Residential greenness and adiposity: Findings from the UK Biobank.

BACKGROUND

With the rapid urbanization and prevailing obesity pandemic, the role of residential green exposures in obesity prevention has gained renewed focus. The study investigated the effects of residential green exposures on adiposity using a large and diverse population sample drawn from the UK Biobank.

MATERIALS AND METHODS

This was a population based cross-sectional study of 333,183 participants aged 38-73years with individual-level data on residential greenness and built environment exposures. Residential greenness was assessed through 0.50-metre resolution normalized difference vegetation index (NDVI) derived from spectral reflectance measurements in remotely sensed colour infrared data and measured around geocoded participants' dwelling. A series of continuous and binary outcome models examined the associations between residential greenness and markers of adiposity, expressed as body-mass index (BMI) in kg/m, waist circumference (WC) in cm, whole body fat (WBF) in kg and obesity (BMI≥30kg/m) after adjusting for other activity-influencing built environment and individual-level confounders. Sensitivity analyses involved studying effect modification by gender, age, urbanicity and SES as well as examining relationships between residential greenness and active travel behaviour.

RESULTS

Residential greenness was independently and consistently associated with lower adiposity, the association being robust to adjustments. An interquartile increment in NDVI greenness was associated with lower BMI (β=-0.123kg/m, 95% CI: -0.14, -0.10kg/m), WC (β=-0.551cm, 95% CI: -0.61, -0.50cm), and WBF (β=-0.138kg, 95% CI: -0.18, -0.10kg) as well as a reduced relative risk of obesity (RR=0.968, 95% CI: 0.96, 0.98). Residential greenness was beneficially related with active travel, being associated with higher odds of using active mode for non-work travel (OR=1.093, 95% CI: 1.08, 1.11) as well as doing >30min walking (OR=1.039, 95% CI: 1.03, 1.05).

CONCLUSION

Residing in greener areas was associated with healthy weight outcomes possibly through a physical activity-related mechanism. Green allocation and design may act as upstream-level public health interventions ameliorating the negative health externalities of obesogenic urban environments. Further prospective studies are needed to identify potential causal pathways and thereby effectively guide such interventions.