Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
Department of Medical Statistics and Centre for Global Non-Communicable Diseases, London School of Hygiene & Tropical Medicine, London, UK.
Lancet Public Health. 2018 Jan;3(1):e24-e33. doi: 10.1016/S2468-2667(17)30212-8. Epub 2017 Dec 13.
The built environment might be associated with development of obesity and related disorders. We examined whether neighbourhood exposure to fast-food outlets and physical activity facilities were associated with adiposity in UK adults.
We used cross-sectional observational data from UK Biobank. Participants were aged 40-70 years and attended 21 assessment centres between 2006 and 2010. Using linked data on environments around each participant's residential address, we examined whether density of physical activity facilities and proximity to fast-food outlets were associated with waist circumference, body-mass index (BMI), and body fat percentage. We used multilevel linear regression models adjusted for potential confounders, and conducted several sensitivity analyses.
Complete case sample sizes were 401 917 (waist circumference models), 401 435 (BMI), and 395 640 (body fat percentage). Greater density of physical activity facilities within 1000 m of home was independently associated with smaller waist circumference and lower BMI and body fat percentage. Compared with people with no nearby facilities, those with at least six facilities close to home had 1·22 cm smaller waist circumference (95% CI -1·64 to -0·80), 0·57 kg/m lower BMI (-0·74 to -0·39), and 0·81 percentage points lower body fat (-1·03 to -0·59). Living further from a fast-food outlet was weakly associated with waist circumference and BMI, mostly among women. Compared with people living fewer than 500 m from a fast-food outlet, those living at least 2000 m away had 0·26 cm smaller waist circumference (-0·52 to 0·01).
This study shows strong associations between high densities of physical activity facilities and lower adiposity for adults in mid-life. We observed weaker associations for access to fast food, but these are likely to be underestimated owing to limitations of the food environment measure. Policy makers should consider interventions aimed at tackling the obesogenic built environment.
Commonwealth Scholarship Commission, Wellcome Trust Institutional Strategic Support Fund.
建筑环境可能与肥胖和相关疾病的发展有关。我们研究了英**成年人居住环境中快餐店和体育设施的暴露程度是否与肥胖有关。
我们使用了来自英国生物库的横断面观察性数据。参与者年龄在 40-70 岁之间，于 2006 年至 2010 年期间在 21 个评估中心参加了研究。我们利用与每个参与者居住地址周围环境相关的链接数据，研究了体育设施的密度和距离快餐店的远近与腰围、体重指数（BMI）和体脂百分比的关系。我们使用调整了潜在混杂因素的多层次线性回归模型，并进行了几项敏感性分析。
完整的病例样本量分别为 401917 例（腰围模型）、401435 例（BMI）和 395640 例（体脂百分比）。家庭周围 1000 米范围内体育设施密度较高与腰围较小、BMI 和体脂百分比较低有关。与附近没有设施的人相比，家中至少有 6 个设施的人腰围小 1.22 厘米（95%CI-1.64 至-0.80），BMI 低 0.57kg/m（-0.74 至-0.39），体脂低 0.81 个百分点（-1.03 至-0.59）。距离快餐店越远与腰围和 BMI 呈弱相关，主要见于女性。与距离快餐店少于 500 米的人相比，距离至少 2000 米的人腰围小 0.26 厘米（-0.52 至 0.01）。
本研究表明，在中年成年人中，体育设施密度高与较低的肥胖率之间存在很强的关联。我们观察到与获得快餐的关联较弱，但由于食物环境测量的局限性，这些关联可能被低估了。政策制定者应考虑采取干预措施，解决肥胖的建筑环境问题。
英联邦奖学金委员会、惠康信托基金会机构战略支持基金。
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