Sanders T, Feng X, Fahey P P, Lonsdale C, Astell-Burt T
School of Science and Health, University of Western Sydney, Penrith, NSW, Australia.
1] School of Science and Health, University of Western Sydney, Penrith, NSW, Australia [2] School of Health and Society, University of Wollongong, Wollongong, NSW, Australia [3] Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia [4] Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, NSW, Australia.
Int J Obes (Lond). 2015 Aug;39(8):1224-9. doi: 10.1038/ijo.2015.69. Epub 2015 Apr 28.
There is a growing belief that green space (for example, parks) help prevent obesity. There is evidence of an inverse association between green space and childhood body mass index (BMI); however, the majority of these studies are cross-sectional. Longitudinal studies that track change in BMI across childhood in relation to levels of green space proximity would improve the quality of evidence available for decision making.
Objectively measured BMI was obtained every 2 years between 2006 and 2012 for 4423 participants initially aged 6-7 years in the Longitudinal Study of Australian Children (LSAC). The LSAC is a nationally representative study on a range of health and socio-demographic measures. Using Australian Bureau of Statistics mesh block data, which classify small scale land areas based on the main usage, each participant was assigned an objective measure of green space availability within their Statistical Area (level 2) of residence. Gender-stratified multilevel linear regression was used to estimate BMI growth curves across childhood in relation to green space availability. Family income, Australian Indigenous status, mothers' education and language spoken were used to adjust for socio-economic confounding.
Age was found to be an effect modifier of associations between green space and BMI for boys (P=0.005) and girls (P=0.048). As children grew older, an inverse patterning of BMI by green space availability emerged. These findings held after adjustment for socio-economic circumstances for boys (P=0.009), though were less robust for girls after this adjustment (P=0.056).
A beneficial effect of green space on BMI emerges as children grow older. However, there was little additional benefit after a modest amount of green space was met. Further research is needed to understand whether the drivers of this effect are from age-specific mechanisms, or whether the benefit of living in a greener neighbourhood is accumulated through childhood.
人们越来越相信绿色空间(如公园)有助于预防肥胖。有证据表明绿色空间与儿童体重指数(BMI)之间存在负相关;然而,这些研究大多是横断面研究。追踪儿童期BMI变化与绿色空间接近程度之间关系的纵向研究将提高可供决策的证据质量。
在澳大利亚儿童纵向研究(LSAC)中,对4423名最初年龄在6至7岁的参与者在2006年至2012年期间每两年进行一次客观测量的BMI。LSAC是一项关于一系列健康和社会人口统计学指标的全国代表性研究。利用澳大利亚统计局的网格街区数据,该数据根据主要用途对小规模土地面积进行分类,为每位参与者在其居住的统计区域(2级)内分配了绿色空间可用性的客观测量值。采用性别分层的多水平线性回归来估计儿童期BMI增长曲线与绿色空间可用性之间的关系。家庭收入、澳大利亚原住民身份、母亲的教育程度和所讲语言用于调整社会经济混杂因素。
发现年龄是男孩(P = 0.005)和女孩(P = 0.048)绿色空间与BMI之间关联的效应修饰因素。随着儿童年龄的增长,出现了BMI随绿色空间可用性呈反向模式的情况。在对男孩的社会经济情况进行调整后,这些发现仍然成立(P = 0.009),尽管在这种调整后女孩的情况不太稳健(P = 0.056)。
随着儿童年龄的增长,绿色空间对BMI产生有益影响。然而,在满足少量绿色空间后,几乎没有额外的益处。需要进一步研究以了解这种影响的驱动因素是来自特定年龄的机制,还是生活在更绿色社区的益处是在儿童期积累的。