Centre for Physical Activity & Nutrition Research, School of Exercise & Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood VIC 3125, Australia.
Int J Behav Nutr Phys Act. 2010 Feb 19;7:18. doi: 10.1186/1479-5868-7-18.
Although neighbourhood environments are often blamed for contributing to rising levels of obesity, current evidence is based predominantly on cross-sectional samples. This study examined associations between objectively-measured environmental characteristics of neighbourhoods and adiposity cross-sectionally and longitudinally over three years in children and their female carers.
Longitudinal study of 140 5-6 year-old and 269 10-12 year-old children and their female carers (n = 369). At baseline (2001) and follow-up (2004), height and weight were measured among children and self-reported among female carers, and were used to compute BMI z-scores and BMI, respectively. A Geographic Information System determined access to destinations (public open spaces, sports options, walking/cycling tracks), road connectivity (density of cul-de-sacs and intersections, proportion of 4-way intersections, length of 'access' paths (overpasses, access lanes, throughways between buildings)) and traffic exposure (length of 'busy' and 'local' roads) within 800 m and 2 km of home. Univariate and multivariable linear regression analyses examined associations between environmental characteristics and BMI/BMI z-scores at baseline and change in BMI/BMI z-scores over the three years.
Cross-sectionally, BMI z-score was inversely associated with length (km) of access paths within 800 m (b = -0.50) and 2 km (b = -0.16) among younger and number of sport/recreation public open spaces (b = -0.14) and length (km) of 'access' paths (b = -0.94) within 800 m and length of local roads within 2 km (b = -0.01) among older children. Among female carers, BMI was associated with length (km) of walking/cycling tracks (b = 0.17) and busy roads (b = -0.34) within 800 m. Longitudinally, the proportion of intersections that were 4-way (b = -0.01) within 800 m of home was negatively associated with change in BMI z-score among younger children, while length (km) of access paths (b = 0.18) within 800 m was significant among older children. Among female carers, options for aerobics/fitness and swimming within 2 km were associated with change in BMI (B = -0.42).
A small number of neighbourhood environment features were associated with adiposity outcomes. These differed by age group and neighbourhood scale (800 m and 2 km) and were inconsistent between cross-sectional and longitudinal findings. However, the results suggest that improvements to road connectivity and slowing traffic and provision of facilities for leisure activities popular among women may support obesity prevention efforts.
尽管人们经常指责邻里环境导致肥胖率上升，但目前的证据主要基于横断面样本。本研究在三年时间里，从横断面和纵向两个角度，观察了儿童及其女性照护者的邻里环境特征与肥胖的相关性。
对 140 名 5-6 岁儿童和 269 名 10-12 岁儿童及其女性照护者（n=369）进行了纵向研究。在基线（2001 年）和随访（2004 年）时，测量了儿童的身高和体重，并由女性照护者自我报告，用于计算 BMI 得分和 BMI。地理信息系统确定了 800 米和 2 公里范围内家庭周围可达目的地（公共开放空间、体育设施、步行/自行车道）、道路连通性（死胡同和交叉口的密度、四向交叉口的比例、“通道”路径（天桥、通道、建筑物之间的通道）的长度）和交通暴露（繁忙道路和本地道路的长度）。单变量和多变量线性回归分析检验了环境特征与基线时 BMI/BMI 得分的相关性，以及三年内 BMI/BMI 得分的变化。
横断面研究发现，年幼儿童的 BMI 得分与 800 米（b=-0.50）和 2 公里（b=-0.16）范围内的通道长度呈负相关，与体育/娱乐公共开放空间的数量（b=-0.14）和 800 米范围内的“通道”长度（b=-0.94）以及 2 公里范围内的本地道路长度呈负相关。年长儿童的 BMI 与 800 米范围内的步行/自行车道长度（b=0.17）和繁忙道路长度（b=-0.34）呈负相关。纵向研究发现，800 米范围内的四向交叉口比例（b=-0.01）与年幼儿童的 BMI 得分变化呈负相关，而 800 米范围内的通道长度（b=0.18）与年长儿童的 BMI 得分变化呈正相关。女性照护者的 BMI 与 2 公里范围内的有氧运动/健身和游泳选项呈负相关（B=-0.42）。
少数邻里环境特征与肥胖结果有关。这些特征因年龄组和邻里规模（800 米和 2 公里）而异，且横断面和纵向研究结果不一致。然而，这些结果表明，改善道路连通性、减缓交通速度和提供受女性欢迎的休闲活动设施可能有助于预防肥胖。
