Thielman Justin, Manson Heather, Chiu Maria, Copes Ray, Rosella Laura C
Public Health Ontario (Thielman, Manson, Copes, Rosella); Dalla Lana School of Public Health (Manson, Chiu, Copes, Rosella), University of Toronto; Institute for Clinical Evaluative Sciences, (Chiu) Toronto, Ont.
CMAJ Open. 2016 Dec 1;4(4):E720-E728. doi: 10.9778/cmajo.20160068. eCollection 2016 Oct-Dec.
Research has shown that neighbourhood walkability is associated with small differences in physical activity; however, the health impacts of these small differences have been questioned. We examined the size of the association of walkability with accelerometer-measured physical activity in a large, national-level Canadian population, and compared results to physical activity levels recommended in international guidelines. Our primary objective was to investigate the direction and size of the differences in physical activity that were related to walkability, and whether these differences depended on age.
Participants were included from among respondents to the 2007-2011 Canadian Health Measures Surveys who lived in urban areas and were aged 6-79 years. The Canadian Health Measures Surveys are ongoing cross-sectional surveys of a Canada-wide population. Respondents were divided into quintiles based on Street Smart Walk Score® values of their census dissemination areas. For all respondents and age subgroups, we used covariate-adjusted generalized linear models to estimate differences between quintiles in accelerometer-measured moderate-to-vigorous physical activity (MVPA) and sedentary time.
We included 7180 respondents. Differences in participant MVPA between highest and lowest Street Smart Walk Score quintiles were 3.2 (95% confidence interval [CI] -3.2 to 9.6) minutes/day for ages 6-11 years, 11.4 (95% CI 5.3 to 17.4) minutes/day for ages 12-17 years, 9.9 (95% CI 2.4 to 17.4) minutes/day for ages 18-29 years, 14.9 (95% CI 10.2 to 19.6) minutes/day for ages 30-44 years, 11.5 (95% CI 6.7 to 16.3) minutes/day for ages 45-64 years and 6.9 (95% CI 3.1 to 10.8) minutes/day for ages 65-79 years. There were no significant differences in sedentary time in any age group.
In all groups except the youngest, participants in the most walkable areas did significantly more MVPA than those in the least walkable areas. For several age groups, this difference was approximately one-half to two-thirds of the amount recommended in guidelines for physical activity. Substantially higher MVPA levels suggest that residents of highly walkable areas may have greater health benefits.
研究表明，邻里的步行便利性与身体活动的微小差异相关；然而，这些微小差异对健康的影响受到了质疑。我们在一个大规模的国家级加拿大人群中，研究了步行便利性与通过加速度计测量的身体活动之间关联的大小，并将结果与国际指南中推荐的身体活动水平进行比较。我们的主要目标是调查与步行便利性相关的身体活动差异的方向和大小，以及这些差异是否取决于年龄。
参与者来自2007 - 2011年加拿大健康测量调查的受访者，他们居住在城市地区，年龄在6 - 79岁之间。加拿大健康测量调查是对全加拿大人口进行的持续横断面调查。受访者根据其人口普查传播区域的街道智能步行得分值被分为五个五分位数组。对于所有受访者和年龄亚组，我们使用协变量调整后的广义线性模型来估计加速度计测量的中度至剧烈身体活动（MVPA）和久坐时间在五分位数组之间的差异。
我们纳入了7180名受访者。在6 - 11岁年龄组中，街道智能步行得分最高和最低五分位数组的参与者MVPA差异为每天3.2（95%置信区间[CI] - 3.2至9.6）分钟；12 - 17岁年龄组为每天11.4（95% CI 5.3至17.4）分钟；18 - 29岁年龄组为每天9.9（95% CI 2.4至17.4）分钟；30 - 44岁年龄组为每天14.9（95% CI 10.2至19.6）分钟；45 - 64岁年龄组为每天11.5（95% CI 6.7至16.3）分钟；65 - 79岁年龄组为每天6.9（95% CI 3.1至10.8）分钟。在任何年龄组中，久坐时间均无显著差异。
在除最年轻组之外的所有组中，步行便利性最高区域的参与者进行的MVPA显著多于步行便利性最低区域的参与者。对于几个年龄组，这种差异约为身体活动指南推荐量的二分之一至三分之二。显著更高的MVPA水平表明，步行便利性高的地区的居民可能有更大的健康益处。
