kasoma, Sandra S; Kolbe-Alexander, Tracy L; Lambert, Estelle V; Larouche, Richard; Moss, Sarah J; Ocansey, Reginald; Onywera, Vincent O; Prista, Antonio; Tremblay, Mark S; Sallis, James F

2017-03-01

The development of valid measures of built environments relevant for physical activity is an important step toward controlling the global epidemic of physical inactivity-related noncommunicable diseases and deaths. This study assessed the construct validity of a self-report neighborhood environment walkability scale adapted for Africa (NEWS-Africa), by examining relationships with self-reported walking for transportation and recreation using pooled data from six sub-Saharan African countries. NEWS was systematically adapted to assess urban, periurban, and rural environments in sub-Saharan Africa. Adults (n = 469, 18-85 yr, 49.7% women) from Cameroon, Ghana, Mozambique, Nigeria, South Africa, and Uganda were purposively recruited from neighborhoods varying in walkability and socioeconomic status, with some from villages. Participants completed the 76-item (13 subscales) NEWS-Africa by structured interview and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire. The overall "walkability" index had a positive relationship with both walking for transportation (η = 0.020, P = 0.005) and recreation (η = 0.013, P = 0.028) in the pooled analyses. The mixed-use access and stranger danger scales were positively related with transport walking (η = 0.020, P = 0.006 and η = 0.021, P = 0.040, respectively). Proximity of recreational facilities (η = 0.016, P = 0.015), road/path connectivity (η = 0.025, P = 0.002), path infrastructure (η = 0.021, P = 0.005), and overall places for walking and cycling (η = 0.012, P = 0.029) scales were positively related to recreational walking. Country-specific results were mostly nonsignificant except for South Africa and Uganda. Of 14 NEWS-Africa scales, 7 were significantly related to walking behavior in pooled analyses, providing partial support for the construct validity of NEWS-Africa. However, effect sizes appeared to be lower than those from other

Association between Neighborhood Walkability, Cardiorespiratory Fitness and Body-Mass Index

PubMed Central

Hoehner, Christine M.; Handy, Susan L.; Yan, Yan; Blair, teven N.; Berrigan, David

2011-01-01

Many studies have found cross-sectional associations between characteristics of the neighborhood built environment and physical activity (PA) behavior. However, most are based on self-reported PA, which is known to result in overestimation of PA and differential misclassification by demographic and biological characteristics. Cardiorespiratory fitness (CRF) is an objective marker of PA because it is primarily determined by PA. Furthermore, it is causally related to long-term health outcomes. Therefore, analyses of the association between CRF and built environment could strengthen arguments for the importance of built environment influences on health. We examined the association between neighborhood walkability and CRF and body-mass index (BMI). This cross-sectional analysis included 16,543 adults (5,017 women, 11,526 men) aged 18–90 years with home addresses in Texas who had a comprehensive clinical examination between 1987 and 2005. Outcomes included CRF from total duration on a maximal exercise treadmill test and measured BMI. Three neighborhood walkability factors emerged from principal components analyses of block-group measures derived from the U.S. Census. In multilevel adjusted analyses, the neighborhood walkability factors were significantly associated with CRF and BMI among men and women in the expected direction. An interaction between one of the neighborhood factors and age was also observed. The interaction suggested that living in neighborhoods with older homes and with residents traveling shorter distances to work was more strongly positively associated with CRF among younger adults and more strongly negatively associated with BMI among older adults. In conclusion, neighborhood characteristics hypothesized to support more PA and less driving were associated with higher levels of CRF and lower BMI. Demonstration of an association between built environment characteristics and CRF is a significant advance over past studies based on self-reported PA

Predictive equations for central obesity via anthropometrics, stereovision imaging, and MRI in adults

PubMed Central

Lee, Jane J; Freeland-Graves, Jeanne H; Pepper, M Reese; Yao, Ming; Xu, Bugao

2013-01-01

Objective Abdominal visceral adiposity is related to risks for insulin resistance and metabolic perturbations. Magnetic resonance imaging (MRI) and computed tomography are advanced instruments that quantify abdominal adiposity; yet field use is constrained by their bulkiness and costliness. The purpose of this study is to develop prediction equations for total abdominal, subcutaneous, and visceral adiposity via anthropometrics, stereovision body imaging (SBI), and MRI. Design and Methods Participants (67 men and 55 women) were measured for anthropometrics, and abdominal adiposity volumes evaluated by MRI umbilicus scans. Body circumferences and central obesity were obtained via SBI. Prediction models were developed via multiple linear regression analysis, utilizing body measurements and demographics as independent predictors, and abdominal adiposity as a dependent variable. Cross-validation was performed by the data-splitting method. Results The final total abdominal adiposity prediction equation was –470.28+7.10waist circumference–91.01gender+5.74sagittal diameter (R²=89.9%); subcutaneous adiposity was –172.37+8.57waist circumference–62.65gender–450.16stereovision waist-to-hip ratio (R²=90.4%); and visceral adiposity was –96.76+11.48central obesity depth–5.09 central obesity width+204.74stereovision waist-to-hip ratio–18.59gender (R²=71.7%). R² significantly improved for predicting visceral fat when SBI variables were included, but not for total abdominal or subcutaneous adiposity. Conclusions SBI is effective for predicting visceral adiposity and the prediction equations derived from SBI measurements can assess obesity. PMID:23613161

A specific prediction equation is necessary to estimate peak oxygen uptake in obese patients with metabolic syndrome.

PubMed

Debeaumont, D; Tardif, C; Folope, V; Castres, I; Lemaitre, F; Tourny, C; Dechelotte, P; Thill, C; Darmon, A; Coquart, J B

2016-06-01

The aims were to: (1) compare peak oxygen uptake ([Formula: see text]peak) predicted from four standard equations to actual [Formula: see text]peak measured from a cardiopulmonary exercise test (CPET) in obese patients with metabolic syndrome (MetS), and (2) develop a new equation to accurately estimate [Formula: see text]peak in obese women with MetS. Seventy-five obese patients with MetS performed a CPET. Anthropometric data were also collected for each participant. [Formula: see text]peak was predicted from four prediction equations (from Riddle et al., Hansen et al., Wasserman et al. or Gläser et al.) and then compared with the actual [Formula: see text]peak measured during the CPET. The accuracy of the predictions was determined with the Bland-Altman method. When accuracy was low, a new prediction equation including anthropometric variables was proposed. [Formula: see text]peak predicted from the equation of Wasserman et al. was not significantly different from actual [Formula: see text]peak in women. Moreover, a significant correlation was found between the predicted and actual values (p < 0.001, r = 0.69). In men, no significant difference was noted between actual [Formula: see text]peak and [Formula: see text]peak predicted from the prediction equation of Gläser et al., and these two values were also correlated (p = 0.03, r = 0.44). However, the LoA95% was wide, whatever the prediction equation or gender. Regression analysis suggested a new prediction equation derived from age and height for obese women with MetS. The methods of Wasserman et al. and Gläser et al. are valid to predict [Formula: see text]peak in obese women and men with MetS, respectively. However, the accuracy of the predictions was low for both methods. Consequently, a new prediction equation including age and height was developed for obese women with MetS. However, new prediction equation remains to develop in obese men with MetS.

Developing prediction equations and a mobile phone application to identify infants at risk of obesity.

PubMed

Santorelli, Gillian; Petherick, Emily S; Wright, John; Wilson, Brad; Samiei, Haider; Cameron, Noël; Johnson, William

2013-01-01

Advancements in knowledge of obesity aetiology and mobile phone technology have created the opportunity to develop an electronic tool to predict an infant's risk of childhood obesity. The study aims were to develop and validate equations for the prediction of childhood obesity and integrate them into a mobile phone application (App). Anthropometry and childhood obesity risk data were obtained for 1868 UK-born White or South Asian infants in the Born in Bradford cohort. Logistic regression was used to develop prediction equations (at 6 ± 1.5, 9 ± 1.5 and 12 ± 1.5 months) for risk of childhood obesity (BMI at 2 years >91(st) centile and weight gain from 0-2 years >1 centile band) incorporating sex, birth weight, and weight gain as predictors. The discrimination accuracy of the equations was assessed by the area under the curve (AUC); internal validity by comparing area under the curve to those obtained in bootstrapped samples; and external validity by applying the equations to an external sample. An App was built to incorporate six final equations (two at each age, one of which included maternal BMI). The equations had good discrimination (AUCs 86-91%), with the addition of maternal BMI marginally improving prediction. The AUCs in the bootstrapped and external validation samples were similar to those obtained in the development sample. The App is user-friendly, requires a minimum amount of information, and provides a risk assessment of low, medium, or high accompanied by advice and website links to government recommendations. Prediction equations for risk of childhood obesity have been developed and incorporated into a novel App, thereby providing proof of concept that childhood obesity prediction research can be integrated with advancements in technology.

From Voice to Choice: African American Youth Examine Childhood Obesity in Rural North Carolina.

PubMed

Balvanz, Peter; Dodgen, Leilani; Quinn, Jeff; Holloway, Tameiya; Hudspeth, Sandra; Eng, Eugenia

2016-01-01

Childhood obesity continues to be a prominent health concern in the United States. Certain demographics of youth have a higher prevalence of obesity, including those living in rural settings, and African American females. Multiple determinants contribute to the childhood obesity epidemic, yet few studies have partnered with youth to investigate community-level determinants and solutions. This study involved youth to assess contextual determinants of childhood obesity in a community, create an action plan for the community, and report findings and actions pursued in partnership with a community-based organization (CBO) and a university. Seven African American female high school students were recruited to investigate factors that contribute to childhood obesity using photovoice, a methodology used in community-based participatory research (CBPR). Through photography and guided discussion, youth partners found a lack of access to healthy food and lack of safe recreation as primary contributors to obesity within their community. Social support from friends was believed to help prevent obesity. In response to findings, two projects were envisioned and implemented in the community, a walkability assessment and an intergenerational community garden. Throughout this study, youth proved to be reliable partners in research, provided unique perspectives while examining local factors perceived to contribute to childhood obesity, and offered thoughtful solutions.

Getting to Know a Place: Built Environment Walkability and Children’s Spatial Representation of Their Home-School (h–s) Route

PubMed Central

Moran, Mika R.; Eizenberg, Efrat; Plaut, Pnina

2017-01-01

The literature on environmental walkability to date has mainly focused on walking and related health outcomes. While previous studies suggest associations between walking and spatial knowledge, the associations between environmental walkability and spatial knowledge is yet to be explored. The current study addresses this lacuna in research by exploring children’s mental representations of their home-school (h–s) route, vis-à-vis objectively measured environmental attributes along the actual routes. Ninety-two children aged 10–12 years old (5th and 6th graders) drew sketch maps depicting their h–s route and drew the actual route on a neighborhood map, in addition to completing a brief survey. h–s routes went through Geographic Information Systems (GIS) analysis, yielding an en-route walkability index and its components. Children in traditional neighborhoods outperformed in the route’s orientation and structure, but not in the richness of the drawn maps. The orientation and structure of the drawn routes was related to objectively measured walkability, density, street connectivity and commercial land-uses along h–s routes. These associations remained significant among children who walked to school, but not among those who were driven to school. These findings highlight the importance of urban form and school travel mode in acquiring navigation skills and getting to know one’s neighborhood. PMID:28587315

From digital earth to digital neighbourhood: A study of subjective measures of walkability attributes in objectively assessed digital neighbourhood

NASA Astrophysics Data System (ADS)

Qureshi, S.; Ho, C. S.

2014-02-01

According to IEA report (2011), about 23% of the World's CO2 emissions result from transport and this is one of the few areas where emissions are still rapidly increasing. The use of private vehicles is one of the principle contributors to green house gas emissions from transport sector. Therefore this paper focuses on the shift to more sustainable and low carbon forms of transportation mode such as walking. Neighbourhood built environment attributes may influence walkability. For this study, the author used a modified version of the "Neighbourhood Environment Walkability Scale" to make comparison between respondents' perceptions regarding attributes of two neighborhoods of Putrajaya. The 21st Century really needs planners to use the Digital Earth Concept, to go from global to regional to national to very local issues, using integrated, advanced technologies such as earth observation, GIS, virtual reality, etc. For this research, two (2) neighborhoods of different densities (High and Low density) were selected. A sample total of 381(195 and 186) between 7 to 65 years old participants were selected For subjective measures we used 54 questions questionnaire survey where as for the objective measures we used desktop 9.3 version of Arc GIS soft ware. Our results shows that respondents who reside in high-walkable neighbourhood precinct 9 in Putrajaya rated factors such as residential density, land use mix, proximity to destination and street connectivity, consistently higher then did respondents of the low walkable neighbourhood precinct 8 in Putrajaya.

GPS-Based Exposure to Greenness and Walkability and Accelerometry-Based Physical Activity.

PubMed

James, Peter; Hart, Jaime E; Hipp, J Aaron; Mitchell, Jonathan A; Kerr, Jacqueline; Hurvitz, Philip M; Glanz, Karen; Laden, Francine

2017-04-01

Background: Physical inactivity is a risk factor for cancer that may be influenced by environmental factors. Indeed, dense and well-connected built environments and environments with natural vegetation may create opportunities for higher routine physical activity. However, studies have focused primarily on residential environments to define exposure and self-reported methods to estimate physical activity. This study explores the momentary association between minute-level global positioning systems (GPS)-based greenness exposure and time-matched objectively measured physical activity. Methods: Adult women were recruited from sites across the United States. Participants wore a GPS device and accelerometer on the hip for 7 days to assess location and physical activity at minute-level epochs. GPS records were linked to 250 m resolution satellite-based vegetation data and Census Block Group-level U.S. Environmental Protection Agency (EPA) Smart Location Database walkability data. Minute-level generalized additive mixed models were conducted to test for associations between GPS measures and accelerometer count data, accounting for repeated measures within participant and allowing for deviations from linearity using splines. Results: Among 360 adult women (mean age of 55.3 ± 10.2 years), we observed positive nonlinear relationships between physical activity and both greenness and walkability. In exploratory analyses, the relationships between environmental factors and physical activity were strongest among those who were white, had higher incomes, and who were middle-aged. Conclusions: Our results indicate that higher levels of physical activity occurred in areas with higher greenness and higher walkability. Impact: Findings suggest that planning and design policies should focus on these environments to optimize opportunities for physical activity. Cancer Epidemiol Biomarkers Prev; 26(4); 525-32. ©2017 AACR See all the articles in this CEBP Focus section, "Geospatial

Do self- or parent-reported dietary, physical activity, and sedentary behaviors predict worsening obesity in children?

PubMed

Dorsey, Karen B; Mauldon, Maria; Magraw, Ruth; Yu, Sunkyung; Krumholz, Harlan M

2010-10-01

To determine whether information gathered during routine healthcare visits regarding obesity related risk factors and risk behaviors predicts increases in BMI z-score over time among overweight and obese children. Medical records from 168 overweight and 441 obese patients seen for repeated visits between September 2003 and April 2006 were examined for reported dietary, physical activity, and sedentary behaviors, family history of obesity and diabetes mellitus, documented Acanthosis nigricans, and BMI values. Random-effects regression analysis was done to determine whether demographic, familial, or behavioral data predicted changes in BMI z-score over time. The presence of A nigricans and a family history of obesity were associated with an increase in BMI z-score (beta=0.56, SE=0.09, P<.001 and beta=0.31, SE=0.13, P=.021). These risk factors explained 8% and 7% of the variation in BMI z-score respectively. Self- or parent-reported dietary and physical activity behaviors did not predict change in BMI z-score. Our findings suggest that the risk factors and self- or parent-reported risk behaviors routinely assessed by pediatric clinicians have limited ability to predict future growth trends, demonstrating the difficulty in determining which patients have the greatest risk of progression of obesity. Copyright (c) 2010 Mosby, Inc. All rights reserved.

Low predictability of anthropometric indicators of obesity in metabolic syndrome (MS) risks among elderly women.

PubMed

Chu, Fu-Ling; Hsu, Chung-Huei; Jeng, Chii

2012-01-01

While diagnostic criteria for MS may vary depending on ethnicity, obesity remains a key risk factor in its development. In Taiwan, the incidence of obesity and MS among women has been increasing; however cut-off values for defining obesity for the diagnosis of MS among different groups of women have not been clearly established. The goal of this research was to examine the suitability of various anthropometric indicators of obesity in predicting the presence of MS criteria and to determine appropriate cut-off values of these indicators for women of different age and menstrual status. The sample was derived from the 2002 "Taiwan Three High Prevalence Survey" database. Women were divided into three groups based on age and menstrual status. Receiver-operating characteristic (ROC) curves was applied to the anthropometric indicators of obesity including, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), to ascertain its value in predicting MS. 2848 cases were included. It was found that most MS component values were worse with age and following menopause. Obesity indicators showed poor predictability for MS risks in post-menopausal women over 65 years, but good predictability in women under 65 years; our study revealed the following as ideal cut-off values for non-menopausal female: WHtR<0.49, WC<78 cm, WHR<0.79, BMI<24 kg/m(2); for menopausal women, WHtR<0.54, WC<83 cm, WHR<0.84, BMI<24.4 kg/m(2). It was concluded that obesity alone is not a reliable predictor of MS risks in women over the age of 65, and cut-off values for obesity indicators need to be further reduced in non-menopausal women. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Obesity indices predict hypertension among indigenous adults in Krau Wildlife Reserve, Peninsular Malaysia.

PubMed

Chua, Ee Yin; Zalilah, Mohd Shariff; Haemamalar, Karppaya; Norhasmah, Sulaiman; Geeta, Appannah

2017-05-25

The disease burden of indigenous peoples has been augmented by the rising prevalence of obesity and hypertension in this population. This study assessed the ability of obesity indices to predict hypertension among indigenous adults of Peninsular Malaysia. In this cross-sectional study, 482 adults (223 men, 259 women) aged ≥18 years old were measured for body mass index (BMI), waist circumference (WC), waist-height ratio (WHtR), waist-hip ratio (WHR), and blood pressure. Receiver operating characteristic (ROC) analysis was used to determine the predictive ability of obesity indices for hypertension in men and women. Gender-specific logistic regression analyses were done to examine the association between obesity, defined by BMI, WC, WHtR and WHR, and hypertension. Prevalence of hypertension was 25.5%. Overall, WHtR was the best predictor of the presence of hypertension, in both men and women. The optimal WHtR cut-off values for hypertension were 0.45 and 0.52 in men and women, respectively. Obese adults with WHtR ≥0.5 had about two times increased odds of having hypertension compared to non-obese adults. WHtR may serve as a simple and inexpensive screening tool to identify individuals with hypertension in this relatively difficult to reach population.

Trend in Obesity Prevalence in European Adult Cohort Populations during Follow-up since 1996 and Their Predictions to 2015

PubMed Central

von Ruesten, Anne; Steffen, Annika; Floegel, Anna; van der A, Daphne L.; Masala, Giovanna; Tjønneland, Anne; Halkjaer, Jytte; Palli, Domenico; Wareham, Nicholas J.; Loos, Ruth J. F.; Sørensen, Thorkild I. A.; Boeing, Heiner

2011-01-01

Objective To investigate trends in obesity prevalence in recent years and to predict the obesity prevalence in 2015 in European populations. Methods Data of 97 942 participants from seven cohorts involved in the European Prospective Investigation into Cancer and Nutrition (EPIC) study participating in the Diogenes project (named as “Diogenes cohort” in the following) with weight measurements at baseline and follow-up were used to predict future obesity prevalence with logistic linear and non-linear (leveling off) regression models. In addition, linear and leveling off models were fitted to the EPIC-Potsdam dataset with five weight measures during the observation period to find out which of these two models might provide the more realistic prediction. Results During a mean follow-up period of 6 years, the obesity prevalence in the Diogenes cohort increased from 13% to 17%. The linear prediction model predicted an overall obesity prevalence of about 30% in 2015, whereas the leveling off model predicted a prevalence of about 20%. In the EPIC-Potsdam cohort, the shape of obesity trend favors a leveling off model among men (R2 = 0.98), and a linear model among women (R2 = 0.99). Conclusion Our data show an increase in obesity prevalence since the 1990ies, and predictions by 2015 suggests a sizeable further increase in European populations. However, the estimates from the leveling off model were considerably lower. PMID:22102897

Energy prediction equations are inadequate for obese Hispanic youth.

PubMed

Klein, Catherine J; Villavicencio, Stephan A; Schweitzer, Amy; Bethepu, Joel S; Hoffman, Heather J; Mirza, Nazrat M

2011-08-01

Assessing energy requirements is a fundamental activity in clinical dietetics practice. A study was designed to determine whether published linear regression equations were accurate for predicting resting energy expenditure (REE) in fasted Hispanic children with obesity (aged 7 to 15 years). REE was measured using indirect calorimetry; body composition was estimated with whole-body air displacement plethysmography. REE was predicted using four equations: Institute of Medicine for healthy-weight children (IOM-HW), IOM for overweight and obese children (IOM-OS), Harris-Benedict, and Schofield. Accuracy of the prediction was calculated as the absolute value of the difference between the measured and predicted REE divided by the measured REE, expressed as a percentage. Predicted values within 85% to 115% of measured were defined as accurate. Participants (n=58; 53% boys) were mean age 11.8±2.1 years, had 43.5%±5.1% body fat, and had a body mass index of 31.5±5.8 (98.6±1.1 body mass index percentile). Measured REE was 2,339±680 kcal/day; predicted REE was 1,815±401 kcal/day (IOM-HW), 1,794±311 kcal/day (IOM-OS), 1,151±300 kcal/day (Harris-Benedict), and, 1,771±316 kcal/day (Schofield). Measured REE adjusted for body weight averaged 32.0±8.4 kcal/kg/day (95% confidence interval 29.8 to 34.2). Published equations predicted REE within 15% accuracy for only 36% to 40% of 58 participants, except for Harris-Benedict, which did not achieve accuracy for any participant. The most frequently accurate values were obtained using IOM-HW, which predicted REE within 15% accuracy for 55% (17/31) of boys. Published equations did not accurately predict REE for youth in the study sample. Further studies are warranted to formulate accurate energy prediction equations for this population. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

GIS-measured walkability, transit, and recreation environments in relation to older Adults' physical activity: A latent profile analysis.

PubMed

Todd, Michael; Adams, Marc A; Kurka, Jonathan; Conway, Terry L; Cain, Kelli L; Buman, Matthew P; Frank, Lawrence D; Sallis, James F; King, Abby C

2016-12-01

An infrequently studied question is how diverse combinations of built environment (BE) features relate to physical activity (PA) for older adults. We derived patterns of geographic information systems- (GIS) measured BE features and explored how they accounted for differences in objective and self-reported PA, sedentary time, and BMI in a sample of older adults. Senior Neighborhood Quality of Life Study participants (N=714, aged 66-97years, 52.1% women, 29.7% racial/ethnic minority) were sampled in 2005-2008 from the Seattle-King County, WA and Baltimore, MD-Washington, DC regions. Participants' home addresses were geocoded, and net residential density, land use mix, retail floor area ratio, intersection density, public transit density, and public park and private recreation facility density measures for 1-km network buffers were derived. Latent profile analyses (LPAs) were estimated from these GIS-based measures. In multilevel regression models, profiles were compared on accelerometer-measured moderate-to-vigorous PA (MVPA) and sedentary time and self-reported PA, adjusting for covariates and clustering. Analyses were conducted in 2014-2015. LPAs yielded three profiles: low walkability/transit/recreation (L-L-L); mean walkability/transit/recreation (M-M-M); and high walkability/transit/recreation (H-H-H). Three PA outcomes were more favorable in the HHH than the LLL profile group (difference of 7.2min/day for MVPA, 97.8min/week for walking for errands, and 79.2min/week for walking for exercise; all ps<0.02). The most and least activity-supportive BE profiles showed greater differences in older adults' PA than did groupings based solely on a 4-component walkability index, suggesting that diverse BE features are important for healthy aging. Copyright © 2016 Elsevier Inc. All rights reserved.

GIS-measured Walkability, Transit, and Recreation Environments in Relation to Older Adults’ Physical Activity: A Latent Profile Analysis

PubMed Central

Todd, Michael; Adams, Marc A.; Kurka, Jonathan; Conway, Terry L.; Cain, Kelli L.; Buman, Matthew P.; Frank, Lawrence D.; Sallis, James F.; King, Abby C.

2016-01-01

An infrequently studied question is how diverse combinations of built environment (BE) features relate to physical activity (PA) for older adults. We derived patterns of Geographical Information Systems- (GIS) measured BE features and explored how they accounted for differences in objective and self-reported PA, sedentary time, and BMI in a sample of older adults. Senior Neighborhood Quality of Life Study participants (N=714, aged 66–97 years, 52.1% women, 29.7% racial/ethnic minority) were sampled in 2005–2008 from the Seattle-King County, WA and Baltimore, MD-Washington, DC regions. Participants’ home addresses were geocoded, and net residential density, land use mix, retail floor area ratio, intersection density, public transit density, and public park and private recreation facility density measures for 1-km network buffers were derived. Latent profile analyses (LPAs) were estimated from these GIS-based measures. In multilevel regression models, profiles were compared on accelerometer-measured moderate-to-vigorous PA (MVPA) and sedentary time and self-reported PA, adjusting for covariates and clustering. Analyses were conducted in 2014–2015. LPAs yielded three profiles: low walkability/transit/recreation (L-L-L); mean walkability/transit/recreation (M-M-M); and high walkability/transit/recreation (H-H-H). Three PA outcomes were more favorable in the HHH than the LLL profile group (difference of 7.2 minutes/day for MVPA, 97.8 minutes/week for walking for errands, and 79.2 minutes/week for walking for exercise; all ps < 0.02). The most and least activity-supportive BE profiles showed greater differences in older adults’ PA than did groupings based solely on a 4-component walkability index, suggesting that diverse BE features are important for healthy aging. PMID:27663428

Where do they go and how do they get there? Older adults' travel behaviour in a highly walkable environment.

PubMed

Winters, Meghan; Voss, Christine; Ashe, Maureen C; Gutteridge, Kaitlyn; McKay, Heather; Sims-Gould, Joanie

2015-05-01

Mobility-the ability to move about in one's neighbourhood and maintain independence-is essential for older adults' wellbeing. Neighbourhood environments support or hinder mobility especially as health declines and physical vulnerability increases with age. Linkages between mobility and planning and policy are key to designing age-friendly neighbourhoods with destinations that encourage older adults to get out and be physically active. We describe the mobility of older adults who live in a highly walkable neighbourhood. Specifically, we address the questions of 'where do older adults go?' (destinations) and 'how they get there?' (travel mode, physical activity). We recruited older adults (age 60+) who live in Vancouver's downtown core, an area acknowledged to be highly walkable (Walk Score(®): 94-97/100), and who leave their houses most days of the week. Participants (n = 184) recorded travel in diaries and wore an ActiGraph GT3X + accelerometer for 7 days during September to October 2012. We classified reported destinations according to the North American Industry Classification System, and analysed mobility [trip rates (overall and walking), steps, moderate to vigorous physical activity (MVPA)] and associations between travel and physical activity-related mobility measures. Key destinations were grocery stores (13.6% of trips), restaurants (7.2%), malls/marketplaces (5.5%), and others' homes (5.4%). Participants made 4.6 (std: 2.5) one-way trips/day, took 7910.1 (3871.1) steps/day, and accrued 39.2 (32.9) minutes/day of MVPA. Two-thirds of trips were by active modes (62.8% walk, 3.2% bike) and 22.4% were by car. Trip rates were significantly associated with physical activity outcomes. Older adults living in highly walkable neighbourhoods were very mobile and frequently used active transportation. Travel destinations signify the importance of nearby commercial and social opportunities, even in a highly walkable environment. The high rates of active travel and

Childhood Obesity: Prediction and Prevention.

ERIC Educational Resources Information Center

Miller, Michael D.

Obesity in children is a problem both insidious and acute. Childhood obesity has been indicated as a forerunner of adult obesity; it is also an immediate problem for the child. Given the lack of evidence for long term maintenance of any weight loss, this paper investigates the etiology of the disorder as a prelude to prevention. Upon review of the…

A clinical scoring system for predicting nonalcoholic steatohepatitis in morbidly obese patients.

PubMed

Campos, Guilherme M; Bambha, Kiran; Vittinghoff, Eric; Rabl, Charlotte; Posselt, Andrew M; Ciovica, Ruxandra; Tiwari, Umesh; Ferrel, Linda; Pabst, Mark; Bass, Nathan M; Merriman, Raphael B

2008-06-01

Nonalcoholic steatohepatitis (NASH) is common in morbidly obese persons. Liver biopsy is diagnostic but technically challenging in such individuals. This study was undertaken to develop a clinically useful scoring system to predict the probability of NASH in morbidly obese persons, thus assisting in the decision to perform liver biopsy. Consecutive subjects undergoing bariatric surgery without evidence of other liver disease underwent intraoperative liver biopsy. The outcome was pathologic diagnosis of NASH. Predictors evaluated were demographic, clinical, and laboratory variables. A clinical scoring system was constructed by rounding the estimated regression coefficients for the independent predictors in a multivariate logistic model for the diagnosis of NASH. Of 200 subjects studied, 64 (32%) had NASH. Median body mass index was 48 kg/m(2) (interquartile range, 43-55). Multivariate analysis identified six predictive factors for NASH: the diagnosis of hypertension (odds ratio [OR], 2.4; 95% confidence interval [CI], 1-5.6), type 2 diabetes (OR, 2.6; 95% CI, 1.1-6.3), sleep apnea (OR, 4.0; 95% CI, 1.3-12.2), AST > 27 IU/L (OR, 2.9; 95% CI, 1.2-7.0), alanine aminotransferase (ALT) > 27 IU/L (OR, 3.3; 95% CI, 1.4-8.0), and non-Black race (OR, 8.4; 95% CI, 1.9-37.1). A NASH Clinical Scoring System for Morbid Obesity was derived to predict the probability of NASH in four categories (low, intermediate, high, and very high). The proposed clinical scoring can predict NASH in morbidly obese persons with sufficient accuracy to be considered for clinical use, identifying a very high-risk group in whom liver biopsy would be very likely to detect NASH, as well as a low-risk group in whom biopsy can be safely delayed or avoided.

Walk Score™ As a Global Estimate of Neighborhood Walkability

PubMed Central

Carr, Lucas J.; Dunsiger, Shira I.; Marcus, Bess H.

2010-01-01

Background Walk Score™ has recently been demonstrated as a valid and reliable tool for estimating access to nearby facilities, a critical component of the physical activity environment. It has not yet been determined whether Walk Score relates to other critical components of the physical activity environment including street connectivity, access to public transit, residential density and/or crime. Purpose The aim of this study is to explore the relationship between Walk Score and objective/subjective measures of the physical activity environment. Methods Walk Scores were calculated for residential addresses of 296 participants of two RCTs (2006–2009). Street connectivity, residential density, access to public transit provisions and crime were objectively measured (GIS) and cross-referenced with Walk Scores and participant's perceptions of the environment (e.g., perceived crime, access to physical activity facilities, perceived neighborhood walkability). Pairwise Pearson correlations were calculated in March 2010 to compare Walk Score to subjective/objective measures of neighborhood walkability. Results Significant positive correlations were identified between Walk Score and several objective (e.g., street connectivity, residential density and access to public transit provisions) and subjective (e.g., summed score of the physical activity environment) measures of the physical activity environment. However, positive correlations were also observed between Walk Score and crime. Conclusions Collectively, these findings support Walk Score as a free, easy to use and quick proxy of neighborhood density and access to nearby amenities. However, positive associations between Walk Score and reported crime highlight a limitation of Walk Score and warrant caution of its use. PMID:20965384

Liver Enlargement Predicts Obstructive Sleep Apnea–Hypopnea Syndrome in Morbidly Obese Women

PubMed Central

Scartabelli, Giovanna; Querci, Giorgia; Marconi, Letizia; Ceccarini, Giovanni; Piaggi, Paolo; Fierabracci, Paola; Salvetti, Guido; Cizza, Giovanni; Mazzeo, Salvatore; Vitti, Jacopo; Berger, Slava; Palla, Antonio; Santini, Ferruccio

2018-01-01

Obstructive sleep apnea–hypopnea syndrome (OSAHS) is frequently present in patients with severe obesity, but its prevalence especially in women is not well defined. OSAHS and non-alcoholic fatty liver disease are common conditions, frequently associated in patients with central obesity and metabolic syndrome and are both the result of the accumulation of ectopic fat mass. Identifying predictors of risk of OSAHS may be useful to select the subjects requiring instrumental sleep evaluation. In this cross-sectional study, we have investigated the potential role of hepatic left lobe volume (HLLV) in predicting the presence of OSAHS. OSAHS was quantified by the apnea/hypopnea index (AHI) and oxygen desaturation index in a cardiorespiratory inpatient sleep study of 97 obese women [age: 47 ± 11 years body mass index (BMI): 50 ± 8 kg/m2]. OSAHS was diagnosed when AHI was ≥5. HLLV, subcutaneous and intra-abdominal fat were measured by ultrasound. After adjustment for age and BMI, both HLLV and neck circumference (NC) were independent predictors of AHI. OSAHS was found in 72% of patients; HLLV ≥ 370 cm3 was a predictor of OSAHS with a sensitivity of 66%, a specificity of 70%, a positive and negative predictive values of 85 and 44%, respectively (AUC = 0.67, p < 0.005). A multivariate logistic model was used including age, BMI, NC, and HLLV (the only independent predictors of AHI in a multiple linear regression analyses), and a cut off value for the predicted probability of OSAHS equal to 0.7 provided the best diagnostic results (AUC = 0.79, p < 0.005) in terms of sensitivity (76%), specificity (89%), negative and positive predictive values (59 and 95%, respectively). All patients with severe OSAHS were identified by this prediction model. In conclusion, HLLV, an established index of visceral adiposity, represents an anthropometric parameter closely associated with OSAHS in severely obese women. PMID:29928260

Liver Enlargement Predicts Obstructive Sleep Apnea-Hypopnea Syndrome in Morbidly Obese Women.

PubMed

Scartabelli, Giovanna; Querci, Giorgia; Marconi, Letizia; Ceccarini, Giovanni; Piaggi, Paolo; Fierabracci, Paola; Salvetti, Guido; Cizza, Giovanni; Mazzeo, Salvatore; Vitti, Jacopo; Berger, Slava; Palla, Antonio; Santini, Ferruccio

2018-01-01

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is frequently present in patients with severe obesity, but its prevalence especially in women is not well defined. OSAHS and non-alcoholic fatty liver disease are common conditions, frequently associated in patients with central obesity and metabolic syndrome and are both the result of the accumulation of ectopic fat mass. Identifying predictors of risk of OSAHS may be useful to select the subjects requiring instrumental sleep evaluation. In this cross-sectional study, we have investigated the potential role of hepatic left lobe volume (HLLV) in predicting the presence of OSAHS. OSAHS was quantified by the apnea/hypopnea index (AHI) and oxygen desaturation index in a cardiorespiratory inpatient sleep study of 97 obese women [age: 47 ± 11 years body mass index (BMI): 50 ± 8 kg/m 2 ]. OSAHS was diagnosed when AHI was ≥5. HLLV, subcutaneous and intra-abdominal fat were measured by ultrasound. After adjustment for age and BMI, both HLLV and neck circumference (NC) were independent predictors of AHI. OSAHS was found in 72% of patients; HLLV ≥ 370 cm 3 was a predictor of OSAHS with a sensitivity of 66%, a specificity of 70%, a positive and negative predictive values of 85 and 44%, respectively (AUC = 0.67, p  < 0.005). A multivariate logistic model was used including age, BMI, NC, and HLLV (the only independent predictors of AHI in a multiple linear regression analyses), and a cut off value for the predicted probability of OSAHS equal to 0.7 provided the best diagnostic results (AUC = 0.79, p  < 0.005) in terms of sensitivity (76%), specificity (89%), negative and positive predictive values (59 and 95%, respectively). All patients with severe OSAHS were identified by this prediction model. In conclusion, HLLV, an established index of visceral adiposity, represents an anthropometric parameter closely associated with OSAHS in severely obese women.

Validity of Predictive Equations for Resting Energy Expenditure Developed for Obese Patients: Impact of Body Composition Method

PubMed Central

Achamrah, Najate; Jésus, Pierre; Grigioni, Sébastien; Rimbert, Agnès; Petit, André; Déchelotte, Pierre; Folope, Vanessa; Coëffier, Moïse

2018-01-01

Predictive equations have been specifically developed for obese patients to estimate resting energy expenditure (REE). Body composition (BC) assessment is needed for some of these equations. We assessed the impact of BC methods on the accuracy of specific predictive equations developed in obese patients. REE was measured (mREE) by indirect calorimetry and BC assessed by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). mREE, percentages of prediction accuracy (±10% of mREE) were compared. Predictive equations were studied in 2588 obese patients. Mean mREE was 1788 ± 6.3 kcal/24 h. Only the Müller (BIA) and Harris & Benedict (HB) equations provided REE with no difference from mREE. The Huang, Müller, Horie-Waitzberg, and HB formulas provided a higher accurate prediction (>60% of cases). The use of BIA provided better predictions of REE than DXA for the Huang and Müller equations. Inversely, the Horie-Waitzberg and Lazzer formulas provided a higher accuracy using DXA. Accuracy decreased when applied to patients with BMI ≥ 40, except for the Horie-Waitzberg and Lazzer (DXA) formulas. Müller equations based on BIA provided a marked improvement of REE prediction accuracy than equations not based on BC. The interest of BC to improve REE predictive equations accuracy in obese patients should be confirmed. PMID:29320432

Effect of obesity on preterm delivery prediction by transabdominal recording of uterine electromyography.

PubMed

Lucovnik, Miha; Chambliss, Linda R; Blumrick, Richard; Balducci, James; Gersak, Ksenija; Garfield, Robert E

2016-10-01

It has been shown that noninvasive uterine electromyography (EMG) can identify true preterm labor more accurately than methods available to clinicians today. The objective of this study was to evaluate the effect of body mass index (BMI) on the accuracy of uterine EMG in predicting preterm delivery. Predictive values of uterine EMG for preterm delivery were compared in obese versus overweight/normal BMI patients. Hanley-McNeil test was used to compare receiver operator characteristics curves in these groups. Previously reported EMG cutoffs were used to determine groups with false positive/false negative and true positive/true negative EMG results. BMI in these groups was compared with Student t test (p < 0.05 significant). A total of 88 patients were included: 20 obese, 64 overweight, and four with normal BMI. EMG predicted preterm delivery within 7 days with area under the curve = 0.95 in the normal/overweight group, and with area under the curve = 1.00 in the obese group (p = 0.08). Six patients in true preterm labor (delivering within 7 days from EMG measurement) had low EMG values (false negative group). There were no false positive results. No significant differences in patient's BMI were noted between false negative group patients and preterm labor patients with high EMG values (true positive group) and nonlabor patients with low EMG values (true negative group; p = 0.32). Accuracy of noninvasive uterine EMG monitoring and its predictive value for preterm delivery are not affected by obesity. Copyright © 2016. Published by Elsevier B.V.

Neighborhood environment walkability and health-related quality of life among older adults in Hong Kong.

PubMed

Zhao, Yanan; Chung, Pak-Kwong

2017-11-01

This study examined the associations between walkability related environmental attributes (WREA) and health-related quality of life (HRQoL) among older adults in Hong Kong. A cross-sectional study was conducted among 340 participants (women = 233; mean age = 74.4 years) living in urban communities. Independent variables included residential density, land use mix-diversity, land use mix-access, street connectivity, infrastructure for walking, aesthetics, traffic hazards, crime, access to parking, lack of cul-de-sacs, hilliness, and physical barriers. Physical and mental dimensions of HRQoL were the dependent variables. Results revealed significant associations between WREA and HRQoL and demonstrated that aesthetics and physical barriers were significant determinants of physical health after adjusting age and sex, and crime and physical barriers were significant determinants of mental health after adjusting sex. This study provided empirical evidence that environmental walkability was associated with HRQoL among older adults in Hong Kong. Copyright © 2017 Elsevier B.V. All rights reserved.

Accumulating Data to Optimally Predict Obesity Treatment (ADOPT): Recommendations from the Biological Domain.

PubMed

Rosenbaum, Michael; Agurs-Collins, Tanya; Bray, Molly S; Hall, Kevin D; Hopkins, Mark; Laughlin, Maren; MacLean, Paul S; Maruvada, Padma; Savage, Cary R; Small, Dana M; Stoeckel, Luke

2018-04-01

The responses to behavioral, pharmacological, or surgical obesity treatments are highly individualized. The Accumulating Data to Optimally Predict obesity Treatment (ADOPT) project provides a framework for how obesity researchers, working collectively, can generate the evidence base needed to guide the development of tailored, and potentially more effective, strategies for obesity treatment. The objective of the ADOPT biological domain subgroup is to create a list of high-priority biological measures for weight-loss studies that will advance the understanding of individual variability in response to adult obesity treatments. This list includes measures of body composition, energy homeostasis (energy intake and output), brain structure and function, and biomarkers, as well as biobanking procedures, which could feasibly be included in most, if not all, studies of obesity treatment. The recommended high-priority measures are selected to balance needs for sensitivity, specificity, and/or comprehensiveness with feasibility to achieve a commonality of usage and increase the breadth and impact of obesity research. The accumulation of data on key biological factors, along with behavioral, psychosocial, and environmental factors, can generate a more precise description of the interplay and synergy among them and their impact on treatment responses, which can ultimately inform the design and delivery of effective, tailored obesity treatments. © 2018 The Obesity Society.

Do Inequalities in Neighborhood Walkability Drive Disparities in Older Adults’ Outdoor Walking?

PubMed Central

van Maarseveen, Martin

2017-01-01

Older residents of high-deprivation areas walk less than those of low-deprivation areas. Previous research has shown that neighborhood built environment may support and encourage outdoor walking. The extent to which the built environment supports and encourages walking is called “walkability”. This study examines inequalities in neighborhood walkability in high- versus low-deprivation areas and their possible influences on disparities in older adults’ outdoor walking levels. For this purpose, it focuses on specific neighborhood built environment attributes (residential density, land-use mix and intensity, street connectivity, and retail density) relevant to neighborhood walkability. It applied a mixed-method approach, included 173 participants (≥65 years), and used a Geographic Information System (GIS) and walking interviews (with a sub-sample) to objectively and subjectively measure neighborhood built environment attributes. Outdoor walking levels were measured by using the Geographic Positioning System (GPS) technology. Data on personal characteristics was collected by completing a questionnaire. The results show that inequalities in certain land-use intensity (i.e., green spaces, recreation centers, schools and industries) in high- versus low-deprivation areas may influence disparities in older adults’ outdoor walking levels. Modifying neighborhood land use intensity may help to encourage outdoor walking in high-deprivation areas. PMID:28686219

Weight change during childhood acute lymphoblastic leukemia induction therapy predicts obesity: a report from the Children's Oncology Group.

PubMed

Withycombe, Janice S; Smith, Lynette M; Meza, Jane L; Merkle, Carrie; Faulkner, Melissa Spezia; Ritter, Leslie; Seibel, Nita L; Moore, Ki

2015-03-01

Obesity is a well documented problem associated with childhood acute lymphoblastic leukemia (ALL) with increasing body mass index often observed during therapy. This study aims to evaluate if weight gain, early in therapy, is predictive of obesity at the end of treatment. In this secondary analysis, data from 1,017 high-risk ALL patients previously treated on a Children's Oncology Group protocol (CCG study 1961) were reviewed. Logistic regression was used to examine whether change in BMI z-score at Induction or Delayed Intensification (DI) 1 were predictive of obesity at the end of therapy. The BMI z-score at the beginning of Induction and the change in BMI z-score during Induction were both significant predictors of obesity at the end of therapy. The change in BMI z-score during cycle 1 of DI was not found to be associated with obesity. It is well know that obesity at the beginning of therapy is predictive of obesity at the end of ALL therapy. The new, and more important, finding from this study is that even after adjusting for baseline weight, the increase in BMI z-scores during induction was an independent predictor of obesity at the end of therapy. Most researchers agree that prevention is the best form of treatment for obesity as it is difficult to reverse once it is present. This study suggests that monitoring weight trends during Induction may be useful in guiding healthcare practitioners in identifying which patients are at highest risk for obesity development so that early intervention may occur. © 2014 Wiley Periodicals, Inc.

Ghrelin level negatively predicts quality of life in obese women.

PubMed

Lu, P H; Song, Y L; Hsu, C H

2017-02-01

A cross-sectional cohort study was conducted to investigate whether ghrelin level in obese women predicts the quality of life (QOL). A total of 307 subjects fulfilled the criteria: (1) age between 20 and 65 years old, (2) body mass index ≥27 kg/m 2 (3) waist circumference ≥80 cm were enrolled in the study. All subjects were assigned to one of the plasma ghrelin level categories according to the quartiles. The median of age and BMI of the 307 obese women were 45 ± 18 years and 29.9 ± 4.1 kg/m 2 , respectively. The main outcome evaluated is the associations of plasma ghrelin level and QOL, which were evaluated using multiple linear regression analysis. Results of linear trend test show significant statistical difference in plasma lipoproteins (triglyceride, cholesterol, HDL-cholestero and LDL-cholesterol = and levels of obesity-related hormone peptides, including leptin, adiponectin, insulin among quartiles of ghrelin. Multiple liner regression analysis of serum obesity-related hormone peptide level and QOL using stepwise method shows ghrelin concentration was the only predictor of QOL, including PCS-12 level (β = -0.18, p = 0.001), MCS-12 level (β = -0.14, p = 0.009), WHOQOL-BREF scores: physical (β = -0.13, p = 0.03), psychological (β = -0.16, p = 0.007), social (β = -0.21, p =  < 0.001), and environmental (β = -0.22, p =  <0.001), after adjusting other factors for obese female subjects. This study demonstrated that ghrelin concentration is strongly associated with QOL level among obese women. Hence, ghrelin concentration might be a valuable marker to be monitored in obese women.

Validation of prediction equations for estimating resting energy expenditure in obese Chinese children.

PubMed

Chan, Dorothy F Y; Li, Albert M; Chan, Michael H M; So, Hung Kwan; Chan, Iris H S; Yin, Jane A T; Lam, Christopher W K; Fok, Tai Fai; Nelson, Edmund A S

2009-01-01

(1) To examine the validity of existing prediction equations (PREE) for estimating resting energy expenditure (REE) in obese Chinese children, (2) to correlate the measured REE (MREE) with anthropometric and biochemical parameters and (3) to derive a new PREE for local use. Cross-sectional study. 100 obese children (71 boys) were studied. All subjects underwent physical examination and anthropometric measurement. Upper and central body fat distribution was signified by centrality and conicity index respectively, and REE was measured by indirect calorimetry. Fat free mass (FFM) were measured by DEXA scan. Thirteen existing prediction equations for estimating REE were compared with MREE among these obese children. Fasting blood for glucose, lipid profile and insulin were obtained. The overall, male and female median MREEs were 7.1 mJ/d (IR 6.2-8.4), 7.3 mJ/d (IR 6.3-9.7) and 6.9 mJ/d (IR 5.6-8.1) respectively. No sex difference was noted in MREE (p=0.203). Most of the equations except Schofield equation underestimated REE of our children. By multiple linear regression, MREE was positively correlated with FFM (p<0.0001), conicity index (p<0.001) and centrality index (p=0.001). A new equation for estimating REE for local use was derived as: REE=(17.4*logFFM)+(11.4*conicity index)-(2.4*centrality index)-31.3. The mean difference of new PREE-MREE was -0.011 mJ/d (SD 1.51) with an interclass correlation coefficient of 0.91. None of the existing prediction equations were accurate in their estimation of REE, when applied to obese Chinese children. A new prediction equation has been derived for local use.

Lower levels of maternal capital in early life predict offspring obesity in adulthood.

PubMed

Gillette, Meghan T; Lohman, Brenda J; Neppl, Tricia K

2017-05-01

As of 2013, 65% of the world's population lived in countries where overweight/obesity kills more people than being underweight. Evolutionary perspectives provide a holistic understanding of both how and why obesity develops and its long-term implications. To test whether the maternal capital hypothesis, an evolutionary perspective, is viable for explaining the development of obesity in adulthood. Restricted-use data from the National Longitudinal Study of Adolescent Health (Add Health; n = 11 403) was analysed using logistic regressions. The sample included adolescents and their biological mothers. The odds of obesity in adulthood increased by 22% for every standard deviation increase in lack of maternal capital (Exp (B) = 1.22, p < .001). That is, individuals whose mothers were young, of an ethnic minority and had short breastfeeding durations were more likely to be obese in adulthood, even after controlling for other factors in infancy, adolescence and adulthood. The results showed that those whose mothers had lower capital were more prone to later life disease (specifically, obesity). The maternal capital perspective is useful for explaining how and why early life characteristics (including maternal resources) predict obesity in adulthood. Implications of the findings are discussed.

Six-minute walking test predicts maximal fat oxidation in obese children.

PubMed

Makni, E; Moalla, W; Trabelsi, Y; Lac, G; Brun, J F; Tabka, Z; Elloumi, M

2012-07-01

Obesity is associated with reduced exercise maximal fat oxidation rate (FATmax), which is generally assessed by cardiopulmonary cycling test. The six-minute walking test (6MWT) presents an alternative method in patients. The aim of this study was to establish a practical reference equation facilitating the prediction of FATmax from the 6 MWT in obese children of both genders. This study is a cross-sectional study using mixed linear and multiple regression models. Anthropometric measurements were recorded and submaximal cycling test and 6 MWT conducted for 131 school-aged obese children, 68 boys and 63 girls. A multiple regression analysis for FATmax, including six-minute walking distance (6 MWD), anthropometric and cardiac parameters as the dependent variables, was performed for the two genders separately. Mean 6 MWD and FATmax were 564.9 ± 53.7 m and 126.5 ± 12.1 mg min(-1) for boys and 506.7 ± 55.0 m and 120.7 ± 10.0 mg min(-1) for girls, respectively. The 6MWD, body mass index, Z-score, fat-free mass, waist and hip circumferences (WC and HC), rest heart rate, and systolic and diastolic blood pressures were highly correlated with FATmax for both genders. There was a significant correlation between 6 MWD and FATmax in both boys and girls (r = 0.88 and r = 0.81, P<0.001, respectively). Stepwise regression analyses revealed that the combinations of 6 MWD with HC for boys and 6MWD with WC for girls improved the predictability of the model (R(2) = 0.81 for boys and R(2) = 0.72 for girls; P<0.001). In obese children, the 6MWT can be used to predict FATmax when formal test of exercise capacity and gas exchange analysis are unavailable or impractical. It is therefore possible to prescript targeted exercises at FATmax, without performing indirect calorimetry, just from a field test.

Short Sleep Times Predict Obesity in Internal Medicine Clinic Patients

PubMed Central

Buscemi, Dolores; Kumar, Ashwani; Nugent, Rebecca; Nugent, Kenneth

2007-01-01

Study Objectives: Epidemiological studies have demonstrated an association between short sleep times and obesity as defined by body mass index (BMI). We wanted to determine whether this association occurs in patients with chronic medical diagnoses since the number of confounding factors is likely higher in patients than the general population. Methods: Two hundred patients attending internal medicine clinics completed a survey regarding sleep habits, lifestyle characteristics, and medical diagnoses. An independent surveyor collected the information on the questionnaires and reviewed the medical records. Height and weight were measured by clinic personnel. Data were analyzed with multivariate logistic regression. Results: Subjects with short sleep times (< 7 hours) had an increased likelihood of obesity as defined by a BMI ≥ 30 kg/m2 when compared to the reference group of (8, 9] hours (odds ratio 2.93; 95% confidence interval, 1.06–8.09). There was a U-shaped relationship between obesity and sleep time in women but not in men. Young age (18 to 49 years), not smoking, drinking alcohol, hypertension, diabetes, and sleep apnea were also associated with obesity in the overall model. Conclusions: This study demonstrates an association between short sleep times and obesity in undifferentiated patients attending an internal medicine clinic using models adjusting for age, lifestyle characteristics, and some medical diagnoses. The U-shaped relationship in women suggests that sleep patterns may have gender specific associations. These observations provide the background for therapeutic trials in weight loss in patients with established medical problems. Citation: Buscemi D; Kumar A; Nugent R; Nugent K. Short sleep times predict obesity in internal medicine clinic patients. J Clin Sleep Med 2007;3(7):681–688. PMID:18198800

Obesity management: what brings success?

PubMed Central

Rössner, Stephan

2013-01-01

The upward trend in obesity prevalence across regions and continents is a worldwide concern. Today a majority of the world’s population live in a country where being overweight or obese causes more deaths than being underweight. Only a portion of those qualifying for treatment will get the health care they need. Still, a minor weight loss of 5–10% seems to be sufficient to provide a clinically significant health benefit in terms of risk factors for cardiovascular disease and diabetes. Diet, exercise and behavior modifications remain the current cornerstones of obesity treatment. Weight-loss drugs play a minor role. Drugs which were available and reasonably effective have been withdrawn because of side effects. The fact that the ‘old’ well known, but pretty unexciting tools remain the basic armamentarium causes understandable concern and disappointment among both patients and therapists. Hence, bariatric surgery has increasingly been recognized and developed, as it offers substantial weight loss and prolonged weight control. The present review highlights the conventional tools to counter obesity, lifestyle modification, pharmacotherapy and bariatric surgery, including some of the barriers to successful weight loss: (1) unrealistic expectations of success; (2) high attrition rates; (3) cultural norms of self-acceptance in terms of weight and beliefs of fat being healthy; (4) neighborhood attributes such as a lack of well-stocked supermarkets and rather the presence of convenience stores with low-quality foods; and (5) the perception of the neighborhood as less safe and with low walkability. Prevention is the obvious key. Cost-effective societal interventions such as a tax on unhealthy food and beverages, front-of-pack traffic light nutrition labeling and prohibition of advertising of junk food and beverages to children are also discussed. PMID:23320052

Obesity management: what brings success?

PubMed

Lagerros, Ylva Trolle; Rössner, Stephan

2013-01-01

The upward trend in obesity prevalence across regions and continents is a worldwide concern. Today a majority of the world's population live in a country where being overweight or obese causes more deaths than being underweight. Only a portion of those qualifying for treatment will get the health care they need. Still, a minor weight loss of 5-10% seems to be sufficient to provide a clinically significant health benefit in terms of risk factors for cardiovascular disease and diabetes. Diet, exercise and behavior modifications remain the current cornerstones of obesity treatment. Weight-loss drugs play a minor role. Drugs which were available and reasonably effective have been withdrawn because of side effects. The fact that the 'old' well known, but pretty unexciting tools remain the basic armamentarium causes understandable concern and disappointment among both patients and therapists. Hence, bariatric surgery has increasingly been recognized and developed, as it offers substantial weight loss and prolonged weight control. The present review highlights the conventional tools to counter obesity, lifestyle modification, pharmacotherapy and bariatric surgery, including some of the barriers to successful weight loss: (1) unrealistic expectations of success; (2) high attrition rates; (3) cultural norms of self-acceptance in terms of weight and beliefs of fat being healthy; (4) neighborhood attributes such as a lack of well-stocked supermarkets and rather the presence of convenience stores with low-quality foods; and (5) the perception of the neighborhood as less safe and with low walkability. Prevention is the obvious key. Cost-effective societal interventions such as a tax on unhealthy food and beverages, front-of-pack traffic light nutrition labeling and prohibition of advertising of junk food and beverages to children are also discussed.

Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Behavioral Domain.

PubMed

Lytle, Leslie A; Nicastro, Holly L; Roberts, Susan B; Evans, Mary; Jakicic, John M; Laposky, Aaron D; Loria, Catherine M

2018-04-01

The ability to identify and measure behaviors that are related to weight loss and the prevention of weight regain is crucial to understanding the variability in response to obesity treatment and the development of tailored treatments. The overarching goal of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project is to provide obesity researchers with guidance on a set of constructs and measures that are related to weight control and that span and integrate obesity-related behavioral, biological, environmental, and psychosocial domains. This article describes how the behavioral domain subgroup identified the initial list of high-priority constructs and measures to be included, and it describes practical considerations for assessing the following four behavioral areas: eating, activity, sleep, and self-monitoring of weight. Challenges and considerations for advancing the science related to weight loss and maintenance behaviors are also discussed. Assessing a set of core behavioral measures in combination with those from other ADOPT domains is critical to improve our understanding of individual variability in response to adult obesity treatment. The selection of behavioral measures is based on the current science, although there continues to be much work needed in this field. © 2018 The Obesity Society.

Does Walkability Contribute to Geographic Variation in Psychosocial Distress? A Spatial Analysis of 91,142 Members of the 45 and Up Study in Sydney, Australia

PubMed Central

Morgan, Geoffrey G.; Jalaludin, Bin B.; Bauman, Adrian E.

2018-01-01

Walkability describes the capacity of the built environment to promote walking, and has been proposed as a potential focus for community-level mental health planning. We evaluated this possibility by examining the contribution of area-level walkability to variation in psychosocial distress in a population cohort at spatial scales comparable to those used for regional planning in Sydney, Australia. Data on psychosocial distress were analysed for 91,142 respondents to the 45 and Up Study baseline survey between January 2006 and April 2009. We fit conditional auto regression models at the postal area level to obtain smoothed “disease maps” for psychosocial distress, and assess its association with area-level walkability after adjusting for individual- and area-level factors. Prevalence of psychosocial distress was 7.8%; similar for low (7.9%), low-medium (7.9%), medium-high (8.0%), and high (7.4%) walkability areas; and decreased with reducing postal area socioeconomic disadvantage: 12.2% (most), 9.3%, 7.5%, 5.9%, and 4.7% (least). Unadjusted disease maps indicated strong geographic clustering of psychosocial distress with 99.0% of excess prevalence due to unobserved and spatially structured factors, which was reduced to 55.3% in fully adjusted maps. Spatial and unstructured variance decreased by 97.3% and 39.8% after adjusting for individual-level factors, and another 2.3% and 4.2% with the inclusions of area-level factors. Excess prevalence of psychosocial distress in postal areas was attenuated in adjusted models but remained spatially structured. Postal area prevalence of high psychosocial distress is geographically clustered in Sydney, but is unrelated to postal area walkability. Area-level socioeconomic disadvantage makes a small contribution to this spatial structure; however, community-level mental health planning will likely deliver greatest benefits by focusing on individual-level contributors to disease burden and inequality associated with psychosocial

Does Walkability Contribute to Geographic Variation in Psychosocial Distress? A Spatial Analysis of 91,142 Members of the 45 and Up Study in Sydney, Australia.

PubMed

Mayne, Darren J; Morgan, Geoffrey G; Jalaludin, Bin B; Bauman, Adrian E

2018-02-06

Walkability describes the capacity of the built environment to promote walking, and has been proposed as a potential focus for community-level mental health planning. We evaluated this possibility by examining the contribution of area-level walkability to variation in psychosocial distress in a population cohort at spatial scales comparable to those used for regional planning in Sydney, Australia. Data on psychosocial distress were analysed for 91,142 respondents to the 45 and Up Study baseline survey between January 2006 and April 2009. We fit conditional auto regression models at the postal area level to obtain smoothed "disease maps" for psychosocial distress, and assess its association with area-level walkability after adjusting for individual- and area-level factors. Prevalence of psychosocial distress was 7.8%; similar for low (7.9%), low-medium (7.9%), medium-high (8.0%), and high (7.4%) walkability areas; and decreased with reducing postal area socioeconomic disadvantage: 12.2% (most), 9.3%, 7.5%, 5.9%, and 4.7% (least). Unadjusted disease maps indicated strong geographic clustering of psychosocial distress with 99.0% of excess prevalence due to unobserved and spatially structured factors, which was reduced to 55.3% in fully adjusted maps. Spatial and unstructured variance decreased by 97.3% and 39.8% after adjusting for individual-level factors, and another 2.3% and 4.2% with the inclusions of area-level factors. Excess prevalence of psychosocial distress in postal areas was attenuated in adjusted models but remained spatially structured. Postal area prevalence of high psychosocial distress is geographically clustered in Sydney, but is unrelated to postal area walkability. Area-level socioeconomic disadvantage makes a small contribution to this spatial structure; however, community-level mental health planning will likely deliver greatest benefits by focusing on individual-level contributors to disease burden and inequality associated with psychosocial

Earlier Mother's Age at Menarche Predicts Rapid Infancy Growth and Childhood Obesity

PubMed Central

Ong, Ken K; Northstone, Kate; Wells, Jonathan CK; Rubin, Carol; Ness, Andy R; Golding, Jean; Dunger, David B

2007-01-01

Background Early menarche tends to be preceded by rapid infancy weight gain and is associated with increased childhood and adult obesity risk. As age at menarche is a heritable trait, we hypothesised that age at menarche in the mother may in turn predict her children's early growth and obesity risk. Methods and Findings We tested associations between mother's age at menarche, mother's adult body size and obesity risk, and her children's growth and obesity risk in 6,009 children from the UK population-based Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort who had growth and fat mass at age 9 y measured by dual-energy X-ray absorptiometry. A subgroup of 914 children also had detailed infancy and childhood growth data. In the mothers, earlier menarche was associated with shorter adult height (by 0.64 cm/y), increased weight (0.92 kg/y), and body mass index (BMI, 0.51 kg/m2/y; all p < 0.001). In contrast, in her children, earlier mother's menarche predicted taller height at 9 y (by 0.41 cm/y) and greater weight (0.80 kg/y), BMI (0.29 kg/m2/y), and fat mass index (0.22 kg/m2/year; all p < 0.001). Children in the earliest mother's menarche quintile (≤11 y) were more obese than the oldest quintile (≥15 y) (OR, 2.15, 95% CI 1.46 to 3.17; p < 0.001, adjusted for mother's education and BMI). In the subgroup, children in the earliest quintile showed faster gains in weight (p < 0.001) and height (p < 0.001) only from birth to 2 y, but not from 2 to 9 y (p = 0.3–0.8). Conclusions Earlier age at menarche may be a transgenerational marker of a faster growth tempo, characterised by rapid weight gain and growth, particularly during infancy, and leading to taller childhood stature, but likely earlier maturation and therefore shorter adult stature. This growth pattern confers increased childhood and adult obesity risks. PMID:17455989

Physical Activity and Food Environments: Solutions to the Obesity Epidemic

PubMed Central

Sallis, James F; Glanz, Karen

2009-01-01

Context: Environmental, policy, and societal changes are important contributors to the rapid rise in obesity over the past few decades, and there has been substantial progress toward identifying environmental and policy factors related to eating and physical activity that can point toward solutions. This article is a status report on research on physical activity and food environments, and it suggests how these findings can be used to improve diet and physical activity and to control or reduce obesity. Methods: This article summarizes and synthesizes recent reviews and provides examples of representative studies. It also describes ongoing innovative interventions and policy change efforts that were identified through conference presentations, media coverage, and websites. Findings: Numerous cross-sectional studies have consistently demonstrated that some attributes of built and food environments are associated with physical activity, healthful eating, and obesity. Residents of walkable neighborhoods who have good access to recreation facilities are more likely to be physically active and less likely to be overweight or obese. Residents of communities with ready access to healthy foods also tend to have more healthful diets. Disparities in environments and policies that disadvantage low-income communities and racial minorities have been documented as well. Evidence from multilevel studies, prospective research, and quasi-experimental evaluations of environmental changes are just beginning to emerge. Conclusions: Environment, policy, and multilevel strategies for improving diet, physical activity, and obesity control are recommended based on a rapidly growing body of research and the collective wisdom of leading expert organizations. A public health imperative to identify and implement solutions to the obesity epidemic warrants the use of the most promising strategies while continuing to build the evidence base. PMID:19298418

Postnatal BMI changes in children with different birthweights: A trial study for detecting early predictive factors for pediatric obesity

PubMed Central

Nakagawa, Yuichi; Nakanishi, Toshiki; Satake, Eiichiro; Matsushita, Rie; Saegusa, Hirokazu; Kubota, Akira; Natsume, Hiromune; Shibata, Yukinobu; Fujisawa, Yasuko

2018-01-01

Abstract. The purpose of this study was to clarify the degree of early postnatal growth by birthweight and detect early predictive factors for pediatric obesity. Body mass index (BMI) and degree of obesity were examined in children in the fourth year of elementary school and second year of junior high school. Their BMI at birth and three years of age were also examined. Based on birthweight, participants were divided into three groups: low (< 2500 g), middle (2500–3500 g), and high (> 3500 g). Furthermore, according to the degree of obesity, they were divided into two groups: obese (20% ≤) and non-obese (20% >). The change of BMI from birth to three years of age (ΔBMI) showed a strong inverse relationship with birthweight and was significantly different among the three birthweight groups (low > middle > high). The ΔBMI and BMI at three years of age were higher in obese than in non-obese children and showed significant positive correlations with the degree of obesity. Early postnatal growth might be determined by birthweight and was higher in obese than in non-obese children. The ΔBMI from birth to three years of age and BMI at age of three years could be predictive factors for pediatric obesity. PMID:29403153

Fast-food outlets and walkability in school neighbourhoods predict fatness in boys and height in girls: a Taiwanese population study.

PubMed

Chiang, Po-Huang; Wahlqvist, Mark L; Lee, Meei-Shyuan; Huang, Lin-Yuan; Chen, Hui-Hsin; Huang, Susana Tzy-Ying

2011-09-01

There is increasing evidence that the school food environment contributes to childhood obesity and health in various locations. We investigated the influence of fast-food stores and convenience food stores (FS and CS, respectively) on growth and body composition in a range of residential densities for North-east Asian food culture. Anthropometrics and birth weight of schoolchildren were obtained. Geocoded mapping of schools and food outlets was conducted. Multivariable linear regression models, adjusted for father's ethnicity and education, as well as for household income, pocket money, birth weight, physical activity, television watching, food quality and region, were used to predict body composition from school food environments. Elementary schools and school neighbourhoods in 359 townships/districts of Taiwan. A total of 2283 schoolchildren aged 6-13 years from the Elementary School Children's Nutrition and Health Survey in Taiwan conducted in 2001-2002. Remote and socially disadvantaged locations had the highest prevalence of lower weight, BMI, waist circumference and triceps skinfold thickness. Food store densities, FS and CS, were highest in urban Taiwan and lowest in remote Taiwan. In the fully adjusted models, FS densities predicted weight and BMI in boys; there was a similar association for waist circumference, except when adjusted for region. FS densities also predicted height for girls. Except for weight and BMI in boys, CS did not have effects evident with FS for either boys or girls. A high FS density, more than CS density, in Taiwan increased the risk of general (BMI) and abdominal (waist circumference) obesity in boys and stature in girls. These findings have long-term implications for chronic disease in adulthood.

Impact of obesity on the predictive accuracy of prostate-specific antigen density and prostate-specific antigen in native Korean men undergoing prostate biopsy.

PubMed

Kim, Jae Heon; Doo, Seung Whan; Yang, Won Jae; Lee, Kwang Woo; Lee, Chang Ho; Song, Yun Seob; Jeon, Yoon Su; Kim, Min Eui; Kwon, Soon-Sun

2014-10-01

To evaluate the impact of obesity on the biopsy detection of prostate cancer. We retrospectively reviewed data of 1182 consecutive Korean patients (≥50 years) with serum prostate-specific antigen levels of 3-10 ng/mL who underwent initial extended 12-cores biopsy from September 2009 to March 2013. Patients who took medications that were likely to influence the prostate-specific antigen level were excluded. Receiver operating characteristic curves were plotted for prostate-specific antigen and prostate-specific antigen density predicting cancer status among non-obese and obese men. A total of 1062 patients (mean age 67.1 years) were enrolled in the analysis. A total of 230 men (21.7%) had a positive biopsy. In the overall study sample, the area under the receiver operator characteristic curve of serum prostate-specific antigen for predicting prostate cancer on biopsy were 0.584 and 0.633 for non-obese and obese men, respectively (P = 0.234). However, the area under the curve for prostate-specific antigen density in predicting cancer status showed a significant difference (non-obese 0.696, obese 0.784; P = 0.017). There seems to be a significant difference in the ability of prostate-specific antigen density to predict biopsy results between non-obese and obese men. Obesity positively influenced the overall ability of prostate-specific antigen density to predict prostate cancer. © 2014 The Japanese Urological Association.

Predicting hepatic steatosis and liver fat content in obese children based on biochemical parameters and anthropometry.

PubMed

Zhang, H-X; Xu, X-Q; Fu, J-F; Lai, C; Chen, X-F

2015-04-01

Predictors of quantitative evaluation of hepatic steatosis and liver fat content (LFC) using clinical and laboratory variables available in the general practice in the obese children are poorly identified. To build predictive models of hepatic steatosis and LFC in obese children based on biochemical parameters and anthropometry. Hepatic steatosis and LFC were determined using proton magnetic resonance spectroscopy in 171 obese children aged 5.5-18.0 years. Routine clinical and laboratory parameters were also measured in all subjects. Group analysis, univariable correlation analysis, and multivariate logistic and linear regression analysis were used to develop a liver fat score to identify hepatic steatosis and a liver fat equation to predict LFC in each subject. The predictive model of hepatic steatosis in our participants based on waist circumference and alanine aminotransferase had an area under the receiver operating characteristic curve of 0.959 (95% confidence interval: 0.927-0.990). The optimal cut-off value of 0.525 for determining hepatic steatosis had sensitivity of 93% and specificity of 90%. A liver fat equation was also developed based on the same parameters of hepatic steatosis liver fat score, which would be used to calculate the LFC in each individual. The liver fat score and liver fat equation, consisting of routinely available variables, may help paediatricians to accurately determine hepatic steatosis and LFC in clinical practice, but external validation is needed before it can be employed for this purpose. © 2014 The Authors. Pediatric Obesity © 2014 World Obesity.

Behavioral and Environmental Modification of the Genetic Influence on Body Mass Index: A Twin Study.

PubMed

Horn, Erin E; Turkheimer, Eric; Strachan, Eric; Duncan, Glen E

2015-07-01

Body mass index (BMI) has a strong genetic basis, with a heritability around 0.75, but is also influenced by numerous behavioral and environmental factors. Aspects of the built environment (e.g., environmental walkability) are hypothesized to influence obesity by directly affecting BMI, by facilitating or inhibiting behaviors such as physical activity that are related to BMI, or by suppressing genetic tendencies toward higher BMI. The present study investigated relative influences of physical activity and walkability on variance in BMI using 5079 same-sex adult twin pairs (70 % monozygotic, 65 % female). High activity and walkability levels independently suppressed genetic variance in BMI. Estimating their effects simultaneously, however, suggested that the walkability effect was mediated by activity. The suppressive effect of activity on variance in BMI was present even with a tendency for low-BMI individuals to select into environments that require higher activity levels. Overall, our results point to community- or macro-level interventions that facilitate individual-level behaviors as a plausible approach to addressing the obesity epidemic among US adults.

Behavioral and environmental modification of the genetic influence on body mass index: A twin study

PubMed Central

Horn, Erin E.; Turkheimer, Eric; Strachan, Eric; Duncan, Glen E.

2015-01-01

Body mass index (BMI) has a strong genetic basis, with a heritability around 0.75, but is also influenced by numerous behavioral and environmental factors. Aspects of the built environment (e.g., environmental walkability) are hypothesized to influence obesity by directly affecting BMI, by facilitating or inhibiting behaviors such as physical activity that are related to BMI, or by suppressing genetic tendencies toward higher BMI. The present study investigated relative influences of physical activity and walkability on variance in BMI using 5,079 same-sex adult twin pairs (70% monozygotic, 65% female). High activity and walkability levels independently suppressed genetic variance in BMI. Estimating their effects simultaneously, however, suggested that the walkability effect was mediated by activity. The suppressive effect of activity on variance in BMI was present even with a tendency for low-BMI individuals to select into environments that require higher activity levels. Overall, our results point to community- or macro-level interventions that facilitate individual-level behaviors as a plausible approach to addressing the obesity epidemic among U.S. adults. PMID:25894925

Brain structure predicts risk for obesity ☆

PubMed Central

Smucny, Jason; Cornier, Marc-Andre; Eichman, Lindsay C.; Thomas, Elizabeth A.; Bechtell, Jamie L.; Tregellas, Jason R.

2014-01-01

The neurobiology of obesity is poorly understood. Here we report findings of a study designed to examine the differences in brain regional gray matter volume in adults recruited as either Obese Prone or Obese Resistant based on self-identification, body mass index, and personal/family weight history. Magnetic resonance imaging was performed in 28 Obese Prone (14 male, 14 female) and 25 Obese Resistant (13 male, 12 female) healthy adults. Voxel-based morphometry was used to identify gray matter volume differences between groups. Gray matter volume was found to be lower in the insula, medial orbitofrontal cortex and cerebellum in Obese Prone, as compared to Obese Resistant individuals. Adjusting for body fat mass did not impact these results. Insula gray matter volume was negatively correlated with leptin concentration and measures of hunger. These findings suggest that individuals at risk for weight gain have structural differences in brain regions known to be important in energy intake regulation, and that these differences, particularly in the insula, may be related to leptin. PMID:22963736

Framework for developing a spatial walkability index (SWI) for the light-rail transit (LRT) stations in Kuala Lumpur city centre using analytical network process (ANP) and GIS

NASA Astrophysics Data System (ADS)

Naharudin, Nabilah; Ahamad, Mohd Sanusi S.; Sadullah, Ahmad Farhan Mohd

2017-10-01

In support to the nation's goal of developing a liveable city, Malaysian government aims to improve the mobility in Kuala Lumpur by providing good quality transit services across the city. However, the public starts to demand for more than just a connectivity between two points. They want their transit journey to be comfortable and pleasant from the very first mile. The key here is the first and last mile (FLM) of the transit service which defines their journey to access the station itself. The question is, does the existing transit services' FLM satisfy public's needs? Therefore, many studies had emerged in attempt to assess the pedestrian-friendliness. While most of them did base on the pedestrian's perceptions, there were also studies that spatially measured the connectivity and accessibility to various landuses and point of interests. While both can be a good method, their integration could actually produce a better assessment. However, till date, only a few studies had attempted to do so. This paper proposes a framework to develop a Spatial Walkability Index (SWI) by integrating a multicriteria evaluation technique, Analytical Network Process (ANP) and network analysis on geographical information system (GIS) platform. First, ANP will aggregate the degree of importance for each walkability criteria based on the pedestrian's perceptions. Then, the network analysis will use the weighted criteria as attributes to find the walkable routes within half mile radius from each station. The index will be calculated by rationing the total length of walkable routes in respect to the available footpath. The final outcome is a percentage of walkable FLM transit routes for each station which will be named as the SWI. It is expected that the developed framework can be applied in other cities across the globe. It can also be improvised to suit the demand and purpose there.

Gut Microbiota Signatures Predict Host and Microbiota Responses to Dietary Interventions in Obese Individuals

PubMed Central

Korpela, Katri; Flint, Harry J.; Johnstone, Alexandra M.; Lappi, Jenni; Poutanen, Kaisa; Dewulf, Evelyne; Delzenne, Nathalie; de Vos, Willem M.; Salonen, Anne

2014-01-01

Background Interactions between the diet and intestinal microbiota play a role in health and disease, including obesity and related metabolic complications. There is great interest to use dietary means to manipulate the microbiota to promote health. Currently, the impact of dietary change on the microbiota and the host metabolism is poorly predictable and highly individual. We propose that the responsiveness of the gut microbiota may depend on its composition, and associate with metabolic changes in the host. Methodology Our study involved three independent cohorts of obese adults (n = 78) from Belgium, Finland, and Britain, participating in different dietary interventions aiming to improve metabolic health. We used a phylogenetic microarray for comprehensive fecal microbiota analysis at baseline and after the intervention. Blood cholesterol, insulin and inflammation markers were analyzed as indicators of host response. The data were divided into four training set – test set pairs; each intervention acted both as a part of a training set and as an independent test set. We used linear models to predict the responsiveness of the microbiota and the host, and logistic regression to predict responder vs. non-responder status, or increase vs. decrease of the health parameters. Principal Findings Our models, based on the abundance of several, mainly Firmicute species at baseline, predicted the responsiveness of the microbiota (AUC  =  0.77–1; predicted vs. observed correlation  =  0.67–0.88). Many of the predictive taxa showed a non-linear relationship with the responsiveness. The microbiota response associated with the change in serum cholesterol levels with an AUC of 0.96, highlighting the involvement of the intestinal microbiota in metabolic health. Conclusion This proof-of-principle study introduces the first potential microbial biomarkers for dietary responsiveness in obese individuals with impaired metabolic health, and reveals the potential of

Predictive validity of four bioelectrical impedance equations in determining percent fat mass in overweight and obese children.

PubMed

Cleary, Jane; Daniells, Suzie; Okely, Anthony D; Batterham, Marijka; Nicholls, Jessie

2008-01-01

Bioelectrical impedance equations are frequently used by food and nutrition professionals to estimate percent fat mass in overweight and obese children. However, it is not known whether they are accurate for such children, as they have been primarily developed for children of varying body weights. The aim of this cross-sectional study was to evaluate the predictive validity of four previously published prediction equations developed for the pediatric population, among a sample of overweight and obese children. Thirty overweight or obese children (mean age=7.57+/-1.28 years) underwent measurement of fat mass, percent fat mass, and fat-free mass using dual-energy x-ray absorptiometry (DEXA) and bioelectrical impedance analysis (BIA). Impedance values from the BIA were entered into the four prediction equations and Pearson correlations used to determine the significance of associations between each of the BIA prediction equations and DEXA for percent fat mass, fat mass, and fat-free mass. For percent fat mass, paired t tests were used to assess differences between the methods and the technique of Bland and Altman was used to determine bias and error. Results showed that the mean percent fat mass as determined by DEXA for this age group was 40.79%. In comparison with other BIA prediction equations, the Schaefer equation had the closest mean value of 41.98%, and was the only equation not to significantly differ from the DEXA (P=0.121). This study suggests that the Schaefer equation is the only accurate BIA prediction equation for assessing percent fat mass in this sample of overweight and obese children from primarily white backgrounds.

Cross-validation of the factorial structure of the Neighborhood Environment Walkability Scale (NEWS) and its abbreviated form (NEWS-A)

USDA-ARS?s Scientific Manuscript database

The Neighborhood Environment Walkability Scale (NEWS) and its abbreviated form (NEWS-A) assess perceived environmental attributes believed to influence physical activity. A multilevel confirmatory factor analysis (MCFA) conducted on a sample from Seattle, WA, showed that, at the respondent level, th...

Prediction of Adulthood Obesity Using Genetic and Childhood Clinical Risk Factors in the Cardiovascular Risk in Young Finns Study.

PubMed

Seyednasrollah, Fatemeh; Mäkelä, Johanna; Pitkänen, Niina; Juonala, Markus; Hutri-Kähönen, Nina; Lehtimäki, Terho; Viikari, Jorma; Kelly, Tanika; Li, Changwei; Bazzano, Lydia; Elo, Laura L; Raitakari, Olli T

2017-06-01

Obesity is a known risk factor for cardiovascular disease. Early prediction of obesity is essential for prevention. The aim of this study is to assess the use of childhood clinical factors and the genetic risk factors in predicting adulthood obesity using machine learning methods. A total of 2262 participants from the Cardiovascular Risk in YFS (Young Finns Study) were followed up from childhood (age 3-18 years) to adulthood for 31 years. The data were divided into training (n=1625) and validation (n=637) set. The effect of known genetic risk factors (97 single-nucleotide polymorphisms) was investigated as a weighted genetic risk score of all 97 single-nucleotide polymorphisms (WGRS97) or a subset of 19 most significant single-nucleotide polymorphisms (WGRS19) using boosting machine learning technique. WGRS97 and WGRS19 were validated using external data (n=369) from BHS (Bogalusa Heart Study). WGRS19 improved the accuracy of predicting adulthood obesity in training (area under the curve [AUC=0.787 versus AUC=0.744, P <0.0001) and validation data (AUC=0.769 versus AUC=0.747, P =0.026). WGRS97 improved the accuracy in training (AUC=0.782 versus AUC=0.744, P <0.0001) but not in validation data (AUC=0.749 versus AUC=0.747, P =0.785). Higher WGRS19 associated with higher body mass index at 9 years and WGRS97 at 6 years. Replication in BHS confirmed our findings that WGRS19 and WGRS97 are associated with body mass index. WGRS19 improves prediction of adulthood obesity. Predictive accuracy is highest among young children (3-6 years), whereas among older children (9-18 years) the risk can be identified using childhood clinical factors. The model is helpful in screening children with high risk of developing obesity. © 2017 American Heart Association, Inc.

Food-Predicting Stimuli Differentially Influence Eye Movements and Goal-Directed Behavior in Normal-Weight, Overweight, and Obese Individuals

PubMed Central

Lehner, Rea; Balsters, Joshua H.; Bürgler, Alexandra; Hare, Todd A.; Wenderoth, Nicole

2017-01-01

Obese individuals have been shown to exhibit abnormal sensitivity to rewards and reward-predicting cues as for example food-associated cues frequently used in advertisements. It has also been shown that food-associated cues can increase goal-directed behavior but it is currently unknown, whether this effect differs between normal-weight, overweight, and obese individuals. Here, we investigate this question by using a Pavlovian-to-instrumental transfer (PIT) task in normal-weight (N = 20), overweight (N = 17), and obese (N = 17) individuals. Furthermore, we applied eye tracking during Pavlovian conditioning to measure the participants’ conditioned response as a proxy of the incentive salience of the predicted reward. Our results show that the goal-directed behavior of overweight individuals was more strongly influenced by food-predicting cues (i.e., stronger PIT effect) than that of normal-weight and obese individuals (p < 0.001). The weight groups were matched for age, gender, education, and parental education. Eye movements during Pavlovian conditioning also differed between weight categories (p < 0.05) and were used to categorize individuals based on their fixation style into “high eye index” versus “low eye index” as well. Our main finding was that the fixation style exhibited a complex interaction with the weight category. Furthermore, we found that normal-weight individuals of the group “high eye index” had higher body mass index within the healthy range than individuals of the group “low eye index” (p < 0.001), but this relationship was not found within in the overweight or obese groups (p > 0.646). Our findings are largely consistent with the incentive sensitization theory predicting that overweight individuals are more susceptible to food-related cues than normal-weight controls. However, this hypersensitivity might be reduced in obese individuals, possibly due to habitual/compulsive overeating or differences in

[Prediction instrument for obesity in adolescents at the Policlínico Universitario "Manuel González Díaz", 2013-2014].

PubMed

Piña Borrego, Carlos Enrique; Fernández Fernández, María de Lourdes; Fonte Rodríguez, Norge; Piña Rodríguez, Lorena Karla

Obesity is one of the principal non declarable diseases affecting children and adolescents. With the objective of developing a predictive instrument to identify high-risk adolescents with obesity, a cohort prospective study was carried out at the Policlinic "Manuel González Díaz", Bahía Honda City from 2013-2014. It was developed in three stages. In the first stage, 1800 adolescents from 10-19 years of age were included. The prevalence was identified and the most relevant characteristics of obesity were described (defined as body mass index >97 th percentile according to age and sex). In the second stage we identified the possibility of the diagnosis of factors that increase the probability of obesity. The third stage elaborated and validated an obesity predictor instrument from the results of the initial stages. To apply the instrument to sample A for internal elaboration and validation, sensitivity was 77.78% and specificity was 86.11%. Area under the curve (AUC) receiver operating characteristic (ROC) was 0.86, whereas for sample B the sensitivity was 79.63% and specificity was 92.13%. Positive predictive value (PPV) was 83.5% and negative predictive value (NPV) was 90.05%. The instrument allows predicting the risk for developing obesity in adolescents with acceptable sensitivity and high specificity. Its routine application will be interesting in pediatric health consultations. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Campus Walkability, Pedometer-Determined Steps, and Moderate-to-Vigorous Physical Activity: A Comparison of 2 University Campuses

ERIC Educational Resources Information Center

Sisson, Susan B.; Mcclain, James J.; Tudor-Locke, Catrine

2008-01-01

Objective and Participants: At 2 Arizona State University (ASU) campuses, the authors measured student activity and distance walked on campus, as well as student-reported walkability around the student union. Methods: Students from ASU-Polytechnic (n = 20, 33% male) and ASU-Tempe (n = 20, 60% male) recorded distance walked on campus and wore…

How accurate are resting energy expenditure prediction equations in obese trauma and burn patients?

PubMed

Stucky, Chee-Chee H; Moncure, Michael; Hise, Mary; Gossage, Clint M; Northrop, David

2008-01-01

While the prevalence of obesity continues to increase in our society, outdated resting energy expenditure (REE) prediction equations may overpredict energy requirements in obese patients. Accurate feeding is essential since overfeeding has been demonstrated to adversely affect outcomes. The first objective was to compare REE calculated by prediction equations to the measured REE in obese trauma and burn patients. Our hypothesis was that an equation using fat-free mass would give a more accurate prediction. The second objective was to consider the effect of a commonly used injury factor on the predicted REE. A retrospective chart review was performed on 28 patients. REE was measured using indirect calorimetry and compared with the Harris-Benedict and Cunningham equations, and an equation using type II diabetes as a factor. Statistical analyses used were paired t test, +/-95% confidence interval, and the Bland-Altman method. Measured average REE in trauma and burn patients was 21.37 +/- 5.26 and 21.81 +/- 3.35 kcal/kg/d, respectively. Harris-Benedict underpredicted REE in trauma and burn patients to the least extent, while the Cunningham equation underpredicted REE in both populations to the greatest extent. Using an injury factor of 1.2, Cunningham continued to underestimate REE in both populations, while the Harris-Benedict and Diabetic equations overpredicted REE in both populations. The measured average REE is significantly less than current guidelines. This finding suggests that a hypocaloric regimen is worth considering for ICU patients. Also, if an injury factor of 1.2 is incorporated in certain equations, patients may be given too many calories.

Walkability around primary schools and area deprivation across Scotland.

PubMed

Macdonald, Laura; McCrorie, Paul; Nicholls, Natalie; Ellaway, Anne

2016-04-14

A number of studies based in the US, Canada, and Australia, have found evidence of associations between the built environment (BE) and mode of transport to school, and links between active travel and deprivation. Limited research in the UK compares potential BE supports for walking to school by area deprivation. Within this study, we gathered data on BE attributes previously linked to active travel, i.e., street/path connectivity, and dwelling density, created a composite 'walkability score' (WS) for areas around primary schools across urban Scotland, and explored whether poorer areas exhibit lower scores than more affluent areas, or vice versa. We consider this to be a novel approach as few studies have compared BE features by deprivation across a whole country. Address and road/path maps were obtained and primary schools (N = 937) across mainland Scotland were mapped. Schools were attributed income deprivation scores (scores divided into quintiles (Q1: least deprived, Q5: most deprived)). Catchment area (CA) boundaries, i.e., the geographic area representing eligibility for local school attendance, were drawn around schools, and WS calculated for each CA. We compared mean WS by income quintile (ANOVA), for all local authorities (LAs) combined (N = 29), and separately for the four LAs with the greatest number of schools included in the analysis. For all LAs combined, the least deprived quintile (Q1) showed a significantly lower WS (-0.61), than quintiles 3, 4 and 5 (Q2: -0.04 (non-sig), Q3: 0.38, Q4: 0.09, Q5: 0.18); while for Glasgow the second least deprived quintile (Q2) showed significantly higher WS (Q1: 1.35, Q2: 1.73), than middling (Q3: 0.18) and most deprived quintiles (Q4: 0.06, Q5: -0.10). WS differ by deprivation with patterns varying depending on the spatial scale of the analysis. It is essential that less walkable areas are provided with the resources to improve opportunities to engage in active travel.

Population-Adjusted Street Connectivity, Urbanicity and Risk of Obesity in the U.S

PubMed Central

Wang, Fahui; Wen, Ming; Xu, Yanqing

2013-01-01

Street connectivity, defined as the number of (3-way or more) intersections per area unit, is an important index of built environments as a proxy for walkability in a neighborhood. This paper examines its geographic variations across the rural-urban continuum (urbanicity), major racial-ethnic groups and various poverty levels. The population-adjusted street connectivity index is proposed as a better measure than the regular index for a large area such as county due to likely concentration of population in limited space within the large area. Based on the data from the Behavioral Risk Factor Surveillance System (BRFSS), this paper uses multilevel modeling to analyze its association with physical activity and obesity while controlling for various individual and county-level variables. Analysis of data subsets indicates that the influences of individual and county-level variables on obesity risk vary across areas of different urbanization levels. The positive influence of street connectivity on obesity control is limited to the more but not the mostly urbanized areas. This demonstrates the value of obesogenic environment research in different geographic settings, helps us reconcile and synthesize some seemingly contradictory results reported in different studies, and also promotes that effective policies need to be highly sensitive to the diversity of demographic groups and geographically adaptable. PMID:23667278

Is Obesity Predictive of Cardiovascular Dysfunction Independent of Cardiovascular Risk Factors?

PubMed Central

DeVallance, Evan; Fournier, Sara B.; Donley, David A.; Bonner, Daniel E.; Lee, Kyuwan; Frisbee, Jefferson C.; Chantler, Paul D.

2015-01-01

Introduction Obesity is thought to exert detrimental effects on the cardiovascular (CV) system. However, this relationship is impacted by the co-occurrence of CV risk factors, type II diabetes (T2DM), and overt disease. We examined the relationships between obesity, assessed by body mass index (BMI) and waist circumference (WC), and CV function in 102 subjects without overt CV disease. We hypothesized that obesity would be independently predictive of CV remodeling and functional differences, especially at peak exercise. Methods Brachial (bSBP) and central (cSBP) systolic pressure, carotid-to-femoral pulse wave velocity (PWVcf) augmentation index (AGI) (by SphygmoCor), and carotid remodeling (B-mode ultrasound) were examined at rest. Further, peak exercise cardiac imaging (Doppler ultrasound) was performed to measure the coupling between the heart and arterial system. Results In backward elimination regression models, accounting for CV risk factors, neither BMI nor WC were predictors of carotid thickness or PWVcf; rather age, triglycerides, and hypertension were the main determinants. However, BMI and WC predicted carotid cross-sectional area and lumen diameter. When examining the relationship between body size and SBP, BMI (β=0.32) and WC (β=0.25) were predictors of bSBP (p<0.05), whereas, BMI was the only predictor of cSBP (β=0.22, p<0.05) indicating a differential relationship between cSBP, bSBP and body size. Further, BMI (β=−0.26) and WC (β=−0.27) were independent predictors of AGI (p<0.05). As for resting cardiac diastolic function, WC seemed to be a better predictor than BMI. However, both BMI and WC were inversely and independently related to arterial elastance (net arterial load) and end-systolic elastance (cardiac contractility) at rest and peak exercise. Discussion These findings illustrate that obesity, without T2DM and overt CV disease, and after accounting for CV risk factors, is susceptible to pathophysiological adaptations that may

Prediction equation of resting energy expenditure in an adult Spanish population of obese adult population.

PubMed

de Luis, D A; Aller, R; Izaola, O; Romero, E

2006-01-01

The aim of our study was to evaluate the accuracy of the equations to estimate REE in obese patents and develop a new equation in our obese population. A population of 200 obesity outpatients was analyzed in a prospective way. The following variables were specifically recorded: age, weight, body mass index (BMI), waist circumference, and waist-to-hip ratio. Basal glucose, insulin, and TSH (thyroid-stimulating hormone) were measured. An indirect calorimetry and a tetrapolar electrical bioimpedance were performed. REE measured by indirect calorimetry was compared with REE obtained by prediction equations to obese or nonobese patients. The mean age was 44.8 +/- 16.81 years and the mean BMI 34.4 +/- 5.3. Indirect calorimetry showed that, as compared to women, men had higher resting energy expenditure (REE) (1,998.1 +/- 432 vs. 1,663.9 +/- 349 kcal/day; p < 0.05) and oxygen consumption (284.6 +/- 67.7 vs. 238.6 +/- 54.3 ml/min; p < 0.05). Correlation analysis among REE obtained by indirect calorimetry and REE predicted by prediction equations showed the next data; Berstein's equation (r = 0.65; p < 0.05), Harris Benedict's equation (r = 0.58; p < 0.05), Owen's equation (r = 0.56; p < 0.05), Ireton's equation (r = 0.58; p < 0.05) and WHO's equation (r = 0.57; p < 0.05). Both the Berstein's and the Ireton's equations overpredicted REE and showed nonsignificant mean differences form measured REE. The Owen's, WHO's, and Harris Benedict's equations underpredicted REE. Our male prediction equation was REE = 58.6 + (6.1 x weight (kg)) + (1,023.7 x height (m)) - (9.5 x age). The female model was REE = 1,272.5 + (9.8 x weight (kg)) - (61.6 x height (m)) - (8.2 x age). Our prediction equations showed a nonsignificant difference with REE measured (-3.7 kcal/day) with a significant correlation coefficient (r = 0.67; p < 0.05). Previously developed prediction equations overestimated and underestimated REE measured. WHO equation developed in normal weight individuals provided the

The value of genetic information for diabetes risk prediction - differences according to sex, age, family history and obesity.

PubMed

Mühlenbruch, Kristin; Jeppesen, Charlotte; Joost, Hans-Georg; Boeing, Heiner; Schulze, Matthias B

2013-01-01

Genome-wide association studies have identified numerous single nucleotide polymorphisms associated with type 2 diabetes through the past years. In previous studies, the usefulness of these genetic markers for prediction of diabetes was found to be limited. However, differences may exist between substrata of the population according to the presence of major diabetes risk factors. This study aimed to investigate the added predictive value of genetic information (42 single nucleotide polymorphisms) in subgroups of sex, age, family history of diabetes, and obesity. A case-cohort study (random subcohort N = 1,968; incident cases: N = 578) within the European Prospective Investigation into Cancer and Nutrition Potsdam study was used. Prediction models without and with genetic information were evaluated in terms of the area under the receiver operating characteristic curve and the integrated discrimination improvement. Stratified analyses included subgroups of sex, age (<50 or ≥50 years), family history (positive if either father or mother or a sibling has/had diabetes), and obesity (BMI< or ≥30 kg/m(2)). A genetic risk score did not improve prediction above classic and metabolic markers, but - compared to a non-invasive prediction model - genetic information slightly improved the area under the receiver operating characteristic curve (difference [95%-CI]: 0.007 [0.002-0.011]). Stratified analyses showed stronger improvement in the older age group (0.010 [0.002-0.018]), the group with a positive family history (0.012 [0.000-0.023]) and among obese participants (0.015 [-0.005-0.034]) compared to the younger participants (0.005 [-0.004-0.014]), participants with a negative family history (0.003 [-0.001-0.008]) and non-obese (0.007 [0.000-0.014]), respectively. No difference was found between men and women. There was no incremental value of genetic information compared to standard non-invasive and metabolic markers. Our study suggests that inclusion of genetic

The Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures Project: Rationale and Approach.

PubMed

MacLean, Paul S; Rothman, Alexander J; Nicastro, Holly L; Czajkowski, Susan M; Agurs-Collins, Tanya; Rice, Elise L; Courcoulas, Anita P; Ryan, Donna H; Bessesen, Daniel H; Loria, Catherine M

2018-04-01

Individual variability in response to multiple modalities of obesity treatment is well documented, yet our understanding of why some individuals respond while others do not is limited. The etiology of this variability is multifactorial; however, at present, we lack a comprehensive evidence base to identify which factors or combination of factors influence treatment response. This paper provides an overview and rationale of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project, which aims to advance the understanding of individual variability in response to adult obesity treatment. This project provides an integrated model for how factors in the behavioral, biological, environmental, and psychosocial domains may influence obesity treatment responses and identify a core set of measures to be used consistently across adult weight-loss trials. This paper provides the foundation for four companion papers that describe the core measures in detail. The accumulation of data on factors across the four ADOPT domains can inform the design and delivery of effective, tailored obesity treatments. ADOPT provides a framework for how obesity researchers can collectively generate this evidence base and is a first step in an ongoing process that can be refined as the science advances. © 2018 The Obesity Society.

Failing to learn from negative prediction errors: Obesity is associated with alterations in a fundamental neural learning mechanism.

PubMed

Mathar, David; Neumann, Jane; Villringer, Arno; Horstmann, Annette

2017-10-01

Prediction errors (PEs) encode the difference between expected and actual action outcomes in the brain via dopaminergic modulation. Integration of these learning signals ensures efficient behavioral adaptation. Obesity has recently been linked to altered dopaminergic fronto-striatal circuits, thus implying impairments in cognitive domains that rely on its integrity. 28 obese and 30 lean human participants performed an implicit stimulus-response learning paradigm inside an fMRI scanner. Computational modeling and psycho-physiological interaction (PPI) analysis was utilized for assessing PE-related learning and associated functional connectivity. We show that human obesity is associated with insufficient incorporation of negative PEs into behavioral adaptation even in a non-food context, suggesting differences in a fundamental neural learning mechanism. Obese subjects were less efficient in using negative PEs to improve implicit learning performance, despite proper coding of PEs in striatum. We further observed lower functional coupling between ventral striatum and supplementary motor area in obese subjects subsequent to negative PEs. Importantly, strength of functional coupling predicted task performance and negative PE utilization. These findings show that obesity is linked to insufficient behavioral adaptation specifically in response to negative PEs, and to associated alterations in function and connectivity within the fronto-striatal system. Recognition of neural differences as a central characteristic of obesity hopefully paves the way to rethink established intervention strategies: Differential behavioral sensitivity to negative and positive PEs should be considered when designing intervention programs. Measures relying on penalization of unwanted behavior may prove less effective in obese subjects than alternative approaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

Food-Predicting Stimuli Differentially Influence Eye Movements and Goal-Directed Behavior in Normal-Weight, Overweight, and Obese Individuals.

PubMed

Lehner, Rea; Balsters, Joshua H; Bürgler, Alexandra; Hare, Todd A; Wenderoth, Nicole

2017-01-01

Obese individuals have been shown to exhibit abnormal sensitivity to rewards and reward-predicting cues as for example food-associated cues frequently used in advertisements. It has also been shown that food-associated cues can increase goal-directed behavior but it is currently unknown, whether this effect differs between normal-weight, overweight, and obese individuals. Here, we investigate this question by using a Pavlovian-to-instrumental transfer (PIT) task in normal-weight ( N  = 20), overweight ( N  = 17), and obese ( N  = 17) individuals. Furthermore, we applied eye tracking during Pavlovian conditioning to measure the participants' conditioned response as a proxy of the incentive salience of the predicted reward. Our results show that the goal-directed behavior of overweight individuals was more strongly influenced by food-predicting cues (i.e., stronger PIT effect) than that of normal-weight and obese individuals ( p  < 0.001). The weight groups were matched for age, gender, education, and parental education. Eye movements during Pavlovian conditioning also differed between weight categories ( p  < 0.05) and were used to categorize individuals based on their fixation style into "high eye index" versus "low eye index" as well. Our main finding was that the fixation style exhibited a complex interaction with the weight category. Furthermore, we found that normal-weight individuals of the group "high eye index" had higher body mass index within the healthy range than individuals of the group "low eye index" ( p  < 0.001), but this relationship was not found within in the overweight or obese groups ( p  > 0.646). Our findings are largely consistent with the incentive sensitization theory predicting that overweight individuals are more susceptible to food-related cues than normal-weight controls. However, this hypersensitivity might be reduced in obese individuals, possibly due to habitual/compulsive overeating or differences in

Detailed Assessments of Childhood AdversityEnhance Prediction of Central Obesity Independent of Gender, Race, Adult Psychosocial Risk and Health Behaviors

PubMed Central

Davis, Cynthia R.; Dearing, Eric; Usher, Nicole; Trifiletti, Sarah; Zaichenko, Lesya; Ollen, Elizabeth; Brinkoetter, Mary T.; Crowell-Doom, Cindy; Joung, Kyoung; Park, Kyung Hee; Mantzoros, Christos S.; Crowell, Judith A.

2017-01-01

Objective This study examined whether a novel indicator of overall childhood adversity, incorporating number of adversities, severity, and chronicity, predicted central obesity beyond contributions of “modifiable” risk factors including psychosocial characteristics and health behaviors in a diverse sample of midlife adults. The study also examined whether the overall adversity score (number of adversities X severity X chronicity) better predicted obesity compared to cumulative adversity (number of adversities), a more traditional assessment of childhood adversity. Materials/Methods 210 Black/African Americans and White/European Americans, mean age = 45.8; ±3.3 years, were studied cross-sectionally. Regression analysis examined overall childhood adversity as a direct, non-modifiable risk factor for central obesity (waist-hip ratio) and body mass index (BMI), with and without adjustment for established adult psychosocial risk factors (education, employment, social functioning) and heath behavior risk factors (smoking, drinking, diet, exercise). Results Overall childhood adversity was an independent significant predictor of central obesity, and the relations between psychosocial and health risk factors and central obesity were not significant when overall adversity was in the model. Overall adversity was not a statistically significant predictor of BMI. Conclusions Overall childhood adversity, incorporating severity and chronicity and cumulative scores, predicts central obesity beyond more contemporaneous risk factors often considered modifiable. This is consistent with early dysregulation of metabolic functioning. Findings can inform practitioners interested in the impact of childhood adversity and personalizing treatment approaches of obesity within high-risk populations. Prevention/intervention research is necessary to discover and address the underlying causes and impact of childhood adversity on metabolic functioning. PMID:24211017

Detailed assessments of childhood adversity enhance prediction of central obesity independent of gender, race, adult psychosocial risk and health behaviors.

PubMed

Davis, Cynthia R; Dearing, Eric; Usher, Nicole; Trifiletti, Sarah; Zaichenko, Lesya; Ollen, Elizabeth; Brinkoetter, Mary T; Crowell-Doom, Cindy; Joung, Kyoung; Park, Kyung Hee; Mantzoros, Christos S; Crowell, Judith A

2014-02-01

This study examined whether a novel indicator of overall childhood adversity, incorporating number of adversities, severity, and chronicity, predicted central obesity beyond contributions of "modifiable" risk factors including psychosocial characteristics and health behaviors in a diverse sample of midlife adults. The study also examined whether the overall adversity score (number of adversities × severity × chronicity) better predicted obesity compared to cumulative adversity (number of adversities), a more traditional assessment of childhood adversity. 210 Black/African Americans and White/European Americans, mean age=45.8; ±3.3 years, were studied cross-sectionally. Regression analysis examined overall childhood adversity as a direct, non-modifiable risk factor for central obesity (waist-hip ratio) and body mass index (BMI), with and without adjustment for established adult psychosocial risk factors (education, employment, social functioning) and heath behavior risk factors (smoking, drinking, diet, exercise). Overall childhood adversity was an independent significant predictor of central obesity, and the relations between psychosocial and health risk factors and central obesity were not significant when overall adversity was in the model. Overall adversity was not a statistically significant predictor of BMI. Overall childhood adversity, incorporating severity and chronicity and cumulative scores, predicts central obesity beyond more contemporaneous risk factors often considered modifiable. This is consistent with early dysregulation of metabolic functioning. Findings can inform practitioners interested in the impact of childhood adversity and personalizing treatment approaches of obesity within high-risk populations. Prevention/intervention research is necessary to discover and address the underlying causes and impact of childhood adversity on metabolic functioning. © 2013.

What are the associations between neighbourhood walkability and sedentary time in New Zealand adults? The URBAN cross-sectional study.

PubMed

Hinckson, Erica; Cerin, Ester; Mavoa, Surzanne; Smith, Melody; Badland, Hannah; Witten, Karen; Kearns, Robin; Schofield, Grant

2017-10-22

We estimated associations between objectively determined neighbourhood 'walkability' attributes and accelerometer-derived sedentary time (ST) by sex, city or type of day. A cross-sectional study. The URBAN (Understanding the Relationship between Activity and Neighbourhoods) study was conducted in 48 neighbourhoods across four cities in New Zealand (August 2008 to October 2010). The response rate was 41% (2029 recruited participants/5007 eligible households approached). In total, 1762 participants (aged 41.4±12.1, mean±SD) met the data inclusion criteria and were included in analyses. The exposure variables were geographical information system (GIS) measures of neighbourhood walkability (ie, street connectivity, residential density, land-use mix, retail footprint area ratio) for street network buffers of 500 m and 1000 m around residential addresses. Participants wore an accelerometer for 7 days. The outcome measure was average daily minutes of ST. Data were available from 1762 participants (aged 41.4±12.1 years; 58% women). No significant main effects of GIS-based neighbourhood walkability measures were found with ST. Retail footprint area ratio was negatively associated with sedentary time in women, significant only for 500 m residential buffers. An increase of 1 decile in street connectivity was significantly associated with a decrease of over 5 min of ST per day in Christchurch residents for both residential buffers. Neighbourhoods with proximal retail and higher street connectivity seem to be associated with less ST. These effects were sex and city specific. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Psychosocial Domain.

PubMed

Sutin, Angelina R; Boutelle, Kerri; Czajkowski, Susan M; Epel, Elissa S; Green, Paige A; Hunter, Christine M; Rice, Elise L; Williams, David M; Young-Hyman, Deborah; Rothman, Alexander J

2018-04-01

Within the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project, the psychosocial domain addresses how psychosocial processes underlie the influence of obesity treatment strategies on weight loss and weight maintenance. The subgroup for the psychosocial domain identified an initial list of high-priority constructs and measures that ranged from relatively stable characteristics about the person (cognitive function, personality) to dynamic characteristics that may change over time (motivation, affect). This paper describes (a) how the psychosocial domain fits into the broader model of weight loss and weight maintenance as conceptualized by ADOPT; (b) the guiding principles used to select constructs and measures for recommendation; (c) the high-priority constructs recommended for inclusion; (d) domain-specific issues for advancing the science; and (e) recommendations for future research. The inclusion of similar measures across trials will help to better identify how psychosocial factors mediate and moderate the weight loss and weight maintenance process, facilitate research into dynamic interactions with factors in the other ADOPT domains, and ultimately improve the design and delivery of effective interventions. © 2018 The Obesity Society.

G protein polymorphisms do not predict weight loss and improvement of hypertension in severely obese patients.

PubMed

Potoczna, Natascha; Wertli, Maria; Steffen, Rudolph; Ricklin, Thomas; Lentes, Klaus-Ulrich; Horber, Fritz F

2004-11-01

Both the gene encoding the alpha subunit of G stimulatory proteins (GNAS1) and the beta3 subunit gene (GNB3) of G proteins are associated with obesity and/or hypertension. Moreover, the TT/TC825 polymorphism of GNB3 predicts greater weight loss than the CC825 polymorphism in obese patients (mean body mass index, 35 kg/m2) undergoing a structured nonpharmacologic weight loss program. Gastric banding enforces a low-calorie diet by diminishing the need for volitional adherence. It is unknown whether these polymorphisms predict the variable weight loss in patients after bariatric surgery. Three hundred and four severely obese patients (mean +/- SEM age, 42 +/- 1 years; 245 women and 59 men; mean +/- SEM body mass index, 43.9 +/- 0.3 kg/m2) followed prospectively for at least 3 years after surgery were genotyped for the GNB3 C825T, G814A, and GNAS1 T393 polymorphisms. All analyses were performed blinded to the phenotypic characteristics of the study group. Frequencies of polymorphisms were comparable to those previously published. No polymorphism studied predicted 3-year weight loss or was associated with high blood pressure in severely obese patients after gastric banding. Multivariate analysis of potentially confounding factors such as reoperation rate or use of sibutramine or orlistat revealed similar results (P > 0.1). Regardless of the mechanism(s) involved for these discordant findings, GNB3 C825T, G814A, and GNAS1 T393C polymorphisms do not seem to be reliable predictors of long-term weight loss.

Construct Validity of the Neighborhood Environment Walkability Scale for Africa

PubMed Central

Oyeyemi, Adewale L.; Conway, Terry L.; Adedoyin, Rufus A.; Akinroye, Kingsley K.; Aryeetey, Richmond; Assah, Felix; Cain, Kelli L.; Gavand, Kavita A.; Kasoma, Sandra S.; Kolbe-Alexander, Tracy L.; Lambert, Estelle V.; Larouche, Richard; Mos, Sarah J.; Ocansey, Reginald; Onywera, Vincent O.; Prista, Antonio; Tremblay, Mark S.; Sallis, James F.

2016-01-01

Purpose Development of valid measures of built environments relevant for physical activity is an important step toward controlling the global epidemic of physical inactivity-related noncommunicable diseases and deaths. This study assessed the construct validity of a self-report neighborhood environment walkability scale adapted for Africa (NEWS-Africa), by examining relationships with self-reported walking for transportation and recreation using pooled data from six sub-Saharan African countries. Methods NEWS was systematically adapted to assess urban, peri-urban and rural environments in sub-Saharan Africa. Adults (n=469, 18-85 years, 49.7% women) from Cameroon, Ghana, Mozambique, Nigeria, South Africa and Uganda were purposively recruited from neighborhoods varying in walkability and socioeconomic status, with some from villages. Participants completed the 76-item (13 subscales) NEWS-Africa by structured interview and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire. Results The overall ‘walkability’ index had a positive relationship with both walking for transportation (eta2=0.020, p=0.005) and recreation (eta2=0.013, p=0.028) in the pooled analyses. The mixed-use access and stranger-danger scales were positively related with transport walking (eta2=0.020, p=0.006 and eta2=0.021, p=0.040, respectively). Proximity of recreational facilities (eta2=0.016, p=0.015), road/path connectivity (eta2=0.025, p=0.002), path infrastructure (eta2=0.021, p=0.005), and overall places for walking and cycling (eta2=0.012, p=0.029) scales were positively related to recreational walking. Country-specific results were mostly non-significant except for South Africa and Uganda. Conclusions Seven of 14 NEWS-Africa scales were significantly related to walking behavior in pooled analyses, providing partial support for the construct validity of NEWS-Africa. However, effect sizes appeared to be lower than

How many days of accelerometer monitoring predict weekly physical activity behaviour in obese youth?

PubMed

Vanhelst, Jérémy; Fardy, Paul S; Duhamel, Alain; Béghin, Laurent

2014-09-01

The aim of this study was to determine the type and the number of accelerometer monitoring days needed to predict weekly sedentary behaviour and physical activity in obese youth. Fifty-three obese youth wore a triaxial accelerometer for 7 days to measure physical activity in free-living conditions. Analyses of variance for repeated measures, Intraclass coefficient (ICC) and regression linear analyses were used. Obese youth spent significantly less time in physical activity on weekends or free days compared with school days. ICC analyses indicated a minimum of 2 days is needed to estimate physical activity behaviour. ICC were 0·80 between weekly physical activity and weekdays and 0·92 between physical activity and weekend days. The model has to include a weekday and a weekend day. Using any combination of one weekday and one weekend day, the percentage of variance explained is >90%. Results indicate that 2 days of monitoring are needed to estimate the weekly physical activity behaviour in obese youth with an accelerometer. Our results also showed the importance of taking into consideration school day versus free day and weekday versus weekend day in assessing physical activity in obese youth. © 2013 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

International variation in neighborhood walkability, transit, and recreation environments using geographic information systems: the IPEN adult study.

PubMed

Adams, Marc A; Frank, Lawrence D; Schipperijn, Jasper; Smith, Graham; Chapman, James; Christiansen, Lars B; Coffee, Neil; Salvo, Deborah; du Toit, Lorinne; Dygrýn, Jan; Hino, Adriano Akira Ferreira; Lai, Poh-chin; Mavoa, Suzanne; Pinzón, José David; Van de Weghe, Nico; Cerin, Ester; Davey, Rachel; Macfarlane, Duncan; Owen, Neville; Sallis, James F

2014-10-25

The World Health Organization recommends strategies to improve urban design, public transportation, and recreation facilities to facilitate physical activity for non-communicable disease prevention for an increasingly urbanized global population. Most evidence supporting environmental associations with physical activity comes from single countries or regions with limited variation in urban form. This paper documents variation in comparable built environment features across countries from diverse regions. The International Physical Activity and the Environment Network (IPEN) study of adults aimed to measure the full range of variation in the built environment using geographic information systems (GIS) across 12 countries on 5 continents. Investigators in Australia, Belgium, Brazil, Colombia, the Czech Republic, Denmark, China, Mexico, New Zealand, Spain, the United Kingdom, and the United States followed a common research protocol to develop internationally comparable measures. Using detailed instructions, GIS-based measures included features such as walkability (i.e., residential density, street connectivity, mix of land uses), and access to public transit, parks, and private recreation facilities around each participant's residential address using 1-km and 500-m street network buffers. Eleven of 12 countries and 15 cities had objective GIS data on built environment features. We observed a 38-fold difference in median residential densities, a 5-fold difference in median intersection densities and an 18-fold difference in median park densities. Hong Kong had the highest and North Shore, New Zealand had the lowest median walkability index values, representing a difference of 9 standard deviations in GIS-measured walkability. Results show that comparable measures can be created across a range of cultural settings revealing profound global differences in urban form relevant to physical activity. These measures allow cities to be ranked more precisely than previously

Where does walkability matter the most? An environmental justice interpretation of New Jersey data.

PubMed

Greenberg, Michael R; Renne, John

2005-03-01

Physical inactivity contributes to a growing proportion of premature mortality and morbidity in the United States, and the last decade has been the focus of calls for action. Analysis of 340 residents of New Jersey found that 15%-20% reported multiple problems with using their immediate neighborhoods for physical activity. These respondents were disproportionately African Americans living in neighborhoods that they regard as only of fair or poor quality. Neighborhood walkability is a second-wave environmental justice issue meriting carefully designed research and ameliorative actions in concert with other neighborhood-level redevelopment activities.

Utility and applicability of the "Childhood Obesity Risk Evaluation" (CORE)-index in predicting obesity in childhood and adolescence in Greece from early life: the "National Action Plan for Public Health".

PubMed

Manios, Yannis; Vlachopapadopoulou, Elpis; Moschonis, George; Karachaliou, Feneli; Psaltopoulou, Theodora; Koutsouki, Dimitra; Bogdanis, Gregory; Carayanni, Vilelmine; Hatzakis, Angelos; Michalacos, Stefanos

2016-12-01

Early identification of infants being at high risk to become obese at their later childhood or adolescence can be of vital importance in any obesity prevention initiative. The aim of the present study was to examine the utility and applicability of the "Childhood Obesity Risk Evaluation (CORE)" index as a screening tool for the early prediction of obesity in childhood and adolescence. Anthropometric, socio-demographic data were collected cross-sectionally and retrospectively from a representative sample of 5946 children, and adolescents and were combined for calculating the CORE-index score. Logistic regression analyses were performed to examine the associations of the CORE-index score with obesity by gender and age group, and cut-off point analysis was also applied to identify the optimal value of the CORE-index score that differentiates obese from non-obese children. Mean CORE-index score in the total sample was 3.06 (sd 1.92) units (range 0-11 units). Each unit increase in the CORE-index score was found to be associated with a 30 % (95 % C.I. 1.24-1.36) increased likelihood for obesity in childhood or adolescence, while the optimal cut-off value of the CORE-index score that predicted obesity with the highest possible sensitivity and specificity was found to be 3.5. The present study supports the utility and applicability of the CORE-index as a screening tool for the early identification of infants that are potentially at a higher risk for becoming obese at their childhood and adolescence. This tool could be routinely used by health professionals to identify infants at high risk and provide appropriate counselling to their parents and caregivers so as to maximize the effectiveness of early obesity prevention initiatives. What is known? • Childhood obesity has reached epidemic proportions worldwide. • Certain perinatal and socio-demographic indices that were previously identified as correlates of childhood obesity in children were combined to develop the

Situational cues and momentary food environment predict everyday eating behavior in adults with overweight and obesity.

PubMed

Elliston, Katherine G; Ferguson, Stuart G; Schüz, Natalie; Schüz, Benjamin

2017-04-01

Individual eating behavior is a risk factor for obesity and highly dependent on internal and external cues. Many studies also suggest that the food environment (i.e., food outlets) influences eating behavior. This study therefore examines the momentary food environment (at the time of eating) and the role of cues simultaneously in predicting everyday eating behavior in adults with overweight and obesity. Intensive longitudinal study using ecological momentary assessment (EMA) over 14 days in 51 adults with overweight and obesity (average body mass index = 30.77; SD = 4.85) with a total of 745 participant days of data. Multiple daily assessments of eating (meals, high- or low-energy snacks) and randomly timed assessments. Cues and the momentary food environment were assessed during both assessment types. Random effects multinomial logistic regression shows that both internal (affect) and external (food availability, social situation, observing others eat) cues were associated with increased likelihood of eating. The momentary food environment predicted meals and snacking on top of cues, with a higher likelihood of high-energy snacks when fast food restaurants were close by (odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.22, 2.93) and a higher likelihood of low-energy snacks in proximity to supermarkets (OR = 2.29, 95% CI = 1.38, 3.82). Real-time eating behavior, both in terms of main meals and snacks, is associated with internal and external cues in adults with overweight and obesity. In addition, perceptions of the momentary food environment influence eating choices, emphasizing the importance of an integrated perspective on eating behavior and obesity prevention. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Does low birth weight predict hypertension and obesity in schoolchildren?

PubMed

Zarrati, Mitra; Shidfar, Farzad; Razmpoosh, Elham; Nezhad, Farinaz Nasir; Keivani, Hosein; Hemami, Mohsen Rezaei; Asemi, Zatollah

2013-01-01

Birth weight appears to play a role in determining high blood pressure (BP) and obesity during childhood. The purpose of this study is to investigate the association between birth weight and later obesity and hypertension among 10- to 13-year-old schoolchildren. A total of 1,184 primary school students were selected from 20 randomized schools between 2011 and 2012 in Iran. Height, weight, waist circumference and BP were measured using standard instruments. Data were analyzed using stepwise regression and logistic regression models. 13.5% of children had a history of low birth weight. First-degree family history of obesity, excessive gestational weight gain and birth weight were significantly correlated with overweight/obesity and abdominal obesity (p = 0.001), whereas only birth weight was associated with high BP (p = 0.001). An inverse correlation was found between waist circumference and systolic/diastolic BP. The duration of breastfeeding in children with low birth weight was inversely correlated with obesity/overweight, abdominal obesity and hypertension. The results suggests that birth weight is inversely associated with BP and more so with obesity and abdominal obesity. The duration of having been breastfed could have an influence on later hypertension, obesity and abdominal obesity. Further results are needed to test these correlations as well as diagnosing early life factors to prevent young adult overweight/obesity or hypertension. Copyright © 2013 S. Karger AG, Basel.

Developing small-area predictions for smoking and obesity prevalence in the United States for use in Environmental Public Health Tracking.

PubMed

Ortega Hinojosa, Alberto M; Davies, Molly M; Jarjour, Sarah; Burnett, Richard T; Mann, Jennifer K; Hughes, Edward; Balmes, John R; Turner, Michelle C; Jerrett, Michael

2014-10-01

Globally and in the United States, smoking and obesity are leading causes of death and disability. Reliable estimates of prevalence for these risk factors are often missing variables in public health surveillance programs. This may limit the capacity of public health surveillance to target interventions or to assess associations between other environmental risk factors (e.g., air pollution) and health because smoking and obesity are often important confounders. To generate prevalence estimates of smoking and obesity rates over small areas for the United States (i.e., at the ZIP code and census tract levels). We predicted smoking and obesity prevalence using a combined approach first using a lasso-based variable selection procedure followed by a two-level random effects regression with a Poisson link clustered on state and county. We used data from the Behavioral Risk Factor Surveillance System (BRFSS) from 1991 to 2010 to estimate the model. We used 10-fold cross-validated mean squared errors and the variance of the residuals to test our model. To downscale the estimates we combined the prediction equations with 1990 and 2000 U.S. Census data for each of the four five-year time periods in this time range at the ZIP code and census tract levels. Several sensitivity analyses were conducted using models that included only basic terms, that accounted for spatial autocorrelation, and used Generalized Linear Models that did not include random effects. The two-level random effects model produced improved estimates compared to the fixed effects-only models. Estimates were particularly improved for the two-thirds of the conterminous U.S. where BRFSS data were available to estimate the county level random effects. We downscaled the smoking and obesity rate predictions to derive ZIP code and census tract estimates. To our knowledge these smoking and obesity predictions are the first to be developed for the entire conterminous U.S. for census tracts and ZIP codes. Our

The association of sidewalk walkability and physical disorder with area-level race and poverty.

PubMed

Kelly, Cheryl M; Schootman, Mario; Baker, Elizabeth A; Barnidge, Ellen K; Lemes, Amanda

2007-11-01

There are significant differences in physical inactivity in various geographical areas and among demographic groups. Previous research suggests that walking is the most common form of physical activity; however, not all built environments support walking for recreational or transportation purposes. The purpose of this study was to assess the extent to which area-level factors, poverty rate and racial distribution, are associated with aspects of the street-scale environment (i.e. sidewalk walkability and physical disorder) using community audits. Street segments were randomly selected from 210 block groups. Pairs of trained auditors walked each street segment using an audit tool designed to capture aspects of the street environment. Multilevel logistic regression was used to assess the degree of neighborhood (i.e. block group) variation in sidewalk unevenness, sidewalk obstruction and the presence of physical disorder and the association with area-level characteristics. 1780 street segments were audited. Block groups that were predominantly African-American were 38 times more likely to have a lot of unevenness, 15 times more likely to have many obstructions, and 12 times more likely to have physical disorder. Poverty rate was not independently associated with sidewalk walkability; however, block groups with the highest poverty rates were 21 times more likely to have physical disorder. The results indicate that aspects of the built environment vary by characteristics of the neighborhood. This suggests that there is a differential investment in community infrastructures and resources in neighborhoods that are mostly African-American. This differential investment is likely to influence disparities in rates of physical activity.

EnviroAtlas Estimated Percent Tree Cover Along Walkable Roads Web Service

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. For specific information about each community's Estimated Percent Tree Cover Along Walkable Roads layer, consult their individual metadata records: Austin, TX (https://edg.epa.gov/metadata/catalog/search/resource/details.page?uuid=%7B4876FD99-C14A-464A-9E31-5CB5F2225687%7D); Cleveland, OH (https://edg.epa.gov/metadata/catalog/search/resource/details.page?uuid=%7B28e3f937-6f22-45c5-98cf-1707b0fc92df%7D); Des Moines, IA (https://edg.epa.gov/metadata/catalog/search/resource/details.page?uuid=%7B09FE7D60-B636-405C-BB07-68147DFE8CAF%7D); Durham, NC (https://edg.epa.gov/metadata/catalog/search/resource/details.page?uuid=%7BF341A26B-4972-4C6B-B675-9B5E02F4F25F%7D); Fresno, CA (https://edg.epa.gov/metadata/catalog/search/resource/details.page?uuid=%7BB71334B9-C53A-4674-A739-1031969E5163%7D); Green Bay, WI (https://edg.epa.gov/metadata/catalog/search/resource/details.page?uuid=%7BB9AFEBED-9C29-4DB0-8B54-0CAF58BE5A2D%7D); Memphis, TN (https://edg.epa.gov/metadata/catalog/search/resource/details.page?uuid=%7BBE552E7A-A789-4AA9-ADF9-234109C6517E%7D); Mi

Parental Predictions and Perceptions Regarding Long-Term Childhood Obesity-Related Health Risks

PubMed Central

Wright, Davene R.; Lozano, Paula; Dawson-Hahn, Elizabeth; Christakis, Dimitri A.; Haaland, Wren; Basu, Anirban

2016-01-01

Objectives To assess how parents perceive long-term risks for developing obesity-related chronic health conditions. Methods A web-based nationally representative survey was administered to 502 U.S. parents with a 5–12 year old child. Parents reported whether their child was most likely to be at a healthy weight or overweight, and the probability that their child would develop hypertension, heart disease, depression, or type 2 diabetes in adulthood. Responses of parents of children with overweight and obesity were compared to those of healthy weight children using multivariate models. Results The survey had an overall response rate of 39.2%. The mean (SD) unadjusted parent predicted health risks were 15.4% (17.7%), 11.2% (14.7%), 12.5% (16.2%), and 12.1% (16.1%) for hypertension, heart disease, depression, and diabetes, respectively. Despite under-perceiving their child’s current BMI class, parents of children with obesity estimate their children to be at greater risk for obesity-related health conditions than parents of healthy weight children by 5–6 percentage points. Having a family history of a chronic disease, higher quality of care, and older parent age were also significant predictors of estimating higher risk probabilities. Conclusions Despite evidence that parents of overweight children may not perceive these children as being overweight, parents unexpectedly estimate greater future risk of weight-related health conditions for these children. Focusing communication about weight on screening for and reducing the risk of weight-related diseases may prove useful in engaging parents and children in weight management PMID:26875508

High intake of palatable food predicts binge-eating independent of susceptibility to obesity: an animal model of lean vs obese binge-eating and obesity with and without binge-eating.

PubMed

Boggiano, M M; Artiga, A I; Pritchett, C E; Chandler-Laney, P C; Smith, M L; Eldridge, A J

2007-09-01

To determine the stability of individual differences in non-nutritive 'junk' palatable food (PF) intake in rats; assess the relationship of these differences to binge-eating characteristics and susceptibility to obesity; and evaluate the practicality of using these differences to model binge-eating and obesity. Binge-eating prone (BEP) and resistant (BER) groups were identified. Differential responses to stress, hunger, macronutrient-varied PFs, a diet-induced obesity (DIO) regimen and daily vs intermittent access to a PF+chow diet, were assessed. One hundred and twenty female Sprague-Dawley rats. Reliability of intake patterns within rats; food intake and body weight after various challenges over acute (1, 2, 4 h), 24-h and 2-week periods. Although BEP and BER rats did not differ in amount of chow consumed, BEPs consumed >50% more intermittent PF than BERs (P<0.001) and consistently so (alpha=0.86). BEPs suppressed chow but not PF intake when stressed, and ate as much when sated as when hungry. Conversely, BERs were more affected by stress and ate less PF, not chow, when stressed and were normally hyperphagic to energy deficit. BEP overeating generalized to other PFs varying in sucrose, fat and nutrition content. Half the rats in each group proved to be obesity prone after a no-choice high fat diet (DIO diet) but a continuous diet of PF+chow normalized the BEPs high drive for PF. Greater intermittent intake of PF predicts binge-eating independent of susceptibility to weight gain. Daily fat consumption in a nutritious source (DIO-diet; analogous to a fatty meal) promoted overeating and weight gain but limiting fat to daily non-nutritive food (PF+chow; analogous to a snack with a low fat meal), did not. The data offer an animal model of lean and obese binge-eating, and obesity with and without binge-eating that can be used to identify the unique physiology of these groups and henceforth suggest more specifically targeted treatments for binge-eating and obesity.

Comparison of predictive equations for resting metabolic rate in obese psychiatric patients taking olanzapine.

PubMed

Skouroliakou, Maria; Giannopoulou, Ifigenia; Kostara, Christina; Vasilopoulou, Melanie

2009-02-01

The prediction of resting metabolic rate (RMR) is important to determine the energy expenditure of obese patients with severe mental illnesses (SMIs). However, there is lack of research concerning the most accurate RMR predictive equations. The purpose of this study was to compare the validity of four RMR equations on patients with SMIs taking olanzapine. One hundred twenty-eight obese (body mass index >30 kg/m(2)) patients with SMIs (41 men and 87 women) treated with olanzapine were tested from 2005 to 2008. Measurements of anthropometric parameters (height, weight, body mass index, waist circumference) and body composition (using the BodPod) were performed at the beginning of the study. RMR was measured using indirect calorimetry. Comparisons between measured and estimated RMRs from four equations (Harris-Benedict adjusted and current body weights, Schofield, and Mifflin-St. Jeor) were performed using Pearson's correlation coefficient and Bland-Altman analysis. Significant correlations were found between the measured and predicted RMRs with all four equations (P < 0.001), with the Mifflin-St. Jeor equation demonstrating the strongest correlation in men and women (r = 0.712, P < 0.001). In men and women, the Bland-Altman analysis revealed no significant bias in the RMR prediction using the Harris-Benedict adjusted body weight and the Mifflin equations (P > 0.05). However, in men and women, the Harris-Benedict current body weight and the Schofield equations showed significant overestimation error in the RMR prediction (P < 0.001). When estimating RMR in men and women with SMIs taking olanzapine, the Mifflin-St. Jeor and Harris-Benedict adjusted body weight equations appear to be the most appropriate for clinical use.

Neighborhood walkability, physical activity, and walking for transportation: A cross-sectional study of older adults living on low income.

PubMed

Chudyk, Anna M; McKay, Heather A; Winters, Meghan; Sims-Gould, Joanie; Ashe, Maureen C

2017-04-10

Walking, and in particular, outdoor walking, is the most common form of physical activity for older adults. To date, no study investigated the association between the neighborhood built environment and physical activity habits of older adults of low SES. Thus, our overarching aim was to examine the association between the neighborhood built environment and the spectrum of physical activity and walking for transportation in older adults of low socioeconomic status. Cross-sectional data were from the Walk the Talk Study, collected in 2012. Participants (n = 161, mean age = 74 years) were in receipt of a rental subsidy for low income individuals and resided in neighbourhoods across Metro Vancouver, Canada. We used the Street Smart Walk Score to objectively characterize the built environment main effect (walkability), accelerometry for objective physical activity, and the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to measure walking for transportation. We used regression analyses to examine associations of objectively measured physical activity [total volume, light intensity and moderate intensity physical activity (MVPA)] and self-reported walking for transportation (any, frequency, duration) with walkability. We adjusted analyses for person- and environment-level factors associated with older adult physical activity. Neighbourhood walkability was not associated with physical activity volume or intensity and self-reported walking for transportation, with one exception. Each 10-point increase in Street Smart Walk Score was associated with a 45% greater odds of any walking for transportation (compared with none; OR = 1.45, 95% confidence interval = 1.18, 1.78). Sociodemographic, physical function and attitudinal factors were significant predictors of physical activity across our models. The lack of associations between most of the explored outcomes may be due to the complexity of the relation between the person and

Obesity indices are predictive of elevated C-reactive protein in long-haul truck drivers.

PubMed

Wideman, Laurie; Oberlin, Douglas J; Sönmez, Sevil; Labban, Jeffrey; Lemke, Michael Kenneth; Apostolopoulos, Yorghos

2016-08-01

Obesity rates in long-haul truck drivers have been shown to be significantly higher than the general population. We hypothesized that commercial drivers with the highest levels of general obesity and abdominal adiposity would have higher concentrations of high sensitivity C-reactive protein (CRP), a marker of inflammation. Survey and anthropometric data were collected from 262 commercial drivers. Weight, circumference measures, and blood analysis for CRP (N = 115) were conducted and compared to National Health and Nutrition Examination Survey (NHANES) data. CRP values were non-normally distributed and logarithmically transformed for statistical analyses. BMI, waist circumference, sagittal abdominal diameter, and CRP were significantly higher than in the general population. Anthropometric indices that included height (BMI, waist-to-height ratio, and sagittal diameter-to-height ratio), were most predictive of CRP values. Abdominal obesity is prevalent in commercial vehicle drivers and is an important indicator of the presence of inflammation in this population. Am. J. Ind. Med. 59:665-675, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

EnviroAtlas - Paterson, NJ - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Fresno, CA - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Woodbine, IA - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Phoenix, AZ - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Pittsburgh, PA - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Milwaukee, WI - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Austin, TX - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Cleveland, OH - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Portland, ME - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Portland, OR - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Durham, NC - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Tampa, FL - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Memphis, TN - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

Does Physical Activity Mediate the Association Between Perceived Neighborhood Aesthetics and Overweight/Obesity Among South African Adults Living in Selected Urban and Rural Communities?

PubMed

Malambo, Pasmore; Kengne, Andre P; Lambert, Estelle V; De Villiers, Anniza; Puoane, Thandi

2017-12-01

To investigate the mediation effects of physical activity (PA) on the relationship between the perceived neighborhood aesthetic environment and overweight/obesity in free-living South Africans. A cross-sectional study of 671 adults aged ≥ 35 years was analyzed. PA was assessed using the validated International Physical Activity Questionnaire. Perceived neighborhood aesthetics was assessed using the Neighborhood Environment Walkability Scale Questionnaire. Of 671 participants, 76.0% were women, 34.1% aged 45-54 years, and 69.2% were overweight or obese. In adjusted logistic regression models, overweight/obesity was significantly associated with neighborhood aesthetics [odds ratio (OR) = 0.68; 95% confidence interval (CI), 0.50-0.93] and PA (OR = 0.65; 95% CI, 0.65-0.90). In expanded multivariable models, overweight/obesity was associated with age 45-55 years (OR = 1.59; 95% CI, 1.05-2.40), female gender (OR = 6.24; 95% CI, 3.95-9.86), tertiary education (OR = 4.05; 95% CI, 1.19-13.86), and urban residence (OR = 2.46; 95% CI, 1.66-3.65). Aesthetics was positively associated with PA; both aesthetics and PA were negatively associated with overweight and obesity. There was no evidence to support a significant mediating effect of PA on the relationship between aesthetics and overweight/obesity. Future studies should consider objective assessment of aesthetics and PA. In addition, future studies should consider using longitudinal design to evaluate food-related environments, which are related to overweight or obesity.

Drug disposition in obesity: toward evidence-based dosing.

PubMed

Knibbe, Catherijne A J; Brill, Margreke J E; van Rongen, Anne; Diepstraten, Jeroen; van der Graaf, Piet Hein; Danhof, Meindert

2015-01-01

Obesity and morbid obesity are associated with many physiological changes affecting pharmacokinetics, such as increased blood volume, cardiac output, splanchnic blood flow, and hepatic blood flow. In obesity, drug absorption appears unaltered, although recent evidence suggests that this conclusion may be premature. Volume of distribution may vary largely, but the magnitude and direction of changes seem difficult to predict, with extrapolation on the basis of total body weight being the best approach to date. Changes in clearance may be smaller than in distribution, whereas there is growing evidence that the influence of obesity on clearance can be predicted on the basis of reported changes in the metabolic or elimination pathways involved. For obese children, we propose two methods to distinguish between developmental and obesity-related changes. Future research should focus on the characterization of physiological concepts to predict the optimal dose for each drug in the obese population.

Attentional and motor impulsivity interactively predict 'food addiction' in obese individuals.

PubMed

Meule, Adrian; de Zwaan, Martina; Müller, Astrid

2017-01-01

Impulsivity is a multifaceted construct and constitutes a common risk factor for a range of behaviors associated with poor self-control (e.g., substance use or binge eating). The short form of the Barratt Impulsiveness Scale (BIS-15) measures impulsive behaviors related to attentional (inability to focus attention or concentrate), motor (acting without thinking), and non-planning (lack of future orientation or forethought) impulsivity. Eating-related measures appear to be particularly related to attentional and motor impulsivity and recent findings suggest that interactive effects between these two facets may play a role in eating- and weight-regulation. One-hundred thirty-three obese individuals presenting for bariatric surgery (77.4% female) completed the BIS-15 and the Yale Food Addiction Scale (YFAS) 2.0, which measures addiction-like eating based on the eleven symptoms of substance use disorder outlined in the fifth version of the Diagnostic and Statistical Manual of Mental Disorders. Sixty-three participants (47.4%) were classified as being 'food addicted'. Scores on attentional and motor impulsivity interactively predicted 'food addiction' status: higher attentional impulsivity was associated with a higher likelihood of receiving a YFAS 2.0 diagnosis only at high (+1 SD), but not at low (-1 SD) levels of motor impulsivity. Results support previous findings showing that non-planning impulsivity does not appear to play a role in eating-related self-regulation. Furthermore, this is the first study that shows interactive effects between different impulsivity facets when predicting 'food addiction' in obese individuals. Self-regulatory failure in eating-regulation (e.g., addiction-like overeating) may particularly emerge when both attentional and motor impulsivity levels are elevated. Copyright © 2016 Elsevier Inc. All rights reserved.

Fat-free mass prediction equations for bioelectric impedance analysis compared to dual energy X-ray absorptiometry in obese adolescents: a validation study.

PubMed

Hofsteenge, Geesje H; Chinapaw, Mai J M; Weijs, Peter J M

2015-10-15

In clinical practice, patient friendly methods to assess body composition in obese adolescents are needed. Therefore, the bioelectrical impedance analysis (BIA) related fat-free mass (FFM) prediction equations (FFM-BIA) were evaluated in obese adolescents (age 11-18 years) compared to FFM measured by dual-energy x-ray absorptiometry (FFM-DXA) and a new population specific FFM-BIA equation is developed. After an overnight fast, the subjects attended the outpatient clinic. After measuring height and weight, a full body scan by dual-energy x-ray absorptiometry (DXA) and a BIA measurement was performed. Thirteen predictive FFM-BIA equations based on weight, height, age, resistance, reactance and/or impedance were systematically selected and compared to FFM-DXA. Accuracy of FFM-BIA equations was evaluated by the percentage adolescents predicted within 5% of FFM-DXA measured, the mean percentage difference between predicted and measured values (bias) and the Root Mean Squared prediction Error (RMSE). Multiple linear regression was conducted to develop a new BIA equation. Validation was based on 103 adolescents (60% girls), age 14.5 (sd1.7) years, weight 94.1 (sd15.6) kg and FFM-DXA of 56.1 (sd9.8) kg. The percentage accurate estimations varied between equations from 0 to 68%; bias ranged from -29.3 to +36.3% and RMSE ranged from 2.8 to 12.4 kg. An alternative prediction equation was developed: FFM = 0.527 * H(cm)(2)/Imp + 0.306 * weight - 1.862 (R(2) = 0.92, SEE = 2.85 kg). Percentage accurate prediction was 76%. Compared to DXA, the Gray equation underestimated the FFM with 0.4 kg (55.7 ± 8.3), had an RMSE of 3.2 kg, 63% accurate prediction and the smallest bias of (-0.1%). When split by sex, the Gray equation had the narrowest range in accurate predictions, bias, and RMSE. For the assessment of FFM with BIA, the Gray-FFM equation appears to be the most accurate, but 63% is still not at an acceptable accuracy level for obese adolescents. The new equation appears to

Obesity-related cardiovascular risk factors: intervention recommendations to decrease adolescent obesity

NASA Technical Reports Server (NTRS)

Calderon, Kristine S.; Yucha, Carolyn B.; Schaffer, Susan D.

2005-01-01

The incidence of adolescent obesity is increasing dramatically in the United States with associated risks of hypertension, adverse lipid profiles, and Type II diabetes. Unless reversed, this trend predicts an epidemic of adult cardiovascular disease. Interventions at home, at school, and in the community are required to empower teens to increase physical activity and to modify eating habits. This article describes assessment for obesity-related health problems as well as scientific guidelines and research-based intervention strategies to decrease obesity in adolescents.

Understanding academic clinicians' intent to treat pediatric obesity.

PubMed

Frankfurter, Claudia; Cunningham, Charles; Morrison, Katherine M; Rimas, Heather; Bailey, Karen

2017-02-08

To examine the extent to which the theory of planned behavior (TPB) predicts academic clinicians' intent to treat pediatric obesity. A multi-disciplinary panel iteratively devised a Likert scale survey based on the constructs of the TPB applied to a set of pediatric obesity themes. A cross-sectional electronic survey was then administered to academic clinicians at tertiary care centers across Canada from January to April 2012. Descriptive statistics were used to summarize demographic and item agreement data. A hierarchical linear regression analysis controlling for demographic variables was conducted to examine the extent to which the TPB subscales predicted intent to treat pediatric obesity. A total of 198 physicians, surgeons, and allied health professionals across Canada (British Columbia, Alberta, Manitoba, Saskatchewan, Nova Scotia, Ontario and Quebec) completed the survey. On step 1, demographic factors accounted for 7.4% of the variance in intent scores. Together in step 2, demographic variables and TPB subscales predicted 56.9% of the variance in a measure of the intent to treat pediatric obesity. Perceived behavioral control, that is, confidence in one's ability to manage pediatric obesity, and subjective norms, congruent with one's context of practice, were the most significant predictors of the intent to treat pediatric obesity. Attitudes and barriers did not predict the intent to treat pediatric obesity in this context. Enhancing self-confidence in the ability to treat pediatric obesity and the existence of supportive treatment environments are important to increase clinician's intent to treat pediatric obesity.

EnviroAtlas - New York, NY - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Green Bay, WI - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Des Moines, IA - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - New Bedford, MA - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Austin, TX - Estimated Percent Green Space Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates green space along walkable roads. Green space within 25 meters of the road centerline is included and the percentage is based on the total area between street intersections. Green space provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

Lexical neutrality in environmental health research: Reflections on the term walkability.

PubMed

Hajna, Samantha; Ross, Nancy A; Griffin, Simon J; Dasgupta, Kaberi

2017-12-08

Neighbourhood environments have important implications for human health. In this piece, we reflect on the environments and health literature and argue that precise use of language is critical for acknowledging the complex and multifaceted influence that neighbourhood environments may have on physical activity and physical activity-related outcomes. Specifically, we argue that the term "neighbourhood walkability", commonly used in the neighbourhoods and health literature, constrains recognition of the breadth of influence that neighbourhood environments might have on a variety of physical activity behaviours. The term draws attention to a single type of physical activity and implies that a universal association exists when in fact the literature is quite mixed. To maintain neutrality in this area of research, we suggest that researchers adopt the term "neighbourhood physical activity environments" for collective measures of neighbourhood attributes that they wish to study in relation to physical activity behaviours or physical activity-related health outcomes.

Does availability of physical activity and food outlets differ by race and income? Findings from an enumeration study in a health disparate region.

PubMed

Hill, Jennie L; Chau, Clarice; Luebbering, Candice R; Kolivras, Korine K; Zoellner, Jamie

2012-09-06

Low-income, ethnic/racial minorities and rural populations are at increased risk for obesity and related chronic health conditions when compared to white, urban and higher-socio-economic status (SES) peers. Recent systematic reviews highlight the influence of the built environment on obesity, yet very few of these studies consider rural areas or populations. Utilizing a CBPR process, this study advances community-driven causal models to address obesity by exploring the difference in resources for physical activity and food outlets by block group race and income in a small regional city that anchors a rural health disparate region. To guide this inquiry we hypothesized that lower income and racially diverse block groups would have fewer food outlets, including fewer grocery stores and fewer physical activity outlets. We further hypothesized that walkability, as defined by a computed walkability index, would be lower in the lower income block groups. Using census data and GIS, base maps of the region were created and block groups categorized by income and race. All food outlets and physical activity resources were enumerated and geocoded and a walkability index computed. Analyses included one-way MANOVA and spatial autocorrelation. In total, 49 stores, 160 restaurants and 79 physical activity outlets were enumerated. There were no differences in the number of outlets by block group income or race. Further, spatial analyses suggest that the distribution of outlets is dispersed across all block groups. Under the larger CPBR process, this enumeration study advances the causal models set forth by the community members to address obesity by providing an overview of the food and physical activity environment in this region. This data reflects the food and physical activity resources available to residents in the region and will aid many of the community-academic partners as they pursue intervention strategies targeting obesity.

Distribution of green infrastructure along walkable roads ...

EPA Pesticide Factsheets

Low-income and minority neighborhoods frequently lack healthful resources to which wealthier communities have access. Though important, the addition of facilities such as recreation centers can be costly and take time to implement. Urban green infrastructure, such as street trees and other green space, can be a low-cost alternative to promote frequency and duration of outdoor physical activity. Street trees and other green space may increase outdoor physical activity levels by providing shade, improving aesthetics, and promoting social engagement. Though street trees and green space provide many benefits and are publicly accessible at all times, these resources are not evenly distributed between neighborhoods. An objective analysis of street tree cover and green space in 6,407 block groups across 10 urban areas was conducted using fine-scale land cover data. Distribution of green infrastructure was then analyzed by minority status, income, car ownership, housing density, and employment density. The objective measure of street tree cover and green space is based on 1-meter resolution land cover data from the U.S. EPA-led EnviroAtlas. Tree cover was analyzed along each side of walkable road centerlines in the areas where sidewalks are estimated to be. Green space was calculated within 25 meters of road centerlines. Percent tree cover and green space per city block were then summarized to census block group (CBG). CBG demographics from the U.S. Census and built env

Diagnosing obesity by body mass index in chronic kidney disease: an explanation for the "obesity paradox?".

PubMed

Agarwal, Rajiv; Bills, Jennifer E; Light, Robert P

2010-11-01

Although obesity is associated with poor outcomes, among patients with chronic kidney disease (CKD), obesity is related to improved survival. These results may be related to poor diagnostic performance of body mass index (BMI) in assessing body fat content. Accordingly, among 77 patients with CKD and 20 controls, body fat percentage was estimated by air displacement plethysmography (ADP), skinfold thickness, and body impedance analysis. Defined by BMI ≥30 kg/m(2), the prevalence of obesity was 20% in controls and 65% in patients with CKD. Defined by ADP, the prevalence increased to 60% among controls and to 90% among patients with CKD. Although sensitivity and positive predictive value of BMI to diagnose obesity were 100%, specificity was 72%, but the negative predictive value was only 30%. BMI correctly classified adiposity in 75%. Regardless of the presence or absence of CKD, subclinical obesity (defined as BMI <30 kg/m(2) but excess body fat by ADP) was often missed in people with low lean body mass. The adjusted odds ratio for subclinical obesity per 1 kg of reduced lean body mass by ADP was 1.14 (95% CI: 1.06 to 1.23; P<0.001). Skinfold thickness measurements correctly classified 94% of CKD patients, but bioelectrical impedance analyzer-assessed body fat estimation did so in only 65%. Air displacement plethysmography-, skinfold thickness-, and bioelectrical impedance analyzer-assessed body fat all provided reproducible estimates of adiposity. Skinfold thickness measurements may be a better test to classify obesity among those with CKD. Given the low negative predictive value of BMI for obesity, our study may provide an explanation of the "obesity paradox."

Positive predictive value between medical-chart body-mass-index category and obesity versus codes in a claims-data warehouse.

PubMed

Caplan, Eleanor O; Kamble, Pravin S; Harvey, Raymond A; Smolarz, B Gabriel; Renda, Andrew; Bouchard, Jonathan R; Huang, Joanna C

2018-01-01

To evaluate the positive predictive value of claims-based V85 codes for identifying individuals with varying degrees of BMI relative to their measured BMI obtained from medical record abstraction. This was a retrospective validation study utilizing administrative claims and medical chart data from 1 January 2009 to 31 August 2015. Randomly selected samples of patients enrolled in a Medicare Advantage Prescription Drug (MAPD) or commercial health plan and with a V85 claim were identified. The claims-based BMI category (underweight, normal weight, overweight, obese class I-III) was determined via corresponding V85 codes and compared to the BMI category derived from chart abstracted height, weight and/or BMI. The positive predictive values (PPVs) of the claims-based BMI categories were calculated with the corresponding 95% confidence intervals (CIs). The overall PPVs (95% CIs) in the MAPD and commercial samples were 90.3% (86.3%-94.4%) and 91.1% (87.3%-94.9%), respectively. In each BMI category, the PPVs (95% CIs) for the MAPD and commercial samples, respectively, were: underweight, 71.0% (55.0%-87.0%) and 75.9% (60.3%-91.4%); normal, 93.8% (85.4%-100%) and 87.8% (77.8%-97.8%); overweight, 97.4% (92.5%-100%) and 93.5% (84.9%-100%); obese class I, 96.9 (90.9%-100%) and 97.2% (91.9%-100%); obese class II, 97.0% (91.1%-100%) and 93.0% (85.4%-100%); and obese class III, 85.0% (73.3%-96.1%) and 97.1% (91.4%-100%). BMI categories derived from administrative claims, when available, can be used successfully particularly in the context of obesity research.

Endocrine and Metabolic Biomarkers Predicting Early Childhood Obesity Risk.

PubMed

Socha, Piotr; Hellmuth, Christian; Gruszfeld, Dariusz; Demmelmair, Hans; Rzehak, Peter; Grote, Veit; Weber, Martina; Escribano, Joaquin; Closa-Monasterolo, Ricardo; Dain, Elena; Langhendries, Jean-Paul; Riva, Enrica; Verduci, Elvira; Koletzko, Berthold

2016-01-01

There is growing evidence of long-term effects of early dietary intervention in infancy on later obesity risk. Many studies showed reduced risk of obesity with breastfeeding in infancy, which could be related to the reduced protein intake with human milk compared to infant formula. In a randomized controlled trial (Childhood Obesity Project), we were able to show that infant formula with reduced protein content results in lower BMI both at 2 and 6 years. These effects seem to be mediated mainly by branched-chain amino acids which stimulate the insulin-like growth factor (IGF)-1 axis and insulin release. In this trial, we also showed an influence of high-protein diet on larger kidney size, which seems to be partly explained by a significant effect of free IGF-1 on kidney volume. The IGF-1 axis was shown to regulate early growth, adipose tissue differentiation and early adipogenesis in animals and in humans. Leptin and adiponectin can also be regarded as important endocrine regulators of obesity. These markers were tested in observational studies. Leptin seems to be closely correlated with BMI but changes in adiponectin require further exploration. Still, there is a lack of good data or some results are contradictory to indicate the role of either leptin or adiponectin in infancy for determining later obesity risk. © 2016 Nestec Ltd., Vevey/S. Karger AG, Basel.

Understanding academic clinicians’ intent to treat pediatric obesity

PubMed Central

Frankfurter, Claudia; Cunningham, Charles; Morrison, Katherine M; Rimas, Heather; Bailey, Karen

2017-01-01

AIM To examine the extent to which the theory of planned behavior (TPB) predicts academic clinicians’ intent to treat pediatric obesity. METHODS A multi-disciplinary panel iteratively devised a Likert scale survey based on the constructs of the TPB applied to a set of pediatric obesity themes. A cross-sectional electronic survey was then administered to academic clinicians at tertiary care centers across Canada from January to April 2012. Descriptive statistics were used to summarize demographic and item agreement data. A hierarchical linear regression analysis controlling for demographic variables was conducted to examine the extent to which the TPB subscales predicted intent to treat pediatric obesity. RESULTS A total of 198 physicians, surgeons, and allied health professionals across Canada (British Columbia, Alberta, Manitoba, Saskatchewan, Nova Scotia, Ontario and Quebec) completed the survey. On step 1, demographic factors accounted for 7.4% of the variance in intent scores. Together in step 2, demographic variables and TPB subscales predicted 56.9% of the variance in a measure of the intent to treat pediatric obesity. Perceived behavioral control, that is, confidence in one’s ability to manage pediatric obesity, and subjective norms, congruent with one’s context of practice, were the most significant predictors of the intent to treat pediatric obesity. Attitudes and barriers did not predict the intent to treat pediatric obesity in this context. CONCLUSION Enhancing self-confidence in the ability to treat pediatric obesity and the existence of supportive treatment environments are important to increase clinician’s intent to treat pediatric obesity. PMID:28224097

Predictive score of sarcopenia occurrence one year after bariatric surgery in severely obese patients.

PubMed

Voican, Cosmin Sebastian; Lebrun, Amandine; Maitre, Sophie; Lainas, Panagiotis; Lamouri, Karima; Njike-Nakseu, Micheline; Gaillard, Martin; Tranchart, Hadrien; Balian, Axel; Dagher, Ibrahim; Perlemuter, Gabriel; Naveau, Sylvie

2018-01-01

Sarcopenic obesity is a risk factor of morbidity and mortality. The aim of this study was to generate a predictive score of sarcopenia occurrence one year after bariatric surgery. We conducted an observational prospective cohort study on a total of 184 severely obese patients admitted to our institution to undergo sleeve gastrectomy. Skeletal muscle cross-sectional area at the third lumbar vertebrae (SMA, cm2) was measured from the routinely performed computed tomography. The skeletal muscle index (SMI) was calculated as follows: SMA/height2 (cm2/m2). Sarcopenia was defined as an SMI < 38.5 cm2/m2 for women and < 52.4 cm2/m2 for men. Measurements were performed at surgery and one year later. Most of the included patients were female (79%), with a mean age of 42±0.9 years and body mass index of 43.2±0.5 kg/m2. Fifteen patients (8%) had sarcopenia before surgery and 59 (32%) at the one-year follow-up. Male gender (p<0.0001), SMA before surgery (p<0.0001), and SMI before surgery (p<0.0001) significantly correlated with the occurrence of sarcopenia one year after surgery by multivariate analysis. Two predictive sarcopenia occurrence scores were constructed using SMA and gender (SS1 score) or SMI and gender (SS2 score). The area under receiver operating characteristic (AUROC) curve of the SS2 score was significantly greater than that of the SS1 score for the diagnosis of postoperative sarcopenia occurrence (0.95±0.02 versus 0.90±0.02; p<0.01). A cut-off value for the SS2 score of 0.53 had a sensitivity of 90%, a specificity of 91%, a positive predictive value of 83%, and a negative predictive value of 95%. In the group of patients without baseline sarcopenia, the SS2 score had still an excellent AUROC of 0.92±0.02. A cut-off of 0.55 predicted development of sarcopenia one year after sleeve gastrectomy in these patients with a sensitivity of 87%, a specificity of 88%, and negative predictive value of 95%. The SS2 score has excellent predictive value for the

Childhood obesity affects adult metabolic syndrome and diabetes.

PubMed

Liang, Yajun; Hou, Dongqing; Zhao, Xiaoyuan; Wang, Liang; Hu, Yuehua; Liu, Junting; Cheng, Hong; Yang, Ping; Shan, Xinying; Yan, Yinkun; Cruickshank, J Kennedy; Mi, Jie

2015-09-01

We seek to observe the association between childhood obesity by different measures and adult obesity, metabolic syndrome (MetS), and diabetes. Thousand two hundred and nine subjects from "Beijing Blood Pressure Cohort Study" were followed 22.9 ± 0.5 years in average from childhood to adulthood. We defined childhood obesity using body mass index (BMI) or left subscapular skinfold (LSSF), and adult obesity as BMI ≥ 28 kg/m(2). MetS was defined according to the joint statement of International Diabetes Federation and American Heart Association with modified waist circumference (≥ 90/85 cm for men/women). Diabetes was defined as fasting plasma glucose ≥ 7.0 mmol/L or blood glucose 2 h after oral glucose tolerance test ≥ 11.1 mmol/L or currently using blood glucose-lowering agents. Multiple linear and logistic regression models were used to assess the association. The incidence of adult obesity was 13.4, 60.0, 48.3, and 65.1 % for children without obesity, having obesity by BMI only, by LSSF only, and by both, respectively. Compared to children without obesity, children obese by LSSF only or by both had higher risk of diabetes. After controlling for adult obesity, childhood obesity predicted independently long-term risks of diabetes (odds ratio 2.8, 95 % confidence interval 1.2-6.3) or abdominal obesity (2.7, 1.6-4.7) other than MetS as a whole (1.2, 0.6-2.4). Childhood obesity predicts long-term risk of adult diabetes, and the effect is independent of adult obesity. LSSF is better than BMI in predicting adult diabetes.

Prediction of Difficult Laryngoscopy in Obese Patients by Ultrasound Quantification of Anterior Neck Soft Tissue1

PubMed Central

Ezri, T.; Gewürtz, G.; Sessler, D.I.; Medalion, B.; Szmuk, P.; Hagberg, C.; Susmallian, S.

2005-01-01

Prediction of difficult laryngoscopy in obese patients is challenging. In 50 morbidly obese patients, we quantified the neck soft tissue from skin to anterior aspect of trachea at the vocal cords using ultrasound. Thyromental distance <6 cm, mouth opening <4 cm, limited neck mobility, Mallampati score >2, abnormal upper teeth, neck circumference >45 cm, and sleep apnoea were considered predictors of difficult laryngoscopy. Of the nine (18%) difficult laryngoscopy cases, seven had obstructive sleep apnoea history; whereas, only 2 of the 41 easy laryngoscopy patients did (P<0.001). Difficult laryngoscopy patients had larger neck circumference [50 (3.8) vs. 43.5 (2.2) cm; P<0.001] and more pre-tracheal soft tissue [28 (2.7) mm vs. 17.5 (1.8) mm; P<0.001] [mean (SD)]. Soft tissue values completely separated difficult and easy laryngoscopies. None of the other predictors correlated with difficult laryngoscopy. Thus, an abundance of pretracheal soft tissue at the level of vocal cords is a good predictor of difficult laryngoscopy in obese patients. PMID:14616599

Lay theories of obesity predict actual body mass.

PubMed

McFerran, Brent; Mukhopadhyay, Anirban

2013-08-01

Obesity is a major public health problem, but despite much research into its causes, scientists have largely neglected to examine laypeople's personal beliefs about it. Such naive beliefs are important because they guide actual goal-directed behaviors. In a series of studies across five countries on three continents, we found that people mainly believed either that obesity is caused by a lack of exercise or that it is caused by a poor diet. Moreover, laypeople who indicted a lack of exercise were more likely to actually be overweight than were those who implicated a poor diet. This effect held even after controlling for several known correlates of body mass index (BMI), thereby explaining previously unexplained variance. We also experimentally demonstrated the mechanism underlying this effect: People who implicated insufficient exercise tended to consume more food than did those who indicted a poor diet. These results suggest that obesity has an important, pervasive, and hitherto overlooked psychological antecedent.

Epigenetics and obesity.

PubMed

Campión, Javier; Milagro, Fermin; Martínez, J Alfredo

2010-01-01

The etiology of obesity is multifactorial, involving complex interactions among the genetic makeup, neuroendocrine status, fetal programming, and different unhealthy environmental factors, such as sedentarism or inadequate dietary habits. Among the different mechanisms causing obesity, epigenetics, defined as the study of heritable changes in gene expression that occur without a change in the DNA sequence, has emerged as a very important determinant. Experimental evidence concerning dietary factors influencing obesity development through epigenetic mechanisms has been described. Thus, identification of those individuals who present with changes in DNA methylation profiles, certain histone modifications, or other epigenetically related processes could help to predict their susceptibility to gain or lose weight. Indeed, research concerning epigenetic mechanisms affecting weight homeostasis may play a role in the prevention of excessive fat deposition, the prediction of the most appropriate weight reduction plan, and the implementation of newer therapeutic approaches. Copyright © 2010 Elsevier Inc. All rights reserved.

Can the Theory of Planned Behavior Predict Dietary Intention and Future Dieting in an Ethnically Diverse Sample of Overweight and Obese Veterans Attending Medical Clinics?

PubMed Central

Lash, Denise N.; Smith, Jane Ellen; Rinehart, Jenny K.

2016-01-01

Obesity has become a world-wide epidemic; in the United States (U.S.) approximately two-thirds of adults are classified as overweight or obese. Military veterans’ numbers are even higher, with 77% of retired or discharged U.S. veterans falling in these weight categories. One of the most common methods of changing one’s weight is through dieting, yet little is known regarding the factors that facilitate successful dieting behavior. The current investigation tested the Theory of Planned Behavior’s (TPB) ability to predict dietary intention and future dieting in a sample of 84 overweight and obese patients attending medical clinics at a Veterans Affairs Hospital in the southwestern part of the U.S. Participants primarily were male (92%) and ethnic/racial minorities (58%). Perceived need and anticipated regret were added to the standard TPB model. While the TPB predicted dietary intention, it did not significantly account for improved dietary behaviors. Anticipated regret significantly enhanced the basic TPB’s ability to predict intention to diet, while perceived need did not. These findings highlight the difficulty in predicting sustained change in a complex behavior such as dieting to lose weight. The need for more work with older, overweight/obese medical patients attending veterans’ facilities is stressed, as is the need for such work with male patients and ethnic minorities in particular. PMID:26792774

Adaptation and reliability of neighborhood environment walkability scale (NEWS) for Iran: A questionnaire for assessing environmental correlates of physical activity.

PubMed

Hakimian, Pantea; Lak, Azadeh

2016-01-01

Background: In spite of the increased range of inactivity and obesity among Iranian adults, insufficient research has been done on environmental factors influencing physical activity. As a result adapting a subjective (self-report) measurement tool for assessment of physical environment in Iran is critical. Accordingly, in this study Neighborhood Environment Walkability Scale (NEWS) was adapted for Iran and also its reliability was evaluated. Methods: This study was conducted using a systematic adaptation method consisting of 3 steps: translate-back translation procedures, revision by a multidisciplinary panel of local experts and a cognitive study. Then NEWS-Iran was completed among adults aged 18 to 65 years (N=19) with an interval of 15 days. Intra-Class Coefficient (ICC) was used to evaluate the reliability of the adapted questionnaire. Results: NEWS-Iran is an adapted version of NEWS-A (abbreviated) and in the adaptation process five items were added from other versions of NEWS, two subscales were significantly modified for a shorter and more effective questionnaire, and five new items were added about climate factors and site-specific uses. NEWS-Iran showed almost perfect reliability (ICCs: more than 0.8) for all subscales, with items having moderate to almost perfect reliability scores (ICCs: 0.56-0.96). Conclusion: This study introduced NEWS-Iran, which is a reliable version of NEWS for measuring environmental perceptions related to physical activity behavior adapted for Iran. It is the first adapted version of NEWS which demonstrates a systematic adaptation process used by earlier studies. It can be used for other developing countries with similar environmental, social and cultural context.

Does albuminuria predict renal risk and/or cardiovascular risk in obese type 2 diabetic patients?

PubMed Central

Bentata, Yassamine; Abouqal, Redouane

2014-01-01

Increased urinary albumin excretion (UAE) is a marker of renal and cardiovascular risk in patients with type 2 diabetes (DT2). What about the obese patient with DT2? Does albuminuria predict the progression of renal disease and/or cardiovascular disease? The objective of this study is to determine the link between albuminuria, renal risk and cardiovascular risk in a cohort of obese DT2 patients. This is a prospective study begun in September 2006. It included DT2 patients presenting obesity defined by a body mass index (BMI)>30 Kg/m2. Three groups of patients were defined: normo-albuminuria (Urinary Albumin Excretion UAE<30 mg/day or Albumin Creatinine Ratio ACR<30 mg/g), micro-albuminuria (UAE=30-300 mg/day or ACR=30-300 mg/g) and macro-albuminuria (UAE>300 mg/day or ACR>300 mg/g). Data on 144 obese DT2 patients were compiled: The mean age of our patients was 59 ± 9 years and the sex ratio 0.26. The incidence of ESRD was higher in the macro-albuminuria group than in the two other groups (26.5% vs. 1.2%, p<0.001). The incidence of cardiovascular events was 15.4%, 14.3% and 23.5% in the normo, micro and macro-albuminuria groups (p=0.48). A history of cardiovascular comorbidities was the main cardiovascular risk in multivariate analysis (0R=15.07; 95% CI=5.30-42.82; p<0.001) and the low admission GFR (0R=5.67; 95% CI=1.23-9.77; p=0.008) was the main factor for progression of kidney disease in multivariate analysis. Albuminuria may be a better marker of kidney disease progression than of cardiovascular risk in the obese DT2 patient, according to our results. However, to accurately demonstrate the link albuminuria - renal risk and albuminuria - cardiovascular risk in the obese DT2 patient, additional studies using very strict criteria of selection and judgment are needed. PMID:24551483

The utility of childhood and adolescent obesity assessment in relation to adult health

PubMed Central

Goldhaber-Fiebert, Jeremy D.; Rubinfeld, Rachel E.; Bhattacharya, Jay; Robinson, Thomas N.; Wise, Paul H.

2014-01-01

The high prevalence of childhood obesity has raised concerns regarding long-term patterns of adult health and has generated calls for obesity screening of young children. This study examined patterns of obesity and the predictive utility of obesity screening for children of different ages in terms of adult health outcomes. Using the National Longitudinal Survey of Youth, the Population Study of Income Dynamics, and National Health and Nutrition Evaluation Surveys, we estimated the sensitivity, specificity and predictive value of childhood BMI to identify 2, 5, 10, or 15 year-olds who will become obese adults. We constructed models assessing the relationship of childhood BMI to obesity-related diseases through middle age stratified by sex and race/ethnicity. 12% of 18 year-olds were obese. While 50% of these adolescents would not have been identified by screening at age 5, 9% would have been missed at age 15. Approximately 70% of obese children at age 5 became non-obese at age 18. The predictive utility of obesity screening below the age of 10 was low, even when maternal obesity was also included. The elevated risk of diabetes, obesity, and hypertension in middle age predicted by obesity at age 15 was significantly higher than at age 5 (e.g., the RR of diabetes for obese white male 15 year-olds was 4.5; for 5 year-olds, it was 1.6). Early childhood obesity assessment adds limited predictive utility to strategies that also include later childhood assessment. Targeted approaches in later childhood or universal strategies to prevent unhealthy weight gain should be considered. PMID:22647830

EnviroAtlas - Minneapolis/St. Paul, MN - Estimated Intersection Density of Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates the intersection density of walkable roads within a 750 meter radius of any given 10 meter pixel in the community. Intersections are defined as any point where 3 or more roads meet and density is calculated using kernel density, where closer intersections are weighted higher than further intersections. Intersection density is highly correlated with walking for transportation. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Memphis, TN - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Portland, ME - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Pittsburgh, PA - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Portland, OR - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Paterson, NJ - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Cleveland, OH - Estimated Percent Green Space Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates green space along walkable roads. Green space within 25 meters of the road centerline is included and the percentage is based on the total area between street intersections. In this community, green space is defined as Trees & Forest, Grass & Herbaceous, Woody Wetlands, and Emergent Wetlands. In this metric, water is also included in green space. Green space provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Phoenix, AZ - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Cleveland, OH - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. In this community, tree cover is defined as Trees & Forest and Woody Wetlands. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets)

EnviroAtlas - Milwaukee, WI - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Tampa, FL - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Durham, NC - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Fresno, CA - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Woodbine, IA - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Austin, TX - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

De novo PHIP-predicted deleterious variants are associated with developmental delay, intellectual disability, obesity, and dysmorphic features.

PubMed

Webster, Emily; Cho, Megan T; Alexander, Nora; Desai, Sonal; Naidu, Sakkubai; Bekheirnia, Mir Reza; Lewis, Andrea; Retterer, Kyle; Juusola, Jane; Chung, Wendy K

2016-11-01

Using whole-exome sequencing, we have identified novel de novo heterozygous pleckstrin homology domain-interacting protein ( PHIP ) variants that are predicted to be deleterious, including a frameshift deletion, in two unrelated patients with common clinical features of developmental delay, intellectual disability, anxiety, hypotonia, poor balance, obesity, and dysmorphic features. A nonsense mutation in PHIP has previously been associated with similar clinical features. Patients with microdeletions of 6q14.1, including PHIP , have a similar phenotype of developmental delay, intellectual disability, hypotonia, and obesity, suggesting that the phenotype of our patients is a result of loss-of-function mutations. PHIP produces multiple protein products, such as PHIP1 (also known as DCAF14), PHIP, and NDRP. PHIP1 is one of the multiple substrate receptors of the proteolytic CUL4-DDB1 ubiquitin ligase complex. CUL4B deficiency has been associated with intellectual disability, central obesity, muscle wasting, and dysmorphic features. The overlapping phenotype associated with CUL4B deficiency suggests that PHIP mutations cause disease through disruption of the ubiquitin ligase pathway.

Do Maternal Caregiver Perceptions of Childhood Obesity Risk Factors and Obesity Complications Predict Support for Prevention Initiatives Among African Americans?

PubMed

Alexander, Dayna S; Alfonso, Moya L; Cao, Chunhua; Wright, Alesha R

2017-07-01

Objectives African American maternal caregiver support for prevention of childhood obesity may be a factor in implementing, monitoring, and sustaining children's positive health behaviors. However, little is known about how perceptions of childhood obesity risk factors and health complications influence caregivers' support of childhood obesity prevention strategies. The objective of this study was to determine if childhood obesity risk factors and health complications were associated with maternal caregivers' support for prevention initiatives. Methods A convenience sample of maternal caregivers (N = 129, ages 22-65 years) completed the childhood obesity perceptions (COP) survey. A linear regression was conducted to determine whether perceptions about childhood obesity risk factors and subsequent health complications influenced caregivers' support for prevention strategies. Results Caregivers' perceptions of childhood obesity risk factors were moderate (M = 3.4; SD = 0.64), as were their perceptions of obesity-related health complications (M = 3.3; SD = 0.75); however, they perceived a high level of support for prevention strategies (M = 4.2; SD = 0.74). In the regression model, only health complications were significantly associated with caregiver support (β = 0.348; p < 0.004). Conclusions Childhood obesity prevention efforts should emphasize health complications by providing education and strategies that promote self-efficacy and outcome expectations among maternal caregivers.

Predictive Validity of the Body Adiposity Index in Overweight and Obese Adults Using Dual-Energy X-ray Absorptiometry

PubMed Central

Ramírez-Vélez, Robinson; Correa-Bautista, Jorge Enrique; González-Ruíz, Katherine; Vivas, Andrés; García-Hermoso, Antonio; Triana-Reina, Hector Reynaldo

2016-01-01

The body adiposity index (BAI) is a recent anthropometric measure proven to be valid in predicting body fat percentage (BF%) in some populations. However, the results have been inconsistent across populations. This study was designed to verify the validity of BAI in predicting BF% in a sample of overweight/obese adults, using dual-energy X-ray absorptiometry (DEXA) as the reference method. A cross-sectional study was conducted in 48 participants (54% women, mean age 41.0 ± 7.3 years old). DEXA was used as the “gold standard” to determine BF%. Pearson’s correlation coefficient was used to evaluate the association between BAI and BF%, as assessed by DEXA. A paired sample t-test was used to test differences in mean BF% obtained with BAI and DEXA methods. To evaluate the concordance between BF% as measured by DEXA and as estimated by BAI, we used Lin’s concordance correlation coefficient and Bland–Altman agreement analysis. The correlation between BF% obtained by DEXA and that estimated by BAI was r = 0.844, p < 0.001. Paired t-test showed a significant mean difference in BF% between methods (BAI = 33.3 ± 6.2 vs. DEXA 39.0 ± 6.1; p < 0.001). The bias of the BAI was −6.0 ± 3.0 BF% (95% CI = −12.0 to 1.0), indicating that the BAI method significantly underestimated the BF% compared to the reference method. Lin’s concordance correlation coefficient was considered stronger (ρc = 0.923, 95% CI = 0.862 to 0.957). In obese adults, BAI presented low agreement with BF% measured by DEXA; therefore, BAI is not recommended for BF% prediction in this overweight/obese sample studied. PMID:27916871

Obesity's effect on asthma extends to diagnostic criteria.

PubMed

Lugogo, Njira; Green, Cynthia L; Agada, Noah; Zhang, Siyi; Meghdadpour, Susanne; Zhou, Run; Yang, Siyun; Anstrom, Kevin J; Israel, Elliot; Martin, Richard; Lemanske, Robert F; Boushey, Homer; Lazarus, Stephen C; Wasserman, Stephen I; Castro, Mario; Calhoun, William; Peters, Stephen P; DiMango, Emily; Chinchilli, Vernon; Kunselman, Susan; King, Tonya S; Icitovic, Nikolina; Kraft, Monica

2018-03-01

The use of inflammatory biomarkers to delineate the type of lung inflammation present in asthmatic subjects is increasingly common. However, the effect of obesity on these markers is unknown. We aimed to determine the effect of obesity on conventional markers of inflammation in asthmatic subjects. We performed secondary analysis of data from 652 subjects previously enrolled in 2 Asthma Clinical Research Network trials. We performed linear correlations between biomarkers and logistic regression analysis to determine the predictive value of IgE levels, blood eosinophil counts, and fraction of exhaled nitric oxide values in relationship to sputum eosinophil counts (>2%), as well as to determine whether cut points existed that would maximize the sensitivity and specificity for predicting sputum eosinophilia in the 3 weight groups. Overall, statistically significant but relatively weak correlations were observed among all 4 markers of inflammation. Within obese subjects, the only significant correlation found was between IgE levels and blood eosinophil counts (r = 0.33, P < .001); furthermore, all other correlations between inflammatory markers were approximately 0, including correlations with sputum eosinophil counts. In addition, the predictive value of each biomarker alone or in combination was poor in obese subjects. In fact, in obese subjects none of the biomarkers of inflammation significantly predicted the presence of high sputum eosinophil counts. Obese asthmatic subjects have lower cut points for IgE levels (268 IU), fraction of exhaled nitric oxide values (14.5 ppb), and blood eosinophil counts (96 cells/μL) than all other groups. In obese asthmatic subjects conventional biomarkers of inflammation are poorly predictive of eosinophilic airway inflammation. As such, biomarkers currently used to delineate eosinophilic inflammation in asthmatic subjects should be approached with caution in these subjects. Copyright © 2017 American Academy of Allergy

Dietary and Behavioral Prediction of Obesity in the Navy

DTIC Science & Technology

1989-12-28

1986). In terms of nutritional preferences and dietary composition, there is some evidence that the obese prefer fats to sweets , which could account...dysfunction. That the obese appear more responsive to taste than the nonobese (Hashim & Van Itallie, 1965) and show tendencies with more problems with body... salty food (alpha - .64) 2. Eat high fat food 3. E’t sugar-rich food 4. Eat fast food or in restaurants How often do you do the following things? I

Cardiovascular consequences of childhood obesity.

PubMed

McCrindle, Brian W

2015-02-01

Childhood and adolescent overweight and obesity is an important and increasingly prevalent public health problem in Canada and worldwide. High adiposity in youth is indicated in clinical practice by plotting body mass index on appropriate percentile charts normed for age and sex, although waist measures might be a further tool. High adiposity can lead to adiposopathy in youth, with associated increases in inflammation and oxidative stress, changes in adipokines, and endocrinopathy. This is manifest as cardiometabolic risk factors in similar patterns to those in noted in obese adults. Obesity and cardiometabolic risk factors have been shown to be associated with vascular changes indicative of early atherosclerosis, and ventricular hypertrophy, dilation, and dysfunction. These cardiovascular consequences are evident in youth, but childhood obesity is also predictive of similar consequences in adulthood. Childhood obesity and risk factors have been shown to track into adulthood and worsen in most individuals. The result is an exponential acceleration of atherosclerosis, which can be predicted to translate into an epidemic of premature cardiovascular disease and events. A change in paradigm is needed toward preventing and curing atherosclerosis and not just preventing cardiovascular disease. This would necessarily create an imperative for preventing and treating childhood obesity. Urgent attention, policy, and action are needed to avoid the enormous future social and health care costs associated with the cardiovascular consequences of obesity in youth. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Impact of obesity-related genes in Spanish population

PubMed Central

2013-01-01

Background The objective was to investigate the association between BMI and single nucleotide polymorphisms previously identified of obesity-related genes in two Spanish populations. Forty SNPs in 23 obesity-related genes were evaluated in a rural population characterized by a high prevalence of obesity (869 subjects, mean age 46 yr, 62% women, 36% obese) and in an urban population (1425 subjects, mean age 54 yr, 50% women, 19% obese). Genotyping was assessed by using SNPlex and PLINK for the association analysis. Results Polymorphisms of the FTO were significantly associated with BMI, in the rural population (beta 0.87, p-value <0.001). None of the other SNPs showed significant association after Bonferroni correction in the two populations or in the pooled analysis. A weighted genetic risk score (wGRS) was constructed using the risk alleles of the Tag-SNPs with a positive Beta parameter in both populations. From the first to the fifth quintile of the score, the BMI increased 0.45 kg/m2 in Hortega and 2.0 kg/m2 in Pizarra. Overall, the obesity predictive value was low (less than 1%). Conclusion The risk associated with polymorphisms is low and the overall effect on BMI or obesity prediction is minimal. A weighted genetic risk score based on genes mainly acting through central nervous system mechanisms was associated with BMI but it yields minimal clinical prediction for the obesity risk in the general population. PMID:24267414

Impact of obesity-related genes in Spanish population.

PubMed

Martínez-García, Fernando; Mansego, María L; Rojo-Martínez, Gemma; De Marco-Solar, Griselda; Morcillo, Sonsoles; Soriguer, Federico; Redón, Josep; Pineda Alonso, Monica; Martín-Escudero, Juan C; Cooper, Richard S; Chaves, Felipe J

2013-11-23

The objective was to investigate the association between BMI and single nucleotide polymorphisms previously identified of obesity-related genes in two Spanish populations. Forty SNPs in 23 obesity-related genes were evaluated in a rural population characterized by a high prevalence of obesity (869 subjects, mean age 46 yr, 62% women, 36% obese) and in an urban population (1425 subjects, mean age 54 yr, 50% women, 19% obese). Genotyping was assessed by using SNPlex and PLINK for the association analysis. Polymorphisms of the FTO were significantly associated with BMI, in the rural population (beta 0.87, p-value <0.001). None of the other SNPs showed significant association after Bonferroni correction in the two populations or in the pooled analysis. A weighted genetic risk score (wGRS) was constructed using the risk alleles of the Tag-SNPs with a positive Beta parameter in both populations. From the first to the fifth quintile of the score, the BMI increased 0.45 kg/m2 in Hortega and 2.0 kg/m2 in Pizarra. Overall, the obesity predictive value was low (less than 1%). The risk associated with polymorphisms is low and the overall effect on BMI or obesity prediction is minimal. A weighted genetic risk score based on genes mainly acting through central nervous system mechanisms was associated with BMI but it yields minimal clinical prediction for the obesity risk in the general population.

Adaptation and reliability of neighborhood environment walkability scale (NEWS) for Iran: A questionnaire for assessing environmental correlates of physical activity

PubMed Central

Hakimian, Pantea; Lak, Azadeh

2016-01-01

Background: In spite of the increased range of inactivity and obesity among Iranian adults, insufficient research has been done on environmental factors influencing physical activity. As a result adapting a subjective (self-report) measurement tool for assessment of physical environment in Iran is critical. Accordingly, in this study Neighborhood Environment Walkability Scale (NEWS) was adapted for Iran and also its reliability was evaluated. Methods: This study was conducted using a systematic adaptation method consisting of 3 steps: translate-back translation procedures, revision by a multidisciplinary panel of local experts and a cognitive study. Then NEWS-Iran was completed among adults aged 18 to 65 years (N=19) with an interval of 15 days. Intra-Class Coefficient (ICC) was used to evaluate the reliability of the adapted questionnaire. Results: NEWS-Iran is an adapted version of NEWS-A (abbreviated) and in the adaptation process five items were added from other versions of NEWS, two subscales were significantly modified for a shorter and more effective questionnaire, and five new items were added about climate factors and site-specific uses. NEWS-Iran showed almost perfect reliability (ICCs: more than 0.8) for all subscales, with items having moderate to almost perfect reliability scores (ICCs: 0.56-0.96). Conclusion: This study introduced NEWS-Iran, which is a reliable version of NEWS for measuring environmental perceptions related to physical activity behavior adapted for Iran. It is the first adapted version of NEWS which demonstrates a systematic adaptation process used by earlier studies. It can be used for other developing countries with similar environmental, social and cultural context. PMID:28210592

Quantification of Cardiorespiratory Fitness in Healthy Nonobese and Obese Men and Women

PubMed Central

Lorenzo, Santiago

2012-01-01

Background: The quantification and interpretation of cardiorespiratory fitness (CRF) in obesity is important for adequately assessing cardiovascular conditioning, underlying comorbidities, and properly evaluating disease risk. We retrospectively compared peak oxygen uptake (V˙o2peak) (ie, CRF) in absolute terms, and relative terms (% predicted) using three currently suggested prediction equations (Equations R, W, and G). Methods: There were 19 nonobese and 66 obese participants. Subjects underwent hydrostatic weighing and incremental cycling to exhaustion. Subject characteristics were analyzed by independent t test, and % predicted V˙o2peak by a two-way analysis of variance (group and equation) with repeated measures on one factor (equation). Results: V˙o2peak (L/min) was not different between nonobese and obese adults (2.35 ± 0.80 [SD] vs 2.39 ± 0.68 L/min). V˙o2peak was higher (P < .02) relative to body mass and lean body mass in the nonobese (34 ± 8 mL/min/kg vs 22 ± 5 mL/min/kg, 42 ± 9 mL/min/lean body mass vs 37 ± 6 mL/min/lean body mass). Cardiorespiratory fitness assessed as % predicted was not different in the nonobese and obese (91% ± 17% predicted vs 95% ± 15% predicted) using Equation R, while using Equation W and G, CRF was lower (P < .05) but within normal limits in the obese (94 ± 15 vs 87 ± 11; 101% ± 17% predicted vs 90% ± 12% predicted, respectively), depending somewhat on sex. Conclusions: Traditional methods of reporting V˙o2peak do not allow adequate assessment and quantification of CRF in obese adults. Predicted V˙o2peak does allow a normalized evaluation of CRF in the obese, although care must be taken in selecting the most appropriate prediction equation, especially in women. In general, otherwise healthy obese are not grossly deconditioned as is commonly believed, although CRF may be slightly higher in nonobese subjects depending on the uniqueness of the prediction equation. PMID:21940772

Quantification of cardiorespiratory fitness in healthy nonobese and obese men and women.

PubMed

Lorenzo, Santiago; Babb, Tony G

2012-04-01

The quantification and interpretation of cardiorespiratory fitness (CRF) in obesity is important for adequately assessing cardiovascular conditioning, underlying comorbidities, and properly evaluating disease risk. We retrospectively compared peak oxygen uptake (VO(2)peak) (ie, CRF) in absolute terms, and relative terms (% predicted) using three currently suggested prediction equations (Equations R, W, and G). There were 19 nonobese and 66 obese participants. Subjects underwent hydrostatic weighing and incremental cycling to exhaustion. Subject characteristics were analyzed by independent t test, and % predicted VO(2)peak by a two-way analysis of variance (group and equation) with repeated measures on one factor (equation). VO(2)peak (L/min) was not different between nonobese and obese adults (2.35 ± 0.80 [SD] vs 2.39 ± 0.68 L/min). VO(2)peak was higher (P < .02) relative to body mass and lean body mass in the nonobese (34 ± 8 mL/min/kg vs 22 ± 5 mL/min/kg, 42 ± 9 mL/min/lean body mass vs 37 ± 6 mL/min/lean body mass). Cardiorespiratory fitness assessed as % predicted was not different in the nonobese and obese (91% ± 17% predicted vs 95% ± 15% predicted) using Equation R, while using Equation W and G, CRF was lower (P < .05) but within normal limits in the obese (94 ± 15 vs 87 ± 11; 101% ± 17% predicted vs 90% ± 12% predicted, respectively), depending somewhat on sex. Traditional methods of reporting VO(2)peak do not allow adequate assessment and quantification of CRF in obese adults. Predicted VO(2)peak does allow a normalized evaluation of CRF in the obese, although care must be taken in selecting the most appropriate prediction equation, especially in women. In general, otherwise healthy obese are not grossly deconditioned as is commonly believed, although CRF may be slightly higher in nonobese subjects depending on the uniqueness of the prediction equation.

High Body Mass Index in Infancy May Predict Severe Obesity in Early Childhood.

PubMed

Smego, Allison; Woo, Jessica G; Klein, Jillian; Suh, Christina; Bansal, Danesh; Bliss, Sherri; Daniels, Stephen R; Bolling, Christopher; Crimmins, Nancy A

2017-04-01

To characterize growth trajectories of children who develop severe obesity by age 6 years and identify clinical thresholds for detection of high-risk children before the onset of obesity. Two lean (body mass index [BMI] 5th to ≤75th percentile) and 2 severely obese (BMI ≥99th percentile) groups were selected from populations treated at pediatric referral and primary care clinics. A population-based cohort was used to validate the utility of identified risk thresholds. Repeated-measures mixed modeling and logistic regression were used for analysis. A total of 783 participants of normal weight and 480 participants with severe obesity were included in the initial study. BMI differed significantly between the severely obese and normal-weight cohorts by age 4 months (P < .001), at 1 year before the median age at onset of obesity. A cutoff of the World Health Organization (WHO) 85th percentile for BMI at 6, 12, and 18 months was a strong predictor of severe obesity by age 6 years (sensitivity, 51%-95%; specificity, 95%). This BMI threshold was validated in a second independent cohort (n = 2649), with a sensitivity of 33%-77% and a specificity of 74%-87%. A BMI ≥85th percentile in infancy increases the risk of severe obesity by age 6 years by 2.5-fold and the risk of clinical obesity by age 6 years by 3-fold. BMI trajectories in children who develop severe obesity by age 6 years differ from those in children who remain at normal weight by age 4-6 months, before the onset of obesity. Infants with a WHO BMI ≥85th percentile are at increased risk for developing severe obesity by age 6 years. Copyright © 2016 Elsevier Inc. All rights reserved.

A review of machine learning in obesity.

PubMed

DeGregory, K W; Kuiper, P; DeSilvio, T; Pleuss, J D; Miller, R; Roginski, J W; Fisher, C B; Harness, D; Viswanath, S; Heymsfield, S B; Dungan, I; Thomas, D M

2018-05-01

Rich sources of obesity-related data arising from sensors, smartphone apps, electronic medical health records and insurance data can bring new insights for understanding, preventing and treating obesity. For such large datasets, machine learning provides sophisticated and elegant tools to describe, classify and predict obesity-related risks and outcomes. Here, we review machine learning methods that predict and/or classify such as linear and logistic regression, artificial neural networks, deep learning and decision tree analysis. We also review methods that describe and characterize data such as cluster analysis, principal component analysis, network science and topological data analysis. We introduce each method with a high-level overview followed by examples of successful applications. The algorithms were then applied to National Health and Nutrition Examination Survey to demonstrate methodology, utility and outcomes. The strengths and limitations of each method were also evaluated. This summary of machine learning algorithms provides a unique overview of the state of data analysis applied specifically to obesity. © 2018 World Obesity Federation.

Predictive performance of the 'Minto' remifentanil pharmacokinetic parameter set in morbidly obese patients ensuing from a new method for calculating lean body mass.

PubMed

La Colla, Luca; Albertin, Andrea; La Colla, Giorgio; Porta, Andrea; Aldegheri, Giorgio; Di Candia, Domenico; Gigli, Fausto

2010-01-01

In a previous article, we showed that the pharmacokinetic set of remifentanil used for target-controlled infusion (TCI) might be biased in obese patients because it incorporates flawed equations for the calculation of lean body mass (LBM), which is a covariate of several pharmacokinetic parameters in this set. The objectives of this study were to determine the predictive performance of the original pharmacokinetic set, which incorporates the James equation for LBM calculation, and to determine the predictive performance of the pharmacokinetic set when a new method to calculate LBM was used (the Janmahasatian equations). This was an observational study with intraoperative observations and no follow-up. Fifteen morbidly obese inpatients scheduled for bariatric surgery were included in the study. The intervention included manually controlled continuous infusion of remifentanil during the surgery and analysis of arterial blood samples to determine the arterial remifentanil concentration, to be compared with concentrations predicted by either the unadjusted or the adjusted pharmacokinetic set. The statistical analysis included parametric and non-parametric tests on continuous variables and determination of the median performance error (MDPE), median absolute performance error (MDAPE), divergence and wobble. The median values (interquartile ranges) of the MDPE, MDAPE, divergence and wobble for the James equations during maintenance were -53.4% (-58.7% to -49.2%), 53.4% (49.0-58.7%), 3.3% (2.9-4.7%) and 1.4% h(-1) (1.1-2.5% h(-1)), respectively. The respective values for the Janmahasatian equations were -18.9% (-24.2% to -10.4%), 20.5% (13.3-24.8%), 2.6% (-0.7% to 4.5%) and 1.9% h(-1) (1.4-3.0% h(-1)). The performance (in terms of the MDPE and MDAPE) of the corrected pharmacokinetic set was better than that of the uncorrected one. The predictive performance of the original pharmacokinetic set is not clinically acceptable. Use of a corrected LBM value in morbidly obese

Eating styles in the morbidly obese: restraint eating, but not emotional and external eating, predicts dietary behaviour.

PubMed

Brogan, Amy; Hevey, David

2013-01-01

The research explored (1) the relationships between self-reported eating style (restraint, emotional and external eating) and dietary intake and (2) emotional eater status as a moderator of food intake when emotional, in a morbidly obese population. A sample of 57 obese participants (BMI: M = 51.84, SD = 8.66) completed a five-day food diary together with a reflective diary, which assessed eating style and positive and negative affect daily. A dietician-scored food pyramid analysis of intake. Restraint eating was the only predictor (negative) of overall food intake and the variable most strongly associated with the consumption of top-shelf foods. Emotional and external eating were unrelated to food intake. Emotional eater status did not moderate food intake in response to positive and negative mood states. The findings indicated largely analogous relationships between eating style and dietary intake in this obese sample compared with previous results from healthy populations. The lack of predictive validity for emotional eating scales (when emotional) raises questions over people's ability to adequately assess their eating style and consequently, the overall validity of emotional eater scales.

The predictive ability of triglycerides and waist (hypertriglyceridemic waist) in assessing metabolic triad change in obese children and adolescents.

PubMed

Hobkirk, James P; King, Roderick F; Gately, Paul; Pemberton, Philip; Smith, Alexander; Barth, Julian H; Harman, Nicola; Davies, Ian; Carroll, Sean

2013-10-01

The metabolic triad [fasting insulin, apolipoprotein B, and low-density lipoporotein (LDL) peak particle density] is characteristic of increased intra-abdominal adipose tissue and insulin resistance and can be predicted by the simple and adoptable screening tool, the hypertriglyceridemic waist. The associations between hypertriglyceridemic waist components [fasting triglycerides (TG) and waist circumference cut-points derived from a child-specific metabolic syndrome definition] with the metabolic triad were examined in obese youth before and after weight loss. A continuous metabolic triad score (MTS) was calculated as a cumulative and standardized residual score of fasting insulin, apolipoprotein B, and LDL peak particle density (z-scores of the metabolic triad variables regressed onto age and sex). The predictive ability of TG and waist in assessing metabolic triad change was undertaken in 75 clinically obese boys and girls, aged 8-18, body mass index (BMI) 34.2±6.4 kg/m(2) before and after weight loss. Fasting TG concentrations (r(2)=0.216, P<0.0001) and waist circumference (r(2)=0.049, P=0.019) were both significant independent predictors of the cumulative MTS, together accounting for 26.5% of its total variance. All cardiometabolic risk factors [except a reduction in high-density lipoprotein cholesterol (HDL-C)] were favorably modified following weight loss. Fasting TG change was the only significant predictor of the MTS change (r(2)=0.177, P<0.0001). Waist circumference was not a significant predictor of MTS change. The reduction in fasting TG concentration (but not waist circumference) was the only significant predictor of MTS change. Fasting TG may be the most important metabolic syndrome component to best characterize the metabolic heterogeneity in obese cohorts and the changes in metabolic risk in clinically obese youth.

Body Mass Index as a Measure of Obesity: Racial Differences in Predictive Value for Health Parameters During Pregnancy.

PubMed

Gillespie, Shannon L; Christian, Lisa M

2016-12-01

As a measure of obesity, body mass index (BMI; kg/m 2 ) is an imperfect predictor of health outcomes, particularly among African Americans. However, BMI is used to guide prenatal care. We examined racial differences in the predictive value of maternal BMI for physiologic correlates of obesity, serum interleukin (IL)-6 and C-reactive protein (CRP), as well as cesarean section and infant birth weight. One hundred five pregnant women (40 European American, 65 African American) were assessed during the second trimester. BMI was defined as per prepregnancy weight. Electrochemiluminescence and enzyme-linked immunosorbent assays were used to quantify IL-6 and CRP, respectively. Birth outcomes were determined by medical record review. Women of both races classified as obese had higher serum IL-6 and CRP than their normal-weight counterparts (ps ≤ 0.01). However, among women with overweight, elevations in IL-6 (p < 0.01) and CRP (p = 0.06) were observed among European Americans, but not African Americans (ps ≥ 0.61). Maternal obesity was a significantly better predictor of cesarean section among European Americans versus African Americans (p = 0.03) and BMI was associated with infant birth weight among European Americans (p < 0.01), but not African Americans (p = 0.94). Effects remained after controlling for gestational age at delivery, gestational diabetes, and gestational weight gain as appropriate. BMI may be a less valid predictor of correlates of overweight/obesity among African Americans versus European Americans during pregnancy. This should be considered in epidemiological studies of maternal-child health. In addition, studies examining the comparative validity of alternative/complementary measures to define obesity in pregnancy are warranted to inform clinical care.

Obesity screening in the pediatric emergency department.

PubMed

Vaughn, Lisa M; Nabors, Laura; Pelley, Terri J; Hampton, Rebecca R; Jacquez, Farrah; Mahabee-Gittens, E Melinda

2012-06-01

The purposes of this study were (1) to examine parental perception of childhood obesity and race with measured body mass index (BMI), (2) to determine if parents are receptive to obesity screening in the pediatric emergency department and if receptivity varies by race or weight status, and (3) to determine eating habits that are predictors of obesity. This study is a cross-sectional study, with a convenience sample of 213 patients (aged 4-16 years accompanied by a parent/legal guardian to a pediatric emergency department). Weight and height were obtained, and parents were asked to complete a survey about perception of their child's weight, nutrition, and exercise habits. The current study found that parent perception of weight status was fairly accurate, and perception was predictive of BMI. Race, however, was not predictive of BMI. Parents were generally receptive of weight screening in the pediatric emergency department, and this did not vary as a function of weight status; however, receptivity did vary based on ethnicity, with African American parents being more receptive than white parents. Large portion sizes and the number of times a child eats fast food per week were found to be predictive of obesity. Greater than half of the children presenting to our pediatric emergency department were overweight or obese. Parents were generally accurate in their perception of their child's weight but were still receptive to obesity prevention and screening in the pediatric emergency department.

EnviroAtlas - New York, NY - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Green Bay, WI - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - Des Moines, IA - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

EnviroAtlas - New Bedford, MA - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

Energy expenditure in obesity associated with craniopharyngioma

PubMed Central

Shah, Rachana; Tershakovec, Andy M.; Zemel, Babette S.; Sutton, Leslie N.; Grimberg, Adda; Moshang, Thomas

2010-01-01

Background and purpose Obesity is a common yet incompletely understood complication of childhood craniopharyngioma. We hypothesized that craniopharyngioma is associated with specific defects in energy balance compared to obese control children. Methods Eleven craniopharyngioma patients were recruited for a study on body composition and energy balance. Eight subjects were obese. The obese craniopharyngioma patients had a mean age (±SD) of 11.2±1.7 years. The average body mass index z score was 2.33 (±0.32). A previously studied group of obese children (BMI z score 2.46±0.46) served as controls. Resting energy expenditure (REE) was determined by indirect calorimetry and body composition by dual energy X-ray absorptiometry in all children. Results Obese craniopharyngioma patient subjects had increased mean (±standard error) fat-free mass compared to obese controls (57%±0.88 % vs 50.0%±0.87%, p=0.02). The obese craniopharyngioma patients had a 17% lower REE compared to values expected from the World Health Organization equation (1,541±112.6 vs 1,809±151.8 kcal; p=0.01). In contrast, the obese control children had measured REE within 1% of predicted (1,647±33.2 vs. 1,652±40.2; p=0.8). In a linear regression model, REE remained significantly lower than predicted after controlling for FFM. Conclusions Lower REE may be a factor contributing to obesity in children with craniopharyngioma. Further study is needed into the mechanisms for reduced energy expenditure in patients with craniopharyngioma. PMID:20107994

Identification of Genetic and Environmental Factors Predicting Metabolically Healthy Obesity in Children: Data From the BCAMS Study.

PubMed

Li, Lujiao; Yin, Jinhua; Cheng, Hong; Wang, Ying; Gao, Shan; Li, Mingyao; Grant, Struan F A; Li, Changhong; Mi, Jie; Li, Ming

2016-04-01

Available data related to the metabolically healthy obesity (MHO) phenotype are mainly derived from studies in adults because studies during childhood are very limited to date. The objective of the study was to determine the prevalence of MHO in Chinese children and to investigate environmental and genetic factors impacting on MHO status. This was a cross-sectional study. A total of 1213 children with a body mass index at the 95th percentile or greater aged 6–18 years were included in this study. Participants were classified as MHO or of metabolically unhealthy obesity based on insulin resistance (IR) or cardiometabolic risk (CR) factors (blood pressure, lipids, and glucose). Twenty-two genetic variants previously reported from genome-wide association studies of obesity and diabetes plus the environmental factors of lifestyle, socioeconomic status, and birth weight was assessed. The prevalence of MHO-IR and MHO-CR were 27.1% and 37.2%, respectively. Waist circumference was an independent predictor of MHO, regardless of definitions, whereas walking to school and KCNQ1-rs2237897 were independent predictors of MHO-CR. Acanthosis nigricans, birth weight, the frequency of soft drink consumption, the mother's education status, and KCNQ1-rs2237892 were independent predictors of MHO-IR. Multiplicative interaction effects were found between KCNQ1-rs2237897 and walking to school on MHO-CR (odds ratio 1.31 [95% confidence interval 1.05–1.63]) and between rs2237892 and consumption of soft drinks on MHO-IR (odds ratio 0.80 [95% confidence interval 0.68–0.94]). Approximately one-third of Chinese obese children can be classified as MHO. Both genetic predisposition and environment factors and their interaction contribute to the prediction of MHO status. This study provides novel insights into the heterogeneity of obesity and has the potential to impact the optimization of the intervention options and regimens in the management of pediatric obesity.

Key Clinical Factors Predicting Adipokine and Oxidative Stress Marker Concentrations among Normal, Overweight and Obese Pregnant Women Using Artificial Neural Networks.

PubMed

Solis-Paredes, Mario; Estrada-Gutierrez, Guadalupe; Perichart-Perera, Otilia; Montoya-Estrada, Araceli; Guzmán-Huerta, Mario; Borboa-Olivares, Héctor; Bravo-Flores, Eyerahi; Cardona-Pérez, Arturo; Zaga-Clavellina, Veronica; Garcia-Latorre, Ethel; Gonzalez-Perez, Gabriela; Hernández-Pérez, José Alfredo; Irles, Claudine

2017-12-28

Maternal obesity has been related to adverse neonatal outcomes and fetal programming. Oxidative stress and adipokines are potential biomarkers in such pregnancies; thus, the measurement of these molecules has been considered critical. Therefore, we developed artificial neural network (ANN) models based on maternal weight status and clinical data to predict reliable maternal blood concentrations of these biomarkers at the end of pregnancy. Adipokines (adiponectin, leptin, and resistin), and DNA, lipid and protein oxidative markers (8-oxo-2'-deoxyguanosine, malondialdehyde and carbonylated proteins, respectively) were assessed in blood of normal weight, overweight and obese women in the third trimester of pregnancy. A Back-propagation algorithm was used to train ANN models with four input variables (age, pre-gestational body mass index (p-BMI), weight status and gestational age). ANN models were able to accurately predict all biomarkers with regression coefficients greater than R² = 0.945. P-BMI was the most significant variable for estimating adiponectin and carbonylated proteins concentrations (37%), while gestational age was the most relevant variable to predict resistin and malondialdehyde (34%). Age, gestational age and p-BMI had the same significance for leptin values. Finally, for 8-oxo-2'-deoxyguanosine prediction, the most significant variable was age (37%). These models become relevant to improve clinical and nutrition interventions in prenatal care.

Postpartum Care and Contraception in Obese Women.

PubMed

Maclean, Courtney C; Thompson, Ivana S

2016-03-01

Postpartum obese women have an increased risk of breastfeeding difficulties and depression. Retaining the pregnancy weight at 6 months postpartum predicts long-term obesity. Risks for weight retention include excessive gestational weight gain, ethnicity, socioeconomic status, diet, exercise, depression, and duration of breastfeeding. Exercise and reducing total caloric intake promote postpartum weight loss. Intrauterine devices and contraceptive implants are the most effective contraceptives for obese women. Contraceptive pills, patches, and vaginal rings are effective options; however, obese women should be made aware of a potential increased risk of venous thromboembolism. Vasectomy and hysteroscopic sterilization carry the least surgical risk for obese women.

Lifestyle habits and obesity progression in overweight and obese American young adults: Lessons for promoting cardiometabolic health.

PubMed

Cha, EunSeok; Akazawa, Margeaux K; Kim, Kevin H; Dawkins, Colleen R; Lerner, Hannah M; Umpierrez, Guillermo; Dunbar, Sandra B

2015-12-01

Obesity among young adults is a growing problem in the United States and is related to unhealthy lifestyle habits, such as high caloric intake and inadequate exercise. Accurate assessment of lifestyle habits across obesity stages is important for informing age-specific intervention strategies to prevent and reduce obesity progression. Using a modified version of the Edmonton Obesity Staging System (mEOSS), a new scale for defining obesity risk and predicting obesity morbidity and mortality, this cross-sectional study assessed the prevalence of overweight/obese conditions in 105 young adults and compared their lifestyle habits across the mEOSS stages. Descriptive statistics, chi-square tests, and one-way analyses of variance were performed. Eighty percent of participants (n = 83) fell into the mEOSS-2 group and had obesity-related chronic disorders, such as diabetes, hypertension, and/or dyslipidemia. There were significant differences in dietary quality and patterns across the mEOSS stages. Findings highlighted the significance of prevention and early treatment for overweight and obese young adults to prevent and cease obesity progression. © 2015 Wiley Publishing Asia Pty Ltd.

Evidence in obese children: contribution of hyperlipidemia, obesity-inflammation, and insulin sensitivity.

PubMed

Chang, Chi-Jen; Jian, Deng-Yuan; Lin, Ming-Wei; Zhao, Jun-Zhi; Ho, Low-Tone; Juan, Chi-Chang

2015-01-01

Evidence shows a high incidence of insulin resistance, inflammation and dyslipidemia in adult obesity. The aim of this study was to assess the relevance of inflammatory markers, circulating lipids, and insulin sensitivity in overweight/obese children. We enrolled 45 male children (aged 6 to 13 years, lean control = 16, obese = 19, overweight = 10) in this study. The plasma total cholesterol, HDL cholesterol, triglyceride, glucose and insulin levels, the circulating levels of inflammatory factors, such as TNF-α, IL-6, and MCP-1, and the high-sensitive CRP level were determined using quantitative colorimetric sandwich ELISA kits. Compared with the lean control subjects, the obese subjects had obvious insulin resistance, abnormal lipid profiles, and low-grade inflammation. The overweight subjects only exhibited significant insulin resistance and low-grade inflammation. Both TNF-α and leptin levels were higher in the overweight/obese subjects. A concurrent correlation analysis showed that body mass index (BMI) percentile and fasting insulin were positively correlated with insulin resistance, lipid profiles, and inflammatory markers but negatively correlated with adiponectin. A factor analysis identified three domains that explained 74.08% of the total variance among the obese children (factor 1: lipid, 46.05%; factor 2: obesity-inflammation, 15.38%; factor 3: insulin sensitivity domains, 12.65%). Our findings suggest that lipid, obesity-inflammation, and insulin sensitivity domains predominantly exist among obese children. These factors might be applied to predict the outcomes of cardiovascular diseases in the future.

Obesity and coronary artery calcification: Can it explain the obesity-paradox?

PubMed

Aljizeeri, Ahmed; Coutinho, Thais; Pen, Ally; Chen, Li; Yam, Yeung; Dent, Robert; McPherson, Ruth; Chow, Benjamin J W

2015-06-01

The inverse relationship between obesity and adverse cardiovascular outcomes has been coined the 'obesity-paradox'. We sought to determine the relationship between measures of obesity [body mass index (BMI), body surface area (BSA) and body fat percentage (BF%)] and coronary artery calcification (CAC). We retrospectively analyzed patients who underwent CAC using the Agatston score. Baseline demographics were collected and BMI, BSA and BF% were calculated. A two-stage regression modeling approach was used to evaluate the association between BMI, BSA, BF% and Agatston score. Of the 6661 patients [mean age = 57.1 ± 10.8 years, men = 54.3%, median Agatston score = 14 (0, 163)], 0.1% were underweight, 21.3% had normal BMI, 39.1% were overweight and 39.4% were obese. The mean BMI, BSA and BF% were 29.6 ± 6.1 kg/m(2), 1.97 ± 0.25 m(2) and 37 ± 10 %, respectively. There was an independent association between the presence of CAC and BMI (5 kg/m(2) increments) (OR 1.05, CI 1.00-1.11, P = 0.038) and BF% (OR 2.38, CI 1.05-5.41, P = 0.038). Neither BMI categories nor large BSA independently predicted the presence of CAC. BF% predicted the extent of CAC in men but not in women, and higher BF% was associated with higher category of CAC severity in men only. BMI and BF% were independent predictors of the presence of CAC. BF% was associated with the extent of CAC and higher BF% was associated with higher category of CAC severity in men only. These results suggest that further study is needed to better understand the obesity-paradox.

Preserved insulin sensitivity predicts metabolically healthy obese phenotype in children and adolescents.

PubMed

Vukovic, Rade; Milenkovic, Tatjana; Mitrovic, Katarina; Todorovic, Sladjana; Plavsic, Ljiljana; Vukovic, Ana; Zdravkovic, Dragan

2015-12-01

Available data on metabolically healthy obese (MHO) phenotype in children suggest that gender, puberty, waist circumference, insulin sensitivity, and other laboratory predictors have a role in distinguishing these children from metabolically unhealthy obese (MUO) youth. The goal of this study was to identify predictors of MHO phenotype and to analyze glucose and insulin metabolism during oral glucose tolerance test (OGTT) in MHO children. OGTT was performed in 244 obese children and adolescents aged 4.6-18.9 years. Subjects were classified as MHO in case of no fulfilled criterion of metabolic syndrome except anthropometry or as MUO (≥2 fulfilled criteria). Among the subjects, 21.7 % had MHO phenotype, and they were more likely to be female, younger, and in earlier stages of pubertal development, with lower degree of abdominal obesity. Insulin resistance was the only independent laboratory predictor of MUO phenotype (OR 1.59, CI 1.13-2.25), with 82 % sensitivity and 60 % specificity for diagnosing MUO using HOMA-IR cutoff point of ≥2.85. Although no significant differences were observed in glucose regulation, MUO children had higher insulin demand throughout OGTT, with 1.53 times higher total insulin secretion. Further research is needed to investigate the possibility of targeted treatment of insulin resistance to minimize pubertal cross-over to MUO in obese children. • Substantial proportion of the obese youth (21-68 %) displays a metabolically healthy (MHO) phenotype. • Gender, puberty, waist circumference, insulin sensitivity, and lower levels of uric acid and transaminases have a possible role in distinguishing MHO from metabolically unhealthy obese (MUO) children. • Insulin resistance was found to be the only significant laboratory predictor of MUO when adjusted for gender, puberty, and the degree of abdominal obesity. • Besides basal insulin resistance, MUO children were found to have a significantly higher insulin secretion throughout OGTT in

Neighborhood Design for Walking and Biking

PubMed Central

Brown, Barbara B.; Smith, Ken R.; Hanson, Heidi; Fan, Jessie X.; Kowaleski-Jones, Lori; Zick, Cathleen D.

2013-01-01

Background Neighborhood designs often relate to physical activity and to BMI. Purpose Does neighborhood walkability/bikeability relate to BMI and obesity risk and does moderate-to-vigorous physical activity (MVPA) account for some of the relationship? Methods Census 2000 provided walkability/bikeability measures—block group proportions of workers who walk or bike to work, housing age, and population density—and National Health and Nutrition Examination Study (NHANES 2003–2006) provided MVPA accelerometer measures. Regression analyses (2011–2012) adjusted for geographic clustering and multiple control variables. Results Greater density and older housing were associated with lower male BMI in bivariate analyses, but there were no density and housing age effects in multivariate models. For women, greater proportions of neighborhood workers who walk to work (M=0.02) and more MVPA was associated with lower BMI and lower obesity risk. For men, greater proportions of workers who bike to work (M=0.004) and more MVPA was associated with lower BMI and obesity risk. For both effects, MVPA partially mediated the relationships between walkability/bikeability and BMI. If such associations are causal, doubling walk and bike-to-work proportions (to 0.04 and 0.008) would have –0.3 and –0.33 effects on the average BMIs of adult women and men living in the neighborhood. This equates to 1.5 lbs for a 64” woman and 2.3 lbs for a 69” man. Conclusions Although walking/biking to work is rare in the U.S., greater proportions of such workers in neighborhoods relate to lower weight and higher MVPA. Bikeability merits greater attention as a modifiable activity-friendliness factor, particularly for men. PMID:23415119

Preoperative Detection of Sarcopenic Obesity Helps to Predict the Occurrence of Gastric Leak After Sleeve Gastrectomy.

PubMed

Gaillard, Martin; Tranchart, Hadrien; Maitre, Sophie; Perlemuter, Gabriel; Lainas, Panagiotis; Dagher, Ibrahim

2018-03-02

Sleeve gastrectomy (SG) has become the primary procedure for many bariatric teams and staple-line leak represents its most feared complication. Sarcopenic obesity combines the risks of obesity and depleted lean mass leading possibly to an inferior surgical outcome after abdominal surgery. The aim of this study was to evaluate the existence of a potential link between radiologically determined sarcopenic obesity and staple-line leak risk after SG. A retrospective analysis of a prospective database was performed in consecutive patients undergoing SG as primary procedure. Total psoas muscles (TPA) and total visible muscles (TMA) areas were measured on a preoperative computed tomography (CT). Sarcopenia was defined as lowest tertile of skeletal muscular mass indexes (muscular areas over square of height) in each gender (using TPA or TMA). Multivariate analysis was performed to determine preoperative risk factors for staple-line leak. During the study period, 205 patients were included in the analysis. Median BMI was 40.8 kg/m 2 (34.2-49.6), and 9 patients (4.4%) presented a gastric leak. The sex-specific cut-offs for skeletal muscular mass index according to TPA were 8.2 cm 2 /m 2 for men and 6.08 cm 2 /m 2 for women. After multivariate analysis, preoperative weight (OR = 1043) and sarcopenia (TPA) (OR = 5204) were independent predictive factors for gastric leak. The present series suggests that CT scan-determined sarcopenic obesity is associated with increased risk of gastric leak after SG. This preoperatively radiological examination would be a useful clinical tool to tailor patient management according to gastric leak risk.

Genetics of pediatric obesity.

PubMed

Manco, Melania; Dallapiccola, Bruno

2012-07-01

Onset of obesity has been anticipated at earlier ages, and prevalence has dramatically increased worldwide over the past decades. Epidemic obesity is mainly attributable to modern lifestyle, but family studies prove the significant role of genes in the individual's predisposition to obesity. Advances in genotyping technologies have raised great hope and expectations that genetic testing will pave the way to personalized medicine and that complex traits such as obesity will be prevented even before birth. In the presence of the pressing offer of direct-to-consumer genetic testing services from private companies to estimate the individual's risk for complex phenotypes including obesity, the present review offers pediatricians an update of the state of the art on genomics obesity in childhood. Discrepancies with respect to genomics of adult obesity are discussed. After an appraisal of findings from genome-wide association studies in pediatric populations, the rare variant-common disease hypothesis, the theoretical soil for next-generation sequencing techniques, is discussed as opposite to the common disease-common variant hypothesis. Next-generation sequencing techniques are expected to fill the gap of "missing heritability" of obesity, identifying rare variants associated with the trait and clarifying the role of epigenetics in its heritability. Pediatric obesity emerges as a complex phenotype, modulated by unique gene-environment interactions that occur in periods of life and are "permissive" for the programming of adult obesity. With the advent of next-generation sequencing techniques and advances in the field of exposomics, sensitive and specific tools to predict the obesity risk as early as possible are the challenge for the next decade.

Clinical performance of the Prostate Health Index (PHI) for the prediction of prostate cancer in obese men: data from the PROMEtheuS project, a multicentre European prospective study.

PubMed

Abrate, Alberto; Lazzeri, Massimo; Lughezzani, Giovanni; Buffi, Nicolòmaria; Bini, Vittorio; Haese, Alexander; de la Taille, Alexandre; McNicholas, Thomas; Redorta, Joan Palou; Gadda, Giulio M; Lista, Giuliana; Kinzikeeva, Ella; Fossati, Nicola; Larcher, Alessandro; Dell'Oglio, Paolo; Mistretta, Francesco; Freschi, Massimo; Guazzoni, Giorgio

2015-04-01

To test serum prostate-specific antigen (PSA) isoform [-2]proPSA (p2PSA), p2PSA/free PSA (%p2PSA) and Prostate Health Index (PHI) accuracy in predicting prostate cancer in obese men and to test whether PHI is more accurate than PSA in predicting prostate cancer in obese patients. The analysis consisted of a nested case-control study from the pro-PSA Multicentric European Study (PROMEtheuS) project. The study is registered at http://www.controlled-trials.com/ISRCTN04707454. The primary outcome was to test sensitivity, specificity and accuracy (clinical validity) of serum p2PSA, %p2PSA and PHI, in determining prostate cancer at prostate biopsy in obese men [body mass index (BMI) ≥30 kg/m(2) ], compared with total PSA (tPSA), free PSA (fPSA) and fPSA/tPSA ratio (%fPSA). The number of avoidable prostate biopsies (clinical utility) was also assessed. Multivariable logistic regression models were complemented by predictive accuracy analysis and decision-curve analysis. Of the 965 patients, 383 (39.7%) were normal weight (BMI <25 kg/m(2) ), 440 (45.6%) were overweight (BMI 25-29.9 kg/m(2) ) and 142 (14.7%) were obese (BMI ≥30 kg/m(2) ). Among obese patients, prostate cancer was found in 65 patients (45.8%), with a higher percentage of Gleason score ≥7 diseases (67.7%). PSA, p2PSA, %p2PSA and PHI were significantly higher, and %fPSA significantly lower in patients with prostate cancer (P < 0.001). In multivariable logistic regression models, PHI significantly increased accuracy of the base multivariable model by 8.8% (P = 0.007). At a PHI threshold of 35.7, 46 (32.4%) biopsies could have been avoided. In obese patients, PHI is significantly more accurate than current tests in predicting prostate cancer. © 2014 The Authors. BJU International © 2014 BJU International.

Higher neonatal growth rate and body condition score at 7 months are predictive factors of obesity in adult female Beagle dogs.

PubMed

Leclerc, Lucie; Thorin, Chantal; Flanagan, John; Biourge, Vincent; Serisier, Samuel; Nguyen, Patrick

2017-04-13

The risks during early growth on becoming overweight in adulthood are widely studied in humans. However, early-life predictive factors for canine adult overweight and obesity have not yet been studied. To identify factors that may help explain the development of overweight and obesity at adulthood in dogs, a longitudinal study of 2 years was conducted in 24 female Beagle dogs of the same age, sexual status, and raised under identical environmental conditions. By means of a hierarchical classification on principal components with the following quantitative values: fat-free mass (FFM), percentage fat mass and pelvic circumference at 2 years of age, three groups of dogs were established and were nominally named: ideal weight (IW, n = 9), slightly overweight (OW1, n = 6) and overweight (OW2, n = 9). With the aim of identifying predictive factors of development of obesity at adulthood parental characteristics, growth pattern, energy balance and plasma factors were analysed by logistic regression analysis. At 24 months, the group compositions were in line with the body condition scores (BCS 1-9) values of the IW (5 or 6/9), the OW1 (6/9) and the OW2 (7 or 8/9) groups. Logistic regression analysis permitted the identification of neonatal growth rate during the first 2 weeks of life (GR 2W ) and BCS at 7 months as predictors for the development of obesity at adulthood. Seventy percent of dogs with either GR 2W >125% or with BCS > 6/9 at 7 months belonged to the OW2 group. Results from energy intake and expenditure, corrected for FFM, showed that there was a greater positive energy imbalance between 7 and 10 months for the OW2, compared to the IW group. This study expands the understanding of previously reported risk factors for being overweight or obese in dogs, establishing that (i) 15 out of 24 of the studied dogs became overweight and (ii) GR 2W and BCS at 7 months of age could be used as predictive factors as overweight adult dogs in the OW2

Evaluating the Determinants of Sugary Beverage Consumption among Overweight and Obese Adults: An Application of the Integrative Model of Behavioural Prediction

ERIC Educational Resources Information Center

Collado-Rivera, Maria; Branscum, Paul; Larson, Daniel; Gao, Haijuan

2018-01-01

Objective: The objective of this study was to evaluate the determinants of sugary drink consumption among overweight and obese adults attempting to lose weight using the Integrative Model of Behavioural Prediction (IMB). Design: Cross-sectional design. Method: Determinants of behavioural intentions (attitudes, perceived norms and perceived…

Predictors of obesity in Michigan Operating Engineers.

PubMed

Duffy, Sonia A; Cohen, Kathleen A; Choi, Seung Hee; McCullagh, Marjorie C; Noonan, Devon

2012-06-01

Blue collar workers are at risk for obesity. Little is known about obesity in Operating Engineers, a group of blue collar workers, who operate heavy earth-moving equipment in road building and construction. Therefore, 498 Operating Engineers in Michigan were recruited to participate in a cross-sectional survey to determine variables related to obesity in this group. Bivariate and multivariate analyses were conducted to determine personal, psychological, and behavioral factors predicting obesity. Approximately 45% of the Operating Engineers screened positive for obesity, and another 40% were overweight. Multivariate analysis revealed that younger age, male sex, higher numbers of self-reported co-morbidities, not smoking, and low physical activity levels were significantly associated with obesity among Operating Engineers. Operating Engineers are significantly at risk for obesity, and workplace interventions are needed to address this problem.

Obesity discrimination: the role of physical appearance, personal ideology, and anti-fat prejudice.

PubMed

O'Brien, K S; Latner, J D; Ebneter, D; Hunter, J A

2013-03-01

Self-report measures of anti-fat prejudice are regularly used by the field, however, there is no research showing a relationship between explicit measures of anti-fat prejudice and the behavioral manifestation of them; obesity discrimination. The present study examined whether a recently developed measure of anti-fat prejudice, the universal measure of bias (UMB), along with other correlates of prejudicial attitudes and beliefs (that is, authoritarianism, social dominance orientation; SDO, physical appearance investment) predict obesity discrimination. Under the guise of a personnel selection task, participants (n=102) gave assessments of obese and non-obese females applying for a managerial position across a number of selection criteria (for example, starting salary, likelihood of selecting). Participants viewed resumes that had attached either a photo of a pre-bariatric surgery obese female (body mass index (BMI)=38-41) or a photo of the same female post-bariatric surgery (BMI=22-24). Participants also completed measures of anti-fat prejudice (UMB) authoritarianism, SDO, physical appearance evaluation and orientation. Obesity discrimination was displayed across all selection criteria. Higher UMB subscale scores (distance and negative judgement), authoritarianism, physical appearance evaluation and orientation were associated with greater obesity discrimination. In regression models, UMB 'distance' was a predictor of obesity discrimination for perceived leadership potential, starting salary, and overall employability. UMB 'negative judgement' predicted discrimination for starting salary; and authoritarianism predicted likelihood of selecting an obese applicant and candidate ranking. Finally, physical appearance evaluation and appearance orientation predicted obesity discrimination for predicted career success and leadership potential, respectively. Self-report measures of prejudice act as surrogates for discrimination, but there has been no empirical support for

Distinct lipid profiles predict improved glycemic control in obese, nondiabetic patients after a low-caloric diet intervention: the Diet, Obesity and Genes randomized trial.

PubMed

Valsesia, Armand; Saris, Wim Hm; Astrup, Arne; Hager, Jörg; Masoodi, Mojgan

2016-09-01

An aim of weight loss is to reduce the risk of type 2 diabetes (T2D) in obese subjects. However, the relation with long-term glycemic improvement remains unknown. We evaluated the changes in lipid composition during weight loss and their association with long-term glycemic improvement. We investigated the plasma lipidome of 383 obese, nondiabetic patients within a randomized, controlled dietary intervention in 8 European countries at baseline, after an 8-wk low-caloric diet (LCD) (800-1000 kcal/d), and after 6 mo of weight maintenance. After weight loss, a lipid signature identified 2 groups of patients who were comparable at baseline but who differed in their capacities to lose weight and improve glycemic control. Six months after the LCD, one group had significant glycemic improvement [homeostasis model assessment of insulin resistance (HOMA-IR) mean change: -0.92; 95% CI: -1.17, -0.67)]. The other group showed no improvement in glycemic control (HOMA-IR mean change: -0.26; 95% CI: -0.64, 0.13). These differences were sustained for ≥1 y after the LCD. The same conclusions were obtained with other endpoints (Matsuda index and fasting insulin and glucose concentrations). Significant differences between the 2 groups were shown in leptin gene expression in adipose tissue biopsies. Significant differences were also observed in weight-related endpoints (body mass index, weight, and fat mass). The lipid signature allowed prediction of which subjects would be considered to be insulin resistant after 6 mo of weight maintenance [validation's receiver operating characteristic (ROC) area under the curve (AUC): 71%; 95% CI: 62%, 81%]. This model outperformed a clinical data-only model (validation's ROC AUC: 61%; 95% CI: 50%, 71%; P = 0.01). In this study, we report a lipid signature of LCD success (for weight and glycemic outcome) in obese, nondiabetic patients. Lipid changes during an 8-wk LCD allowed us to predict insulin-resistant patients after 6 mo of weight

Genetics of nonsyndromic obesity.

PubMed

Lee, Yung Seng

2013-12-01

Common obesity is widely regarded as a complex, multifactorial trait influenced by the 'obesogenic' environment, sedentary behavior, and genetic susceptibility contributed by common and rare genetic variants. This review describes the recent advances in understanding the role of genetics in obesity. New susceptibility loci and genetic variants are being uncovered, but the collective effect is relatively small and could not explain most of the BMI heritability. Yet-to-be identified common and rare variants, epistasis, and heritable epigenetic changes may account for part of the 'missing heritability'. Evidence is emerging about the role of epigenetics in determining obesity susceptibility, mediating developmental plasticity, which confers obesity risk from early life experiences. Genetic prediction scores derived from selected genetic variants, and also differential DNA methylation levels and methylation scores, have been shown to correlate with measures of obesity and response to weight loss intervention. Genetic variants, which confer susceptibility to obesity-related morbidities like nonalcoholic fatty liver disease, were also discovered recently. We can expect discovery of more rare genetic variants with the advent of whole exome and genome sequencing, and also greater understanding of epigenetic mechanisms by which environment influences genetic expression and which mediate the gene-environment interaction.

Using molecular functional networks to manifest connections between obesity and obesity-related diseases

PubMed Central

Yang, Jialiang; Qiu, Jing; Wang, Kejing; Zhu, Lijuan; Fan, Jingjing; Zheng, Deyin; Meng, Xiaodi; Yang, Jiasheng; Peng, Lihong; Fu, Yu; Zhang, Dahan; Peng, Shouneng; Huang, Haiyun; Zhang, Yi

2017-01-01

Obesity is a primary risk factor for many diseases such as certain cancers. In this study, we have developed three algorithms including a random-walk based method OBNet, a shortest-path based method OBsp and a direct-overlap method OBoverlap, to reveal obesity-disease connections at protein-interaction subnetworks corresponding to thousands of biological functions and pathways. Through literature mining, we also curated an obesity-associated disease list, by which we compared the methods. As a result, OBNet outperforms other two methods. OBNet can predict whether a disease is obesity-related based on its associated genes. Meanwhile, OBNet identifies extensive connections between obesity genes and genes associated with a few diseases at various functional modules and pathways. Using breast cancer and Type 2 diabetes as two examples, OBNet identifies meaningful genes that may play key roles in connecting obesity and the two diseases. For example, TGFB1 and VEGFA are inferred to be the top two key genes mediating obesity-breast cancer connection in modules associated with brain development. Finally, the top modules identified by OBNet in breast cancer significantly overlap with modules identified from TCGA breast cancer gene expression study, revealing the power of OBNet in identifying biological processes involved in the disease. PMID:29156709

Mediation of the bidirectional relations between obesity and depression among women.

PubMed

Vittengl, Jeffrey R

2018-06-01

Past research established that obesity increases risk for development of depression, and depression increases risk for development of obesity. The current study tested physical impairment (difficulty with instrumental activities of daily living), social dysfunction (low social support and high social strain), and emotional eating (using food to cope with stress) as mediators of the bidirectional, longitudinal relations between depression and obesity. A national sample of mid-life adults in the United States (N = 7108) was assessed at three time points over 18 years. Depression predicted increases in obesity, and obesity predicted increases in depression, for women but not for men. Among women, path analyses revealed that physical impairment, social dysfunction, and emotional eating mediated development of obesity from depression, and that physical impairment and emotional eating mediated development of depression from obesity. These results suggest that prevention or treatment of obesity-linked depression and depression-linked obesity in women may need to address multiple connections between these disorders. Copyright © 2018 Elsevier B.V. All rights reserved.

Does body fat percentage predict post-exercise heart rate response in non-obese children and adolescents?

PubMed

Jezdimirovic, Tatjana; Stajer, Valdemar; Semeredi, Sasa; Calleja-Gonzalez, Julio; Ostojic, Sergej M

2017-05-24

A correlation between adiposity and post-exercise autonomic regulation has been established in overweight and obese children. However, little information exists about this link in non-obese youth. The main purpose of this cross-sectional study was to describe the relationship between body fat percentage (BFP) and heart rate recovery after exercise [post-exercise heart rate (PEHR)], a marker of autonomic regulation, in normal-weight children and adolescents. We evaluated the body composition of 183 children and adolescents (age 15.0±2.3 years; 132 boys and 51 girls) who performed a maximal graded exercise test on a treadmill, with the heart rate monitored during and immediately after exercise. A strong positive trend was observed in the association between BFP and PEHR (r=0.14; p=0.06). Hierarchical multiple regression revealed that our model explained 18.3% of the variance in PEHR (p=0.00), yet BFP accounted for only 0.9% of the variability in PEHR (p=0.16). The evaluation of the contribution of each independent variable revealed that only two variables made a unique statistically significant contribution to our model (p<0.01), with age contributing 38.7% to our model (p=0.00) while gender accounted for an additional 25.5% (p=0.01). Neither BFP (14.4%; p=0.16) nor cardiorespiratory endurance (5.0%, p=0.60) made a significant unique contribution to the model. Body fatness seems to poorly predict PEHR in our sample of non-obese children and adolescents, while non-modifiable variables (age and gender) were demonstrated as strong predictors of heart rate recovery. The low amount of body fat reported in non-obese young participants was perhaps too small to cause disturbances in autonomic nervous system regulation.

The utility of childhood and adolescent obesity assessment in relation to adult health.

PubMed

Goldhaber-Fiebert, Jeremy D; Rubinfeld, Rachel E; Bhattacharya, Jay; Robinson, Thomas N; Wise, Paul H

2013-02-01

High childhood obesity prevalence has raised concerns about future adult health, generating calls for obesity screening of young children. To estimate how well childhood obesity predicts adult obesity and to forecast obesity-related health of future US adults. Longitudinal statistical analyses; microsimulations combining multiple data sets. National Longitudinal Survey of Youth, Population Study of Income Dynamics, and National Health and Nutrition Evaluation Surveys. The authors estimated test characteristics and predictive values of childhood body mass index to identify 2-, 5-, 10-, and 15 year-olds who will become obese adults. The authors constructed models relating childhood body mass index to obesity-related diseases through middle age stratified by sex and race. Twelve percent of 18-year-olds were obese. While screening at age 5 would miss 50% of those who become obese adults, screening at age 15 would miss 9%. The predictive value of obesity screening below age 10 was low even when maternal obesity was included as a predictor. Obesity at age 5 was a substantially worse predictor of health in middle age than was obesity at age 15. For example, the relative risk of developing diabetes as adults for obese white male 15-year-olds was 4.5 versus otherwise similar nonobese 15-year-olds. For obese 5-year-olds, the relative risk was 1.6. Main results do not include Hispanics due to sample size. Past relationships between childhood and adult obesity and health may change in the future. Early childhood obesity assessment adds limited information to later childhood assessment. Targeted later childhood approaches or universal strategies to prevent unhealthy weight gain should be considered.

Psychosocial stress predicts abnormal glucose metabolism: the Australian Diabetes, Obesity and Lifestyle (AusDiab) study.

PubMed

Williams, Emily D; Magliano, Dianna J; Tapp, Robyn J; Oldenburg, Brian F; Shaw, Jonathan E

2013-08-01

The evidence supporting a relationship between stress and diabetes has been inconsistent. This study examined the effects of stress on abnormal glucose metabolism, using a population-based sample of 3,759, with normoglycemia at baseline, from the Australian Diabetes, Obesity and Lifestyle study. Perceived stress and stressful life events were measured at baseline, with health behavior and anthropometric information also collected. Oral glucose tolerance tests were undertaken at baseline and 5-year follow-up. The primary outcome was the development of abnormal glucose metabolism (impaired fasting glucose, impaired glucose tolerance, and type 2 diabetes), according to WHO 1999 criteria. Perceived stress predicted incident abnormal glucose metabolism in women but not men, after multivariate adjustment. Life events showed an inconsistent relationship with abnormal glucose metabolism. Perceived stress predicted abnormal glucose metabolism in women. Healthcare professionals should consider psychosocial adversity when assessing risk factor profiles for the development of diabetes.

Walkable Worlds give a Rich Self-Similar Structure to the Real Line

NASA Astrophysics Data System (ADS)

Rosinger, Elemér E.

2010-05-01

It is a rather universal tacit and unquestioned belief—and even more so among physicists—that there is one and only one real line, namely, given by the coodinatisation of Descartes through the usual field R of real numbers. Such a dramatically limiting and thus harmful belief comes, unknown to equally many, from the similarly tacit acceptance of the ancient Archimedean Axiom in Euclid's Geometry. The consequence of that belief is a similar belief in the uniqueness of the coordinatization of the plane by the usual field C of complex numbers, and therefore, of the various spaces, manifolds, etc., be they finite or infinite dimensional, constructed upon the real or complex numbers, including the Hilbert spaces used in Quantum Mechanics. A near total lack of awareness follows therefore about the rich self-similar structure of other possible coordinatisations of the real line, possibilities given by various linearly ordered scalar fields obtained through the ultrapower construction. Such fields contain as a rather small subset the usual field R of real numbers. The concept of walkable world, which has highly intuitive and pragmatic algebraic and geometric meaning, illustrates the mentioned rich self-similar structure.

Usefulness of the neutrophil-to-lymphocyte ratio to prediction of type 2 diabetes mellitus in morbid obesity.

PubMed

Yilmaz, H; Ucan, B; Sayki, M; Unsal, I; Sahin, M; Ozbek, M; Delibasi, T

2015-01-01

There is growing consensus in the literature that inflammation plays a central role in the pathophysiology of obesity and type 2 diabetes mellitus (T2DM) and cardiovascular complications. Neutrophil-to-lymphocyte ratio (NLR) provides a simple method for assessment of inflammatory status and it is a new, inexpensive marker. The aim of the present study was to investigate the predictive value of preprocedural (before the OGTT) NLR on development of type 2 diabetes (T2DM) in morbid obesity patients (MOP). 306 MOP (body mass index ≥ 40 kg/m(2)) and 95 normal weight patients with normal OGTT [fasting plasma glucose (FPG)<100mg/dL. Two-hour glucose during OGTT<140 mg/dL] were evaluated in this study. The mean ± SD NLR of MOP was significantly higher than that of patients with normal weight healthy patients (3.67 ± 0.95 vs. 1.82 ± 1.02, P<0.001, respectively). In receiver operating characteristics curve analysis, NLR>3.12 had 79.2% sensitivity and 64.9% specificity in predicting T2DM. Logistic regression analysis showed that elevated NLR (OR: 2.577, 95% CI: 1.363-4.872, P=0.004) was an independent variable for predicting T2DM in MOP. MOP have higher NLR than healthy controls. High NLR is a powerful and independent predictor of T2DM in MOP. Elevated NLR levels are usually considered as an inflammatory marker. The results of this study suggested that inflammation plays a role in the pathogenesis of T2DM with MOP. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Effect of depressed mood in eating among obese and nonobese dieting and nondieting persons.

PubMed

Baucom, D H; Aiken, P A

1981-09-01

This study explored the relationship among obesity, depressed mood, current dieting habits, and eating. Depressed or nondepressed mood was induced in obese are nonobese dieters and nondieters. As predicted, dieters ate more when depressed than when nondepressed, and nondieters ate less when depressed than when nondepressed. That is, both groups reversed their typical eating patterns when depressed. Also as predicted, among depressed students, dieters ate more than nondieters; among nondepressed students, dieters at less than nondieters. The above pattern of results was found both for obese students and for nonobese students. Dieting habits were highlighted as a more salient variable than obesity in predicting eating responses to depressed mood. These findings are discussed with respect to the psychosomatic theory of obesity, Schachter's stimulus-binding theory of obesity, previous investigations of clinical depression, and Herman and Polivy's theory of restrained eating.

Epigenetics and human obesity.

PubMed

van Dijk, S J; Molloy, P L; Varinli, H; Morrison, J L; Muhlhausler, B S

2015-01-01

Recent technological advances in epigenome profiling have led to an increasing number of studies investigating the role of the epigenome in obesity. There is also evidence that environmental exposures during early life can induce persistent alterations in the epigenome, which may lead to an increased risk of obesity later in life. This paper provides a systematic review of studies investigating the association between obesity and either global, site-specific or genome-wide methylation of DNA. Studies on the impact of pre- and postnatal interventions on methylation and obesity are also reviewed. We discuss outstanding questions, and introduce EpiSCOPE, a multidisciplinary research program aimed at increasing the understanding of epigenetic changes in emergence of obesity. An electronic search for relevant articles, published between September 2008 and September 2013 was performed. From the 319 articles identified, 46 studies were included and reviewed. The studies provided no consistent evidence for a relationship between global methylation and obesity. The studies did identify multiple obesity-associated differentially methylated sites, mainly in blood cells. Extensive, but small, alterations in methylation at specific sites were observed in weight loss intervention studies, and several associations between methylation marks at birth and later life obesity were found. Overall, significant progress has been made in the field of epigenetics and obesity and the first potential epigenetic markers for obesity that could be detected at birth have been identified. Eventually this may help in predicting an individual's obesity risk at a young age and opens possibilities for introducing targeted prevention strategies. It has also become clear that several epigenetic marks are modifiable, by changing the exposure in utero, but also by lifestyle changes in adult life, which implies that there is the potential for interventions to be introduced in postnatal life to modify

Obesity can predict and promote systemic inflammation in healthy adults.

PubMed

Ellulu, Mohammed S; Khaza'ai, Huzwah; Rahmat, Asmah; Patimah, Ismail; Abed, Yehia

2016-07-15

To find out the differences on biomedical data between obese and non-obese participants, and to identify risk factors associated with systemic inflammation in healthy Palestinian adults. A cross-sectional study involved 105 apparently healthy adults. Interview questionnaire was used to collect personal information. Participants were excluded if they suffered from acute or chronic inflammatory diseases, or continued using medicines, which might affect the biomedical results. In association with increased Body Mass Index (BMI), the obese group displayed significant higher markers including: interleukin 6 (IL-6), high sensitivity C reactive protein (hs-CRP), total cholesterol (TC), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Obese group in association with increased waist circumference (WC) was higher significantly in inflammatory markers (IL-6, hs-CRP), lipid profile (TC) and triglyceride (TG), and blood pressure (SBP, DBP). A tertile of a feature of systemic inflammation (hs-CRP) was created, by Ordinal Logistic Regression, after adjusting for the age, gender, smoking habits, physical activity pattern, father and mother's health history; risk factors were the increased BMI [OR: 1.24] (95% CI: 1.005-1.548, P=0.050), IL-6 [OR: 3.35] (95% CI: 1.341-8.398, P=0.010), DBP [OR: 1.19] (95% CI: 1.034-1.367, P=0.015), and reduced Adiponectin [OR: 0.59] (95% CI: 0.435-0.820, P=0.001). Finally, BMI correlated with IL-6 and hs-CRP (r=0.326, P=0.005; r=0.347, P<0.001; respectively), and hs-CRP correlated with IL-6 (r=0.303, P=0.010), and inversely with Adiponectin (r=-0.342, P=0.001). The increased level of IL-6 and reduced Adiponectin, which strongly associated with obesity, indicated that having high BMI is a useful marker in association with IL-6 and further developed systemic inflammation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Neighborhood Food Environment, Diet, and Obesity Among Los Angeles County Adults, 2011

PubMed Central

Lightstone, Amy S.; Basurto-Davila, Ricardo; Morales, Douglas M.; Sturm, Roland

2015-01-01

Introduction The objective of this study was to examine whether an association exists between the number and type of food outlets in a neighborhood and dietary intake and body mass index (BMI) among adults in Los Angeles County. We also assessed whether this association depends on the geographic size of the food environment. Methods We analyzed data from the 2011 Los Angeles County Health Survey. We created buffers (from 0.25 to 3.0 miles in radius) centered in respondents’ residential addresses and counted the number of food outlets by type in each buffer. Dependent variables were weekly intake of fruits and vegetables, sugar-sweetened beverages, and fast food; BMI; and being overweight (BMI ≥25.0 kg/m2) or obese (BMI ≥30.0 kg/m2). Explanatory variables were the number of outlets classified as fast-food outlets, convenience stores, small food stores, grocery stores, and supermarkets. Regressions were estimated for all sets of explanatory variables and buffer size combinations (150 total effects). Results Only 2 of 150 effects were significant after being adjusted for multiple comparisons. The number of fast-food restaurants in nonwalkable areas (in a 3.0-mile radius) was positively associated with fast-food consumption, and the number of convenience stores in a walkable distance (in a 0.25-mile radius) was negatively associated with obesity. Discussion Little evidence was found for associations between proximity of respondents’ homes to food outlets and dietary intake or BMI among adults in Los Angeles County. A possible explanation for the null finding is that shopping patterns are weakly related to neighborhoods in Los Angeles County because of motorized transportation. PMID:26334715

Neighborhood Food Environment, Diet, and Obesity Among Los Angeles County Adults, 2011.

PubMed

Mejia, Nelly; Lightstone, Amy S; Basurto-Davila, Ricardo; Morales, Douglas M; Sturm, Roland

2015-09-03

The objective of this study was to examine whether an association exists between the number and type of food outlets in a neighborhood and dietary intake and body mass index (BMI) among adults in Los Angeles County. We also assessed whether this association depends on the geographic size of the food environment. We analyzed data from the 2011 Los Angeles County Health Survey. We created buffers (from 0.25 to 3.0 miles in radius) centered in respondents' residential addresses and counted the number of food outlets by type in each buffer. Dependent variables were weekly intake of fruits and vegetables, sugar-sweetened beverages, and fast food; BMI; and being overweight (BMI ≥25.0 kg/m(2)) or obese (BMI ≥30.0 kg/m(2)). Explanatory variables were the number of outlets classified as fast-food outlets, convenience stores, small food stores, grocery stores, and supermarkets. Regressions were estimated for all sets of explanatory variables and buffer size combinations (150 total effects). Only 2 of 150 effects were significant after being adjusted for multiple comparisons. The number of fast-food restaurants in nonwalkable areas (in a 3.0-mile radius) was positively associated with fast-food consumption, and the number of convenience stores in a walkable distance (in a 0.25-mile radius) was negatively associated with obesity. Little evidence was found for associations between proximity of respondents' homes to food outlets and dietary intake or BMI among adults in Los Angeles County. A possible explanation for the null finding is that shopping patterns are weakly related to neighborhoods in Los Angeles County because of motorized transportation.

Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review.

PubMed

Frankenfield, David; Roth-Yousey, Lori; Compher, Charlene

2005-05-01

An assessment of energy needs is a necessary component in the development and evaluation of a nutrition care plan. The metabolic rate can be measured or estimated by equations, but estimation is by far the more common method. However, predictive equations might generate errors large enough to impact outcome. Therefore, a systematic review of the literature was undertaken to document the accuracy of predictive equations preliminary to deciding on the imperative to measure metabolic rate. As part of a larger project to determine the role of indirect calorimetry in clinical practice, an evidence team identified published articles that examined the validity of various predictive equations for resting metabolic rate (RMR) in nonobese and obese people and also in individuals of various ethnic and age groups. Articles were accepted based on defined criteria and abstracted using evidence analysis tools developed by the American Dietetic Association. Because these equations are applied by dietetics practitioners to individuals, a key inclusion criterion was research reports of individual data. The evidence was systematically evaluated, and a conclusion statement and grade were developed. Four prediction equations were identified as the most commonly used in clinical practice (Harris-Benedict, Mifflin-St Jeor, Owen, and World Health Organization/Food and Agriculture Organization/United Nations University [WHO/FAO/UNU]). Of these equations, the Mifflin-St Jeor equation was the most reliable, predicting RMR within 10% of measured in more nonobese and obese individuals than any other equation, and it also had the narrowest error range. No validation work concentrating on individual errors was found for the WHO/FAO/UNU equation. Older adults and US-residing ethnic minorities were underrepresented both in the development of predictive equations and in validation studies. The Mifflin-St Jeor equation is more likely than the other equations tested to estimate RMR to within 10% of

Obstructive Sleep Apnea: Differences between Normal-Weight, Overweight, Obese, and Morbidly Obese Children.

PubMed

Scott, Brian; Johnson, Romaine F; Mitchell Md, Ron B

2016-05-01

The severity of obstructive sleep apnea in children determines perioperative management and is an indication for postoperative polysomnography. The relationship between increasing weight and sleep apnea severity in children remains unclear. To compare demographic, clinical, and polysomnography parameters in normal-weight, overweight, obese, and morbidly obese children, as well as identify demographic factors that predict sleep apnea severity. Case series with chart review. Academic children's hospital. A retrospective chart review of 290 children aged 2 to 18 years who underwent polysomnography at an academic children's hospital was performed. Demographics, clinical findings, and polysomnographic parameters were recorded. Children were categorized as normal weight, overweight, obese, or morbidly obese. Differences were assessed using linear and logistical regression models. Significance was set at P < .05. Morbidly obese were older than normal-weight children (mean, 8.0 ± 0.5 years vs 5.8 ± 0.3 years; P < .001) and less likely to have a normal polysomnogram (16% vs 48%; P = .02). There were no differences in sex, ethnicity, birth status (term or preterm), or tonsil size between normal-weight, overweight, obese, and morbidly obese children. Sleep efficiency and percentage of time in rapid eye movement were decreased in morbidly obese compared with other children (P < .05). The apnea-hypopnea index was positively correlated with increasing body mass index z score only as a function of increasing age (P < .001). Obstructive sleep apnea severity is correlated with a combination of increasing age and weight but not with either variable independently. This study suggests that obese and morbidly obese older children are most likely to have severe obstructive sleep apnea. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Subtraction of subcutaneous fat to improve the prediction of visceral adiposity: exploring a new anthropometric track in overweight and obese youth.

PubMed

Samouda, H; De Beaufort, C; Stranges, S; Van Nieuwenhuyse, J-P; Dooms, G; Keunen, O; Leite, S; Vaillant, M; Lair, M-L; Dadoun, F

2017-08-01

The efficiency of traditional anthropometric measurements such as body mass index (BMI) or waist circumference (Waist C) used to replace biomedical imaging for assessing visceral adipose tissue (VAT) is still highly controversial in youth. We evaluated the most accurate model predicting VAT in overweight/obese youth, using various anthropometric measurements and their correlation with different body fat compartments, especially by testing, for the first time in youth, the hypothesis that subtracting the anthropometric measurement the most highly correlated with subcutaneous abdominal adipose tissue (SAAT) and less correlated possible with VAT from an anthropometric abdominal measurement highly correlated with visceral and total abdominal adipose tissue (TAAT), predicts VAT with higher accuracy. VAT and SAAT data resulted from magnetic resonance imaging (MRI) analysis performed on 181 boys and girls (7-17 y) from Diabetes & Endocrinology Care Paediatrics Clinic in Luxembourg. Height, weight, abdominal diameters, waist, hip, and thigh circumferences were measured with a view to developing the anthropometric VAT predictive algorithms. In girls, subtracting proximal thigh circumference (Proximal Thigh C), the most closely correlated anthropometric measurement with SAAT, from Waist C, the most closely correlated anthropometric measurement with VAT was instrumental in improving VAT prediction, in comparison with the most accurate single VAT anthropometric surrogate. [Formula: see text] Residual analysis showed a negligible estimation error (5 cm 2 ). In boys, Waist C was the best VAT predictor. Subtraction of abdominal subcutaneous fat is important to predict VAT in overweight/obese girls. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The impacts of super obesity versus morbid obesity on red blood cell aggregation and deformability among patients qualified for bariatric surgery.

PubMed

Wiewiora, Maciej; Piecuch, Jerzy; Glûck, Marek; Slowinska-Lozynska, Ludmila; Sosada, Krystyn

2014-01-01

The aim of this study was to evaluate the effects of the obesity degree on red blood cell aggregation and deformability. We studied 56 obese patients before weight loss surgery who were divided into two groups: morbid obesity and super obesity. The aggregation and deformability of RBCs were evaluated using a Laser-assisted Optical Rotational Cell Analyzer (Mechatronics, the Netherlands). The following parameters specific to the aggregation process were estimated: aggregation index (AI), aggregation half-time (t1/2) and threshold shear rate (γthr). RBC deformability was expressed as erythrocyte elongation (EI), which was measured at 18.49 Pa and 30.2 Pa shear stresses. Super obese patients presented significantly higher AI (P < 0.05) and γthr (P < 0.05) and significantly lower t1/2 (P < 0.05) compared with morbidly obese individuals. Multivariate analyses showed that fibrinogen (β 0.46, P < 0.01 and β 0.98, P < 0.01) and hematocrit (β 0.38, P < 0.05 and β 1.01, P < 0.01) independently predicted the AI in morbidly obese and super obese patients. Fibrinogen (β -0.4, P < 0.05 and β -0.91, P < 0.05) and hematocrit (β -0.38, P < 0.05 and β -1.11, P < 0.01) were also independent predictors of the t1/2 in both obese groups. The triglyceride level (β 0.32, P < 0.05) was an independent predictor of the t1/2 in the morbidly obese group. No differences in EI were observed between obese subjects. Multivariate analyses showed that the triglyceride level independently predicted EI at 18.49 Pa (β -0.42, P < 0.05 and β -0.53, P < 0.05) and 30.2 Pa (β -0.44, P < 0.01 and β -0.49, P < 0.05) in both obese groups. This study indicated that the obesity degree of patients who qualify for bariatric surgery affects RBC aggregation properties, but it does not indicate the reasons for this difference. Further studies are needed to determine factors associated with hyperaggregation in super obesity.

Neighborhood design for walking and biking: physical activity and body mass index.

PubMed

Brown, Barbara B; Smith, Ken R; Hanson, Heidi; Fan, Jessie X; Kowaleski-Jones, Lori; Zick, Cathleen D

2013-03-01

Neighborhood designs often relate to physical activity and to BMI. Does neighborhood walkability/bikeability relate to BMI and obesity risk and does moderate-to-vigorous physical activity (MVPA) account for some of the relationship? Census 2000 provided walkability/bikeability measures-block group proportions of workers who walk or bike to work, housing age, and population density-and National Health and Nutrition Examination Study (NHANES 2003-2006) provided MVPA accelerometer measures. Regression analyses (2011-2012) adjusted for geographic clustering and multiple control variables. Greater density and older housing were associated with lower male BMI in bivariate analyses, but there were no density and housing age effects in multivariate models. For women, greater proportions of neighborhood workers who walk to work (M=0.02) and more MVPA was associated with lower BMI and lower obesity risk. For men, greater proportions of workers who bike to work (M=0.004) and more MVPA was associated with lower BMI and obesity risk. For both effects, MVPA partially mediated the relationships between walkability/bikeability and BMI. If such associations are causal, doubling walk and bike-to-work proportions (to 0.04 and 0.008) would have -0.3 and -0.33 effects on the average BMIs of adult women and men living in the neighborhood. This equates to 1.5 pounds for a 64-inch-tall woman and 2.3 pounds for a 69-inch-tall man. Although walking/biking to work is rare in the U.S., greater proportions of such workers in neighborhoods relate to lower weight and higher MVPA. Bikeability merits greater attention as a modifiable activity-friendliness factor, particularly for men. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

The Perception of Threat from Emotions in Predicting Binge Eating Behaviours in People Who Are Obese and Seeking Treatment for Their Weight.

PubMed

Fox, J R E; Msetfi, R M; Johnson, R S; Haigh, E

2016-09-01

The affect regulation theory suggests that people binge eat to regulate negative emotional states. In this study, we used a basic emotions perspective to consider the role of perceived threat of emotions, emotional suppression and reduced emotional expressiveness in predicting binge eating behaviours in people who are obese. Treatment-seeking participants with obesity (N = 51, body mass index range from 30.8 to 60.2 kg m -2 ) completed measures of 'perception of threat from emotion' as well as 'emotional expressiveness' and binge eating. The results demonstrated that perceived threat of sadness predicted binge eating (β = .55, p < .05). Additionally, a mediation analysis revealed that reduced emotional expressiveness mediated the relationship between perceived threat of fear and binge eating (β = .25, 95%). These findings are contextualized within a theoretical perspective that suggests that individuals who binge eat are threatened by certain emotional states and they use binge eating to suppress certain, but not all, emotional states. Copyright © 2015 John Wiley & Sons, Ltd. Considering basic emotions within binge eating should be a part of a psychological assessment and treatment. This should consider how emotions could often be perceived as being threatening and their expression is limited. It is possible that the emotions of fear and sadness appear to be particularly threatening within binge eating/obese populations. Copyright © 2015 John Wiley & Sons, Ltd.

Obesity, Diabetes, and Birth Outcomes Among American Indians and Alaska Natives.

PubMed

Anderson, Kermyt G; Spicer, Paul; Peercy, Michael T

2016-12-01

Objectives To examine the relationships between prepregnancy diabetes mellitus (DM), gestational diabetes mellitus (GDM), and prepregnancy body mass index, with several adverse birth outcomes: preterm delivery (PTB), low birthweight (LBW), and macrosomia, comparing American Indians and Alaska Natives (AI/AN) with other race/ethnic groups. Methods The sample includes 5,193,386 singleton US first births from 2009-2013. Logistic regression is used to calculate adjusted odds ratios controlling for calendar year, maternal age, education, marital status, Kotelchuck prenatal care index, and child's sex. Results AI/AN have higher rates of diabetes than all other groups, and higher rates of overweight and obesity than whites or Hispanics. Neither overweight nor obesity predict PTB for AI/AN, in contrast to other groups, while diabetes predicts increased odds of PTB for all groups. Being overweight predicts reduced odds of LBW for all groups, but obesity is not predictive of LBW for AI/AN. Diabetes status also does not predict LBW for AI/AN; for other groups, LBW is more likely for women with DM or GDM. Overweight, obesity, DM, and GDM all predict higher odds of macrosomia for all race/ethnic groups. Conclusions for Practice Controlling diabetes in pregnancy, as well as prepregnancy weight gain, may help decrease preterm birth and macrosomia among AI/AN.

Weight and weight gain during early infancy predict childhood obesity: a case-cohort study.

PubMed

Andersen, L G; Holst, C; Michaelsen, K F; Baker, J L; Sørensen, T I A

2012-10-01

Infant weight and weight gain are positively associated with later obesity, but whether there is a particular critical time during infancy remains uncertain. The aim was to investigate when and how weight and weight gain during infancy become associated with childhood obesity. In a cohort representing 28 340 children born from 1959-67 and measured in Copenhagen schools, 962 obese children (2007 World Health Organization criteria), were compared with a 5% randomly selected sub-cohort of 1417 children. Information on weight at birth, 2 weeks, 1, 2, 3, 4, 6 and 9 months was retrieved from health visitors' records. Odds ratios and 95% confidence intervals (CI) for childhood obesity by tertiles of weight at each age and by change in tertiles of weight between two consecutive measurements were estimated using multivariate logistic regression with adjustment for indicators of socioeconomic status, preterm birth, and breastfeeding. Compared with children in the middle weight-tertile, children with a weight in the upper tertile had a 1.36-fold (CI, 1.10-1.69) to 1.72-fold (CI, 1.36-2.18) higher risk of childhood obesity from birth through 9 months, whereas children in the lower weight-tertile had almost half the risk of obesity from 2 through 9 months. The risk of childhood obesity associated with change in weight-tertile in each interval was stable at ∼1.5-fold per weight-tertile increase throughout infancy. Infant weight and weight gain are associated with obesity in childhood already during the first months of life. Determinants of weight gain shortly after birth may be a suitable target for prevention of obesity.

Prediction of Cardiorespiratory Fitness by the Six-Minute Step Test and Its Association with Muscle Strength and Power in Sedentary Obese and Lean Young Women: A Cross-Sectional Study

PubMed Central

Bonjorno Junior, José Carlos; de Oliveira, Cláudio Ricardo; Luporini, Rafael Luís; Mendes, Renata Gonçalves; Zangrando, Katiany Thais Lopes; Trimer, Renata; Arena, Ross

2015-01-01

Impaired cardiorespiratory fitness (CRF) is a hallmark characteristic in obese and lean sedentary young women. Peak oxygen consumption (VO2peak) prediction from the six-minute step test (6MST) has not been established for sedentary females. It is recognized that lower-limb muscle strength and power play a key role during functional activities. The aim of this study was to investigate cardiorespiratory responses during the 6MST and CPX and to develop a predictive equation to estimate VO2peak in both lean and obese subjects. Additionally we aim to investigate how muscle function impacts functional performance. Lean (LN = 13) and obese (OB = 18) women, aged 20–45, underwent a CPX, two 6MSTs, and isokinetic and isometric knee extensor strength and power evaluations. Regression analysis assessed the ability to predict VO2peak from the 6MST, age and body mass index (BMI). CPX and 6MST main outcomes were compared between LN and OB and correlated with strength and power variables. CRF, functional capacity, and muscle strength and power were lower in the OB compared to LN (<0.05). During the 6MST, LN and OB reached ~90% of predicted maximal heart rate and ~80% of the VO2peak obtained during CPX. BMI, age and number of step cycles (NSC) explained 83% of the total variance in VO2peak. Moderate to strong correlations between VO2peak at CPX and VO2peak at 6MST (r = 0.86), VO2peak at CPX and NSC (r = 0.80), as well as between VO2peak, NSC and muscle strength and power variables were found (p<0.05). These findings indicate the 6MST, BMI and age accurately predict VO2peak in both lean and obese young sedentary women. Muscle strength and power were related to measures of aerobic and functional performance. PMID:26717568

Maternal obesity influences the relationship between location of neonate fat mass and total fat mass.

PubMed

Hull, H R; Thornton, J; Paley, C; Navder, K; Gallagher, D

2015-08-01

It is suggested that maternal obesity perpetuates offspring obesity to future generations. To determine whether location of neonate fat mass (FM: central vs. peripheral) is related to total neonate FM and whether maternal obesity influences this relationship. Neonate body composition and skin-fold thicknesses were assessed in healthy neonates (n = 371; 1-3 days old). Linear regression models examined the relationship between total FM and location of FM (central vs. peripheral). Location of FM was calculated by skin-folds: peripheral was the sum of (biceps and triceps)/2 and central was represented by the subscapular skin-fold. A significant interaction was found for location of FM and maternal obesity. Holding all predictors constant, in offspring born to non-obese mothers, a 0.5 mm increase in central FM predicted a 15 g greater total FM, whereas a 0.5 mm increase in peripheral FM predicted a 66 g greater total FM. However, in offspring born to obese mothers, a 0.5 mm increase in central FM predicted a 56 g total FM, whereas a 0.5 mm increase in peripheral FM predicted a 14 g greater total FM. The relationship between total FM and location of FM is influenced by maternal obesity. © 2014 The Authors. Pediatric Obesity © 2014 World Obesity.

Very low food security predicts obesity predominantly in California Hispanic men and women.

PubMed

Leung, Cindy W; Williams, David R; Villamor, Eduardo

2012-12-01

A high prevalence of food insecurity has persisted in the USA for the past two decades. Previous studies suggest that the association between food insecurity and obesity may vary by gender and race/ethnicity. We examined whether food insecurity was associated with BMI and obesity within gender and racial/ethnic groups in a large, diverse sample of low-income adults. A cross-sectional analysis of a large population-based health survey. We compared the distribution of BMI and obesity by food security levels within gender and racial/ethnic categories. Data were derived from the 2003-2009 waves of the California Health Interview Survey. The study sample included 35 747 non-elderly adults with households ≤200 % of the federal poverty level. Among Hispanic men, very low food security was associated with a 1.0 kg/m2 higher BMI (95 % CI 0.3, 1.7 kg/m2) and a 36 % higher prevalence of obesity (95 % CI 17, 58 %) after multivariate adjustment. Among Hispanic women, very low food security was associated with a 1.1 kg/m2 higher BMI (95 % CI 0.4, 1.9 kg/m2) and a 22 % higher prevalence of obesity (95 % CI 8, 38 %). Positive associations were also observed for Asian women and multi-racial men. No significant associations were observed for non-Hispanic whites, African Americans, Asian men or multi-racial women. Our results suggest that the association of food insecurity and obesity is limited to individuals of certain low-income, minority racial/ethnic groups. Whether targeted interventions to address food insecurity in these individuals may also decrease obesity risk deserves further investigation.

Skinfold thickness, body fat percentage and body mass index in obese and non-obese Indian boys.

PubMed

Chatterjee, Satipati; Chatterjee, Pratima; Bandyopadhyay, Amit

2006-01-01

Childhood obesity is presently increasing worldwide and has created enormous concern for researchers working in the field of obesity related diseases with special interest in child health and development. Selected anthropometric measurements including stature, body mass, and skinfolds are globally accepted sensitive indicators of growth patterns and health status of a child. The present study was therefore aimed not only at evaluating the body mass index (BMI), skinfolds, body fat percentage (%fat) in obese school going boys of West Bengal, India, but also aimed to compare these data with their non-obese counterparts. Ten to sixteen year old obese boys (N = 158) were separated from their non-obese counterparts using the age-wise international cut-off points of BMI. Skinfolds were measured using skinfold calipers, BMI and %fat were calculated from standard equations. Body mass, BMI, skinfolds and %fat were significantly (P<0.001) higher for the sample of obese boys when compared to their non-obese counterparts. The obese group also showed progressive age-wise increments in all recorded anthropometric parameters. Stature (cm) showed no significant inter-group variation except in the 10 year age group (P<0.001). All data for the non-obese group were comparable with other national and international studies, but those collected for the obese group could not feasibly be compared because the availability of data on obese children is limited. Current data and prediction equations will not only serve as a reference standard, but also be of vital clinical importance in order to identify or categorize obese boys, and to take preventative steps to minimise serious health problems that appear during the later part of life.

Interrupting Intergenerational Cycles of Maternal Obesity

PubMed Central

Gillman, Matthew W.

2016-01-01

Factors operating in the preconception and prenatal periods, such as maternal obesity, excessive gestational weight gain, and gestational diabetes, predict a substantial fraction of childhood obesity as well as lifelong adverse health consequences in the mother. These periods may lend themselves to successful intervention to reduce such risk factors because parents may be especially willing to change behavior if it confers health advantages to their children. If effective interventions started before or during pregnancy can be maintained after birth, they have the potential to lower the risk of both maternal obesity in the next pregnancy and obesity in the growing child, thus helping to interrupt maternal and child inter-generational vicious cycles of obesity, diabetes, and related cardiometabolic health consequences. While this paradigm is appealing, challenges include determining the magnitude, causality, and modifiability of these risk factors, and quantifying any adverse consequences of intervention. PMID:27088333

High rates of obesity and non-communicable diseases predicted across Latin America.

PubMed

Webber, Laura; Kilpi, Fanny; Marsh, Tim; Rtveladze, Ketevan; Brown, Martin; McPherson, Klim

2012-01-01

Non-communicable diseases (NCDs) such as cardiovascular disease and stroke are a major public health concern across Latin America. A key modifiable risk factor for NCDs is overweight and obesity highlighting the need for policy to reduce prevalence rates and ameliorate rising levels of NCDs. A cross-sectional regression analysis was used to project BMI and related disease trends to 2050. We tested the extent to which interventions that decrease body mass index (BMI) have an effect upon the number of incidence cases avoided for each disease. Without intervention obesity trends will continue to rise across much of Latin America. Effective interventions are necessary if rates of obesity and related diseases are to be reduced.

High Rates of Obesity and Non-Communicable Diseases Predicted across Latin America

PubMed Central

Webber, Laura; Kilpi, Fanny; Marsh, Tim; Rtveladze, Ketevan; Brown, Martin; McPherson, Klim

2012-01-01

Non-communicable diseases (NCDs) such as cardiovascular disease and stroke are a major public health concern across Latin America. A key modifiable risk factor for NCDs is overweight and obesity highlighting the need for policy to reduce prevalence rates and ameliorate rising levels of NCDs. A cross-sectional regression analysis was used to project BMI and related disease trends to 2050. We tested the extent to which interventions that decrease body mass index (BMI) have an effect upon the number of incidence cases avoided for each disease. Without intervention obesity trends will continue to rise across much of Latin America. Effective interventions are necessary if rates of obesity and related diseases are to be reduced. PMID:22912663

Resting energy expenditure may predict the relationship between obesity and susceptibility to depression disorders.

PubMed

Ahmadi, S; Mirzaei, K; Hossein-Nezhad, A; Keshavarz, S A; Ahmadivand, Z

2013-04-01

The aim of the current research was to investigate the association between depressed mood and resting energy expenditure (REE) in a representative sample of obese women. Fasting blood sample was collected from 254 obese women to determine biochemical indicators. Body composition was measured using body composition analyzer. REE was measured by means of indirect calorimetry. Comparison between depressed group and healthy obese women demonstrated that the mean of body mass index, fat percent, fat mass, visceral fat and triglyceride were higher in women with depressed mood. The level of REE/kg was significantly low in depressed obese women compared to healthy subjects.

EnviroAtlas - Minneapolis/St. Paul, MN - Estimated Percent Tree Cover Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates tree cover along walkable roads. The road width is estimated for each road and percent tree cover is calculated in a 8.5 meter strip beginning at the estimated road edge. Percent tree cover is calculated for each block between road intersections. In this community, tree cover is defined as Trees and Forest and Woody Wetlands. Tree cover provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas/EnviroAtlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets)

EnviroAtlas - Minneapolis/St. Paul, MN - Estimated Percent Green Space Along Walkable Roads

EPA Pesticide Factsheets

This EnviroAtlas dataset estimates green space along walkable roads. Green space within 25 meters of the road centerline is included and the percentage is based on the total area between street intersections. In this community, green space is defined as Trees and Forest, Grass and Herbaceous, Agriculture, Woody Wetlands, and Emergent Wetlands. In this metric, water is also included in green space. Green space provides valuable benefits to neighborhood residents and walkers by providing shade, improved aesthetics, and outdoor gathering spaces. This dataset was produced by the US EPA to support research and online mapping activities related to EnviroAtlas. EnviroAtlas (https://www.epa.gov/enviroatlas/EnviroAtlas) allows the user to interact with a web-based, easy-to-use, mapping application to view and analyze multiple ecosystem services for the contiguous United States. The dataset is available as downloadable data (https://edg.epa.gov/data/Public/ORD/EnviroAtlas) or as an EnviroAtlas map service. Additional descriptive information about each attribute in this dataset can be found in its associated EnviroAtlas Fact Sheet (https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets).

Overweight and obesity among youth participants in American football.

PubMed

Malina, Robert M; Morano, Peter J; Barron, Mary; Miller, Susan J; Cumming, Sean P; Kontos, Anthony P; Little, Bertis B

2007-10-01

To estimate the prevalence of overweight and obesity among participants in youth American football 9 to 14 years of age. Cross-sectional, 653 boys, 8.7 to 14.6 years. Height and weight were measured; body mass index (BMI) was calculated. Overweight and obesity were defined by international (International Obesity Task Force [IOTF]) and United States (Centers for Disease Control [CDC]) criteria. Prevalence and 95% confidence interval were calculated. Player age, height, and weight and midparent height were used to predict mature height; current height was expressed as a percentage of predicted mature height as an estimate of maturity status. Overall 45.0% (41.2% to 48.9%) and 42.6% (38.8% to 46.5%) of players were overweight or obese by CDC and IOTF criteria, respectively. Prevalence was highest in early maturing boys. Based on position-activity at time of injury (n = 180), overweight and obesity were more common among offensive and defensive linemen. Overweight and obesity were more prevalent in youth football players than in national samples of American boys. Allowing for limitations of the BMI and the relative stability of the BMI from adolescence into adulthood, a relatively large number of football participants may be at risk for later overweight or obesity, and the risk appears to be greater for offensive and defensive line positions.

Provider communication behaviors that predict motivation to change in black adolescents with obesity.

PubMed

Carcone, April Idalski; Naar-King, Sylvie; Brogan, Kathryn E; Albrecht, Terrance; Barton, Ellen; Foster, Tanina; Martin, Tim; Marshall, Sharon

2013-10-01

The goal of this research was to identify communication behaviors used by weight loss counselors that mostly strongly predicted black adolescents' motivational statements. Three types of motivational statements were of interest: change talk (CT; statements describing their own desires, abilities, reasons, and need for adhering to weight loss recommendations), commitment language (CML; statements about their intentions or plans for adhering), and counterchange talk (CCT; amotivational statements against change and commitment). Thirty-seven black adolescents with obesity received a single motivational interviewing session targeting weight-related behaviors. The video-recorded transcribed sessions were coded using the Minority Youth Sequential Coding for Observing Process Exchanges generating a sequential chain of communication. Data were then subjected to sequential analysis to determine causal relationships between counselor and adolescent communication. Asking open-ended questions to elicit adolescent CT and emphasizing adolescents' autonomy most often led to CT. Open-ended questions to elicit CML, reflecting adolescent CML, and emphasizing autonomy most often led to CML. In contrast, open-ended questions to elicit CCT, reflecting CCT, reflecting ambivalence, and neutral open-ended questions about the target behavior led to CCT. This study provides clinicians with insight into the most effective way to communicate with black adolescents with obesity about weight loss. Specifically, reflective statements and open questions focusing on their own desires, abilities, reasons, need, and commitment to weight loss recommendations are more likely to increase motivational statements, whereas other types of reflections and questions may be counterproductive. Finally, because adolescents have a strong need for autonomous decision making, emphasizing their autonomy may be particularly effective in evoking motivational statements.

Maternal obesity influences the relationship between location of neonate fat mass and total fat mass

PubMed Central

Hull, Holly R.; Thornton, John; Paley, Charles; Navder, Khursheed; Gallagher, Dympna

2014-01-01

Background It is suggested that maternal obesity perpetuates offspring obesity to future generations. Objective To determine whether location of neonate fat mass (FM: central vs. peripheral) is related to total neonate FM and whether maternal obesity influences this relationship. Methods Neonate body composition and skinfold thicknesses were assessed in healthy neonates (n=371; 1-3 days old). Linear regression models examined the relationship between total FM and location of FM (central vs. peripheral). Location of FM was calculated by skinfolds: peripheral was the sum of (biceps and triceps)/2 and central was represented by the subscapular skinfold. Results A significant interaction was found for location of FM and maternal obesity. Holding all predictors constant, in offspring born to non-obese mothers, a 0.5 mm increase in central FM predicted a 15 g greater total FM whereas a 0.5 mm increase in peripheral FM predicted a 66 g greater total FM. However, in offspring born to obese mothers, a 0.5 mm increase in central FM predicted a 56 g total FM whereas a 0.5 mm increase in peripheral FM predicted a 14 g greater total FM. Conclusions The relationship between total FM and location of FM is influenced by maternal obesity. PMID:25088238

Genotype-phenotype associations in obesity dependent on definition of the obesity phenotype.

PubMed

Kring, Sofia Inez Iqbal; Larsen, Lesli Hingstrup; Holst, Claus; Toubro, Søren; Hansen, Torben; Astrup, Arne; Pedersen, Oluf; Sørensen, Thorkild I A

2008-01-01

In previous studies of associations of variants in the genes UCP2, UCP3, PPARG2, CART, GRL, MC4R, MKKS, SHP, GHRL, and MCHR1 with obesity, we have used a case-control approach with cases defined by a threshold for BMI. In the present study, we assess the association of seven abdominal, peripheral, and overall obesity phenotypes, which were analyzed quantitatively, and thirteen candidate gene polymorphisms in these ten genes in the same cohort. Obese Caucasian men (n = 234, BMI >or= 31.0 kg/m(2)) and a randomly sampled non-obese group (n = 323), originally identified at the draft board examinations, were re-examined at median ages of 47.0 or 49.0 years by anthropometry and DEXA scanning. Obesity phenotypes included BMI, fat body mass index, waist circumference, waist for given BMI, intra-abdominal adipose tissue, hip circumference and lower body fat mass (%). Using logistic regression models, we estimated the odds for defined genotypes (dominant or recessive genetic transmission) in relation to z-scores of the phenotypes. The minor (rare) allele for SHP 512G>C (rs6659176) was associated with increased hip circumference. The minor allele for UCP2 Ins45bp was associated with increased BMI, increased abdominal obesity, and increased hip circumference. The minor allele for UCP2 -866G>A (rs6593669) was associated with borderline increased fat body mass index. The minor allele for MCHR1 100213G>A (rs133072) was associated with reduced abdominal obesity. None of the other genotype-phenotype combinations showed appreciable associations. If replicated in independent studies with focus on the specific phenotypes, our explorative studies suggest significant associations between some candidate gene polymorphisms and distinct obesity phenotypes, predicting beneficial and detrimental effects, depending on compartments for body fat accumulation. Copyright 2008 S. Karger AG, Basel.

Predicting Physical Activity-Related Outcomes in Overweight and Obese Adults: A Health Action Process Approach.

PubMed

Hattar, Anne; Pal, Sebely; Hagger, Martin S

2016-03-01

We tested the adequacy of a model based on the Health Action Process Approach (HAPA) in predicting changes in psychological, body composition, and cardiovascular risk outcomes with respect to physical activity participation in overweight and obese adults. Measures of HAPA constructs (action and maintenance self-efficacy, outcome expectancies, action planning, risk perceptions, intentions, behaviour), psychological outcomes (quality of life, depression, anxiety, stress symptoms), body composition variables (body weight, body fat mass), cardiovascular risk measures (total cholesterol, low density lipoprotein), and self-reported physical activity behaviour were administered to participants (N = 74) at baseline, and 6 and 12 weeks later. Data were analysed using variance-based structural equation modelling with residualised change scores for HAPA variables. The model revealed effects of action self-efficacy and outcome expectancies on physical activity intentions, action self-efficacy on maintenance self-efficacy, and maintenance self-efficacy and intentions on action planning. Intention predicted psychological and body composition outcomes indirectly through physical activity behaviour. Action planning was a direct predictor of psychological, cardiovascular, and body composition outcomes. Data supported HAPA hypotheses in relation to intentions and behaviour, but not the role of action planning as a mediator of the intention-behaviour relationship. Action planning predicted outcomes independent of intentions and behaviour. © 2016 The International Association of Applied Psychology.

Innate biology versus lifestyle behaviour in the aetiology of obesity and type 2 diabetes: the GLACIER Study.

PubMed

Poveda, Alaitz; Koivula, Robert W; Ahmad, Shafqat; Barroso, Inês; Hallmans, Göran; Johansson, Ingegerd; Renström, Frida; Franks, Paul W

2016-03-01

We compared the ability of genetic (established type 2 diabetes, fasting glucose, 2 h glucose and obesity variants) and modifiable lifestyle (diet, physical activity, smoking, alcohol and education) risk factors to predict incident type 2 diabetes and obesity in a population-based prospective cohort of 3,444 Swedish adults studied sequentially at baseline and 10 years later. Multivariable logistic regression analyses were used to assess the predictive ability of genetic and lifestyle risk factors on incident obesity and type 2 diabetes by calculating the AUC. The predictive accuracy of lifestyle risk factors was similar to that yielded by genetic information for incident type 2 diabetes (AUC 75% and 74%, respectively) and obesity (AUC 68% and 73%, respectively) in models adjusted for age, age(2) and sex. The addition of genetic information to the lifestyle model significantly improved the prediction of type 2 diabetes (AUC 80%; p = 0.0003) and obesity (AUC 79%; p < 0.0001) and resulted in a net reclassification improvement of 58% for type 2 diabetes and 64% for obesity. These findings illustrate that lifestyle and genetic information separately provide a similarly high degree of long-range predictive accuracy for obesity and type 2 diabetes.

Delayed clearance of triglyceride‐rich lipoproteins in young, healthy obese subjects†

PubMed Central

Goll, R.; Lekahl, S.; Moen, O. S.; Florholmen, J.

2015-01-01

Summary Obesity is associated with the metabolic syndrome. The aims were, first, to study the postprandial triglyceride clearance in young, healthy obese subjects and, second, to investigate if fasting triglycerides can predict delayed postprandial triglyceride clearance. Eighteen apparently healthy, obese subjects with no clinical signs of metabolic disturbances participated. Controls were age‐ and sex‐matched, healthy, normal weight subjects. Subclinical markers of metabolic disturbances were assessed by measuring postprandial triglycerides in serum and in chylomicrons by oral fat tolerance test. Postprandial triglyceride clearance for 8 h was assessed indirectly as removal of the lipid from serum during the oral fat tolerance test. Insulin resistance was measured by the homeostasis model assessment of insulin resistance (HOMA‐IR). Twelve (66%) of the apparently healthy obese individuals had insulin resistance measured by HOMA‐IR. There was a delayed clearance of serum triglycerides and chylomicron triglycerides at 6 h when compared with the control group, while, at 8 h, the differences were only detected for the chylomicron triglyceride clearance. Triglyceride response was significantly greater in the obese subjects. Fasting triglycerides in upper normal level predicted a delayed postprandial triglyceride clearance and insulin resistance. In young, apparently healthy obese subjects early metabolic disturbances including insulin resistance and delayed postprandial triglyceride clearance can be detected. Fasting serum triglyceride in upper normal level predicted delayed postprandial triglyceride clearance and insulin resistance. PMID:26469529

The effect of obesity on the rate of heparin-induced thrombocytopenia.

PubMed

Marler, Jacob L; Jones, G Morgan; Wheeler, Brian J; Alshaya, Abdulrahman; Hartmann, Jonathan L; Oliphant, Carrie S

2018-06-01

: Heparin-induced thrombocytopenia (HIT) occurs in patients receiving heparin-containing products due to the formation of platelet-activating antibodies to heparin and platelet factor 4. Diagnosis includes utilization of a scoring system known as the 4-T score, and HIT laboratory assays. Recently, obesity was identified as a potential factor associated with the development of HIT. The objective of this study was to evaluate the association of HIT with obesity in ICU and general medicine patients. We performed a chart review of adult patients within the Methodist Healthcare System, and included patients who had an ELISA and serotonin release assay laboratory tests reported within same hospital admission in which they also had documented receipt of heparin. Obese patients were compared with nonobese patients (BMI < 30) for the primary outcome of HIT occurrence, and secondary outcomes including rate of thrombosis, 4-T scores, and ELISA optical density values. We also generated a 5-T score by including one additional point for those with a BMI of 30 or more to determine the predictive value of this score in identifying HIT. Obesity was confirmed to be a risk factor for HIT, and the 5-T score model was also predictive of the development of HIT. However, the 5-T score was not statistically more predictive of HIT than the 4-T score. Predicting HIT remains challenging and novel markers of HIT are needed to improve HIT recognition. Although obesity did not improve the 4-T score, it may improve the predictability of other scoring systems, and further investigation is warranted.

Estimation of Newborn Risk for Child or Adolescent Obesity: Lessons from Longitudinal Birth Cohorts

PubMed Central

Morandi, Anita; Meyre, David; Lobbens, Stéphane; Kleinman, Ken; Kaakinen, Marika; Rifas-Shiman, Sheryl L.; Vatin, Vincent; Gaget, Stefan; Pouta, Anneli; Hartikainen, Anna-Liisa; Laitinen, Jaana; Ruokonen, Aimo; Das, Shikta; Khan, Anokhi Ali; Elliott, Paul; Maffeis, Claudio; Gillman, Matthew W.

2012-01-01

Objectives Prevention of obesity should start as early as possible after birth. We aimed to build clinically useful equations estimating the risk of later obesity in newborns, as a first step towards focused early prevention against the global obesity epidemic. Methods We analyzed the lifetime Northern Finland Birth Cohort 1986 (NFBC1986) (N = 4,032) to draw predictive equations for childhood and adolescent obesity from traditional risk factors (parental BMI, birth weight, maternal gestational weight gain, behaviour and social indicators), and a genetic score built from 39 BMI/obesity-associated polymorphisms. We performed validation analyses in a retrospective cohort of 1,503 Italian children and in a prospective cohort of 1,032 U.S. children. Results In the NFBC1986, the cumulative accuracy of traditional risk factors predicting childhood obesity, adolescent obesity, and childhood obesity persistent into adolescence was good: AUROC = 0·78[0·74–0.82], 0·75[0·71–0·79] and 0·85[0·80–0·90] respectively (all p<0·001). Adding the genetic score produced discrimination improvements ≤1%. The NFBC1986 equation for childhood obesity remained acceptably accurate when applied to the Italian and the U.S. cohort (AUROC = 0·70[0·63–0·77] and 0·73[0·67–0·80] respectively) and the two additional equations for childhood obesity newly drawn from the Italian and the U.S. datasets showed good accuracy in respective cohorts (AUROC = 0·74[0·69–0·79] and 0·79[0·73–0·84]) (all p<0·001). The three equations for childhood obesity were converted into simple Excel risk calculators for potential clinical use. Conclusion This study provides the first example of handy tools for predicting childhood obesity in newborns by means of easily recorded information, while it shows that currently known genetic variants have very little usefulness for such prediction. PMID:23209618

Computer modeling of obesity links theoretical energetic measures with experimental measures of fuel use for lean and obese men.

PubMed

Rossow, Heidi A; Calvert, C Chris

2014-10-01

The goal of this research was to use a computational model of human metabolism to predict energy metabolism for lean and obese men. The model is composed of 6 state variables representing amino acids, muscle protein, visceral protein, glucose, triglycerides, and fatty acids (FAs). Differential equations represent carbohydrate, amino acid, and FA uptake and output by tissues based on ATP creation and use for both lean and obese men. Model parameterization is based on data from previous studies. Results from sensitivity analyses indicate that model predictions of resting energy expenditure (REE) and respiratory quotient (RQ) are dependent on FA and glucose oxidation rates with the highest sensitivity coefficients (0.6, 0.8 and 0.43, 0.15, respectively, for lean and obese models). Metabolizable energy (ME) is influenced by ingested energy intake with a sensitivity coefficient of 0.98, and a phosphate-to-oxygen ratio by FA oxidation rate and amino acid oxidation rate (0.32, 0.24 and 0.55, 0.65 for lean and obese models, respectively). Simulations of previously published studies showed that the model is able to predict ME ranging from 6.6 to 9.3 with 0% differences between published and model values, and RQ ranging from 0.79 to 0.86 with 1% differences between published and model values. REEs >7 MJ/d are predicted with 6% differences between published and model values. Glucose oxidation increases by ∼0.59 mol/d, RQ increases by 0.03, REE increases by 2 MJ/d, and heat production increases by 1.8 MJ/d in the obese model compared with lean model simulations. Increased FA oxidation results in higher changes in RQ and lower relative changes in REE. These results suggest that because fat mass is directly related to REE and rate of FA oxidation, body fat content could be used as a predictor of RQ. © 2014 American Society for Nutrition.

Epigenetics of obesity: beyond the genome sequence.

PubMed

Cordero, Paul; Li, Jiawei; Oben, Jude A

2015-07-01

After the study of the gene code as a trigger for obesity, epigenetic code has appeared as a novel tool in the diagnosis, prognosis and treatment of obesity, and its related comorbidities. This review summarizes the status of the epigenetic field associated with obesity, and the current epigenetic-based approaches for obesity treatment. Thanks to technical advances, novel and key obesity-associated polymorphisms have been described by genome-wide association studies, but there are limitations with their predictive power. Epigenetics is also studied for disease association, which involves decoding of the genome information, transcriptional status and later phenotypes. Obesity could be induced during adult life by feeding and other environmental factors, and there is a strong association between obesity features and specific epigenetic patterns. These patterns could be established during early life stages, and programme the risk of obesity and its comorbidities during adult life. Furthermore, recent studies have shown that DNA methylation profile could be applied as biomarkers of diet-induced weight loss treatment. High-throughput technologies, recently implemented for commercial genetic test panels, could soon lead to the creation of epigenetic test panels for obesity. Nonetheless, epigenetics is a modifiable risk factor, and different dietary patterns or environmental insights during distinct stages of life could lead to rewriting of the epigenetic profile.

Development of a claims-based risk score to identify obese individuals.

PubMed

Clark, Jeanne M; Chang, Hsien-Yen; Bolen, Shari D; Shore, Andrew D; Goodwin, Suzanne M; Weiner, Jonathan P

2010-08-01

Obesity is underdiagnosed, hampering system-based health promotion and research. Our objective was to develop and validate a claims-based risk model to identify obese persons using medical diagnosis and prescription records. We conducted a cross-sectional analysis of de-identified claims data from enrollees of 3 Blue Cross Blue Shield plans who completed a health risk assessment capturing height and weight. The final sample of 71,057 enrollees was randomly split into 2 subsamples for development and validation of the obesity risk model. Using the Johns Hopkins Adjusted Clinical Groups case-mix/predictive risk methodology, we categorized study members' diagnosis (ICD) codes. Logistic regression was used to determine which claims-based risk markers were associated with a body mass index (BMI) > or = 35 kg/m(2). The sensitivities of the scores > or =90(th) percentile to detect obesity were 26% to 33%, while the specificities were >90%. The areas under the receiver operator curve ranged from 0.67 to 0.73. In contrast, a diagnosis of obesity or an obesity medication alone had very poor sensitivity (10% and 1%, respectively); the obesity risk model identified an additional 22% of obese members. Varying the percentile cut-point from the 70(th) to the 99(th) percentile resulted in positive predictive values ranging from 15.5 to 59.2. An obesity risk score was highly specific for detecting a BMI > or = 35 kg/m(2) and substantially increased the detection of obese members beyond a provider-coded obesity diagnosis or medication claim. This model could be used for obesity care management and health promotion or for obesity-related research.

Predictive Factors of Obesity and their Relationships to Dietary Intake in Schoolchildren in Western Algeria

PubMed Central

Saker, Meriem; Merzouk, Hafida; Merzouk, Sid A; Ahmed, Samira Baba; Narce, Michel

2011-01-01

ABSTRACT Background: Obesity has reached epidemic proportions world-wide. Its risk factors are poorly studied, especially among children in developing countries such as Algeria. Objectives: The purpose of this study was therefore to determine the prevalence and risk factors of obesity in Algerian schoolchildren 6 to 8 years aged by conducting a school-site retrospective cohort study in Tlemcen Department (western Algeria). Material and Mthods: From 2008 to 2010, socio-demographic characteristics, body mass index (BMI), physical activity categories, lifestyle and nutritional habits of 1520 children (839 boys and 681 girls), at entrance into primary school, were recorded using a self-administered questionnaire. Results: Among the 1520 participants, 99 (6.5%) were obese. Birthweight ≤ 2.5 kg and ≥ 4 kg, early introduction of solid foods and low physical activity were significantly associated with obesity (p<0.001). Additionally, mother's and grandmother's BMI ≥30 kg/m2, fewer children in the household, higher parental education, household income and the presence of familial obesity may predispose significantly to childhood obesity (p<0.001). Furthermore, child's BMI was significant positively correlated with total energy, fat and saturated fatty acid (SFA) intakes (p<0.01). Mother's and grandmother's BMI were significant positively correlated with child total energy, fat and SFA intakes. Physical activity score was significant negatively correlated with child total energy, fat and SFA (p<0.01) intakes in obese children. Conclusions: Mother's and grandmother's obesity, excess energy and fat intakes and low physical activity are the strong predictors of childhood obesity in Algeria. Preventive measures should focus on the promotion of physical activity and maternal and children nutritional education. PMID:22205890

Prolonged financial stress predicts subsequent obesity: results from a prospective study of an Australian national sample.

PubMed

Siahpush, Mohammad; Huang, Terry T-K; Sikora, Asia; Tibbits, Melissa; Shaikh, Raees A; Singh, Gopal K

2014-02-01

The aim of this research was to assess the association of prolonged financial stress (FS) with subsequent obesity. Data were from Waves 8 (2008), 9 (2009), and 10 (2010) of Household Income and Labor Dynamics in Australia (HILDA) survey. The outcome was obesity measured in 2010. Prolonged FS was defined as having experienced FS in both 2008 and 2009. FS was measured in each year using seven questionnaire items. Analyses adjusted for health, physical activity, income, education, baseline obesity, and other covariates. Prolonged FS was a strong predictor of subsequent obesity. The adjusted risk of being obese in 2010 were 20% higher (RR: 1.20; 95% CI: 1.10-1.30) among individuals who experienced FS in both 2008 and 2009 than those who did not experience FS in either year. The association of FS with obesity was independent of income and constant across income categories. Obesity prevention research should pay more attention to FS as an important dimension of economic deprivation, a concept that is distinct from common indicators of socioeconomic status such as income. Future research can examine the effect of financial education and counseling programs that help individuals with such skills as money management, budgeting, and saving on a reduction in FS and obesity. Copyright © 2013 The Obesity Society.

Identifying risk profiles for childhood obesity using recursive partitioning based on individual, familial, and neighborhood environment factors.

PubMed

Van Hulst, Andraea; Roy-Gagnon, Marie-Hélène; Gauvin, Lise; Kestens, Yan; Henderson, Mélanie; Barnett, Tracie A

2015-02-15

Few studies consider how risk factors within multiple levels of influence operate synergistically to determine childhood obesity. We used recursive partitioning analysis to identify unique combinations of individual, familial, and neighborhood factors that best predict obesity in children, and tested whether these predict 2-year changes in body mass index (BMI). Data were collected in 2005-2008 and in 2008-2011 for 512 Quebec youth (8-10 years at baseline) with a history of parental obesity (QUALITY study). CDC age- and sex-specific BMI percentiles were computed and children were considered obese if their BMI was ≥95th percentile. Individual (physical activity and sugar-sweetened beverage intake), familial (household socioeconomic status and measures of parental obesity including both BMI and waist circumference), and neighborhood (disadvantage, prestige, and presence of parks, convenience stores, and fast food restaurants) factors were examined. Recursive partitioning, a method that generates a classification tree predicting obesity based on combined exposure to a series of variables, was used. Associations between resulting varying risk group membership and BMI percentile at baseline and 2-year follow up were examined using linear regression. Recursive partitioning yielded 7 subgroups with a prevalence of obesity equal to 8%, 11%, 26%, 28%, 41%, 60%, and 63%, respectively. The 2 highest risk subgroups comprised i) children not meeting physical activity guidelines, with at least one BMI-defined obese parent and 2 abdominally obese parents, living in disadvantaged neighborhoods without parks and, ii) children with these characteristics, except with access to ≥1 park and with access to ≥1 convenience store. Group membership was strongly associated with BMI at baseline, but did not systematically predict change in BMI. Findings support the notion that obesity is predicted by multiple factors in different settings and provide some indications of potentially

Assessment of perioperative minute ventilation in obese versus non-obese patients with a non-invasive respiratory volume monitor.

PubMed

Mehta, Jaideep H; Cattano, Davide; Brayanov, Jordan B; George, Edward E

2017-04-26

Monitoring the adequacy of spontaneous breathing is a major patient safety concern in the post-operative setting. Monitoring is particularly important for obese patients, who are at a higher risk for post-surgical respiratory complications and often have increased metabolic demand due to excess weight. Here we used a novel, noninvasive Respiratory Volume Monitor (RVM) to monitor ventilation in both obese and non-obese orthopedic patients throughout their perioperative course, in order to develop better monitoring strategies. We collected respiratory data from 62 orthopedic patients undergoing elective joint replacement surgery under general anesthesia using a bio-impedance based RVM with an electrode PadSet placed on the thorax. Patients were stratified into obese (BMI ≥ 30) and non-obese cohorts and minute ventilation (MV) at various perioperative time points was compared against each patient's predicted minute ventilation (MV PRED ) based on ideal body weight (IBW) and body surface area (BSA). The distributions of MV measurements were also compared across obese and non-obese cohorts. Obese patients had higher MV than the non-obese patients before, during, and after surgery. Measured MV of obese patients was significantly higher than their MV PRED from IBW formulas, with BSA-based MV PRED being a closer estimate. Obese patients also had greater variability in MV post-operatively when treated with standard opioid dosing. Our study demonstrated that obese patients have greater variability in ventilation post-operatively when treated with standard opioid doses, and despite overall higher ventilation, many of them are still at risk for hypoventilation. BSA-based MV PRED formulas may be more appropriate than IBW-based ones when estimating the respiratory demand of obese patients. The RVM allows for the continuous and non-invasive assessment of respiratory function in both obese and non-obese patients.

Association between different combination of measures for obesity and new-onset gallstone disease.

PubMed

Liu, Tong; Wang, Wanchao; Ji, Yannan; Wang, Yiming; Liu, Xining; Cao, Liying; Liu, Siqing

2018-01-01

Body mass index(BMI) is a calculation index of general obesity. Waist circumference(WC) is a measure of body-fat distribution and always used to estimate abdominal obesity. An important trait of general obesity and abdominal obesity is their propensity to coexist. Using one single measure of obesity could not estimate persons at risk for GSD precisely. This study aimed to compare the predictive values of various combination of measures for obesity(BMI, WC, waist to hip ratio) for new-onset GSD. We prospectively studied the predictive values of various combination of measures for obesity for new-onset GSD in a cohort of 88,947 participants who were free of prior gallstone disease, demographic characteristics and biochemical parameters were recorded. 4,329 participants were identified to have GSD among 88,947 participants during 713 345 person-years of follow-up. Higher BMI, WC and waist to hip ratio (WHtR) were significantly associated with higher risks of GSD in both genders even after adjustment for potential confounders. In males, the hazard ratio for the highest versus lowest BMI, WC, WHtR were 1.63(1.47~1.79), 1.53(1.40~1.68), 1.44(1.31~1.58), respectively. In females, the hazard ratio for the highest versus lowest BMI, WC, WHtR were 2.11(1.79~2.49), 1.85(1.55~2.22), 1.84(1.55~2.19), respectively. In male group, the combination of BMI+WC improved the predictive ability of the model more clearly than other combinations after adding them to the multivariate model in turn, while for females the best predictive combination was BMI+WHtR. Elevated BMI, WC and WHtR were independent risk factors for new-onset GSD in both sex groups after additional adjustment was made for potential confounders. In males, the combination of BMI+WC seemed to be the most predictable model to evaluate the effect of obesity on new-onset GSD, while the best combination in females was BMI+WHtR.