Association between individual and environmental factors with body mass index for age z-score in female adolescents living in North-West of Iran

Purpose The purpose of this study was to investigate the association of individual and environmental indicators with body mass-index-for-age-z-score (BAZ) of female adolescents living in the North-West of Iran. Design/methodology/approach In this cross-sectional study, 380 female adolescents aged 16-18 years were selected from two major ethnic groups (Azeri and Kurd) in Urmia city selected by stratified cluster sampling method. In total, 13 high schools (9 public and 4 private) were selected across all municipality zones of Urmia city. BAZ was calculated by Anthro-Plus software. Demographic and socioeconomic information of samples were collected by a questionnaire through interviews. Home environment features (including physical activity facilities, television, computer games and social media use, food consumption habits and family rules) and school environment features (including socioeconomic status [SES], physical activity facilities, food consumption habits) were evaluated by two separate self-constructed questionnaires via an interview with adolescents and schools’ deans, respectively. Findings Azeri adolescents had parents with higher education and job level and higher SES compared to Kurds (p = 0.000). A higher percent of Azeri adolescents were obese than their Kurd counterparts (p = 0.006). No association was found between individual factors and BAZ in each ethnic group. Considering home environment characteristics, in Kurd adolescents, the maternal occupational level was positively associated with BAZ (p = 0.02). With regard to school environmental features, accessibility of physical activity facilities in school was inversely associated with BAZ only in Kurds (p = 0.005). Originality/value To the best of the authors’ knowledge, this is the first study to investigate various environmental factors in association with adolescent’s overweight/obesity prevalence in different ethnical groups in northwest Iran.

Adolescents’ physical activity and sedentary behaviour in Indonesia during the COVID-19 pandemic: a qualitative study of mothers’ perspectives

Background Socio-behavioural adaptations during the COVID-19 pandemic may have significantly affected adolescents’ lifestyle. This study aimed to explore possible reasons affecting changes in physical activity and sedentary behaviour in Indonesian adolescents during the pandemic based on mothers’ perspectives. Methods We recruited parents (n = 20) from the Yogyakarta region of Indonesia (July–August 2020) using purposive and snowball sampling. Individual interviews were audio-recorded, transcribed verbatim and anonymised. Data were imported into NVivo software for a reflexive thematic analysis. Results The interviews lasted between 38 and 113 min (M = 65 min). Participants’ age ranged between 36 and 54 years (M = 42.6 years). Participants’ children ranged in age from 12 to 15 years (M = 13.7 years, female: 9, male: 11). Themes related to changes in physical activity during the pandemic were 1) self-determination and enjoyment, 2) supports from others, and 3) physical activity facilities and equipment. Themes related to changes in sedentary behaviour during the pandemic included 1) educational demands, 2) psychological effects due to the pandemic, 3) devices and internet availability, 4) parental control, and 5) social facilitators. Conclusions During the pandemic, mothers perceived their children to be less active and using more screen-based devices, either for educational or recreational purposes, compared to before. The present themes might be useful when developing interventions and policies promoting physical activity and reducing sedentary behaviour in adolescents. Interventions could, for example, consider increasing parents’ and adolescents’ awareness on current activity guidelines, providing education on healthier recreational screen time, and involving parents, peers, and teachers. Increasing the accessibility of physical activity facilities and equipment, making use of adolescents’ favourite program and social media for interventions, and providing activities that are fun and enjoyable may also important.

Genetic risk of obesity as a modifier of associations between neighbourhood environment and body mass index: an observational study of 335 046 UK Biobank participants

BackgroundThere is growing recognition that recent global increases in obesity are the product of a complex interplay between genetic and environmental factors. However, in gene-environment studies of obesity, ‘environment’ usually refers to individual behavioural factors that influence energy balance, whereas more upstream environmental factors are overlooked. We examined gene-environment interactions between genetic risk of obesity and two neighbourhood characteristics likely to be associated with obesity (proximity to takeaway/fast-food outlets and availability of physical activity facilities).MethodsWe used data from 335 046 adults aged 40–70 in the UK Biobank cohort to conduct a population-based cross-sectional study of interactions between neighbourhood characteristics and genetic risk of obesity, in relation to body mass index (BMI). Proximity to a fast-food outlet was defined as distance from home address to nearest takeaway/fast-food outlet, and availability of physical activity facilities as the number of formal physical activity facilities within 1 km of home address. Genetic risk of obesity was operationalised by weighted Genetic Risk Scores of 91 or 69 single nucleotide polymorphisms (SNP), and by six individual SNPs considered separately. Multivariable, mixed-effects models with product terms for the gene-environment interactions were estimated.ResultsAfter accounting for likely confounding, the association between proximity to takeaway/fast-food outlets and BMI was stronger among those at increased genetic risk of obesity, with evidence of an interaction with polygenic risk scores (p=0.018 and p=0.028 for 69-SNP and 91-SNP scores, respectively) and in particular with a SNP linked to MC4R (p=0.009), a gene known to regulate food intake. We found very little evidence of gene-environment interaction for the availability of physical activity facilities.ConclusionsIndividuals at an increased genetic risk of obesity may be more sensitive to exposure to the local fast-food environment. Ensuring that neighbourhood residential environments are designed to promote a healthy weight may be particularly important for those with greater genetic susceptibility to obesity.

Abstract P449: Associations of Unhealthy Food and Physical Activity Environments With Adverse Cardiac Function: The Coronary Artery Risk Development in Young Adults (Cardia) Study

Background: Substantial disparities in risk of heart failure (HF) exist by race, which may be driven by certain social or environmental factors. The relationship between the neighborhood built environment, including food and physical activity facilities, and risk of HF is unclear. The associations of the built environment and subclinical cardiac dysfunction may offer insight into mechanisms that lead to increased HF risk. Methods: In the CARDIA study, we evaluated the associations between measures of the neighborhood built environment and echocardiographic indices of cardiac function at the Year 25 exam (Y25). Built measures were assessed within a 3-km Euclidean distance from participant residence and included: 1) proportion of fast food restaurants or convenience stores relative to total food outlets and 2) number of public or commercial physical activity facilities. Results: Among 2,363 participants (44% male, 51% black) with available data from Y25, higher proportions of fast food restaurants and convenience stores were independently associated with lower left ventricular (LV) diastolic function (lower e’ tissue velocities and higher E/e’) ( Table ). Lower number of public and commercial physical activity facilities were independently associated with lower LV systolic function (LV longitudinal strain) and diastolic function. Conclusions: Food environments with higher proportions of fast food and convenience stores are associated with lower diastolic function, and environments with less physical activity facilities are associated with worse systolic and diastolic function. These findings suggest relationships between the built environment and subclinical HF.

Public open spaces and physical activity: disparities of resources in Florianópolis

ABSTRACT OBJECTIVE: To analyze the association between sociodemographic characteristics of census tracts and the presence/quality of public open spaces and physical activity facilities. METHODS: A cross-sectional study was conducted in 643 census tracts in Florianópolis, Brazil, the presence and quality of public open spaces and physical activity facilities were objectively analyzed and the data by census tracts using Geographic Information Systems was treated. Outcomes were analyzed considering the census tracts as having: ≥ 1 public open spaces; ≥ 1 public open spaces with high quality; ≥ 2 physical activity facilities and high-quality physical activity facilities. Sociodemographic characteristics were the independent variables. Logistic regression analysis was performed. RESULTS: Census tracts with a medium-income (OR = 1.8; 95%CI 1.1–3.0) and high-income (OR = 2.4; 95%CI 1.4–4.0), in those with medium (OR = 1.7; 95%CI 1.0–2.7) and high residential density (OR = 2.0; 95%CI 1,2–3.3), and with higher proportions of older adults (OR = 3.3; 95%CI 1.9–5.7) had a higher proportion of public open spaces. Census tracts with higher proportions of children/adolescents (OR = 0.3; 95%CI 0.2–0.6) and non-white residents (OR= 0.6; 95%CI 0.3–0.9) were less likely to contain public open spaces. The tracts with medium (OR = 4.0; 95%CI 1.4–11.3) and high-income (OR = 3.6; 95%CI 1.2–10.2) were more likely to contain public open spaces with ≥ 2 structures for physical activity, compared with those with low-income. We observed the inverse in sectors with a high proportion of non-white residents (OR = 0.3; 95%CI 0.1–0.9). CONCLUSIONS: Census tracts with higher proportions of children or adolescents, non-white individuals and those in the low-income strata had lower odds of containing public open spaces and physical activity facilities.

Associations among Neighborhood Socioeconomic Deprivation, Physical Activity Facilities, and Physical Activity in Youth during the Transition from Childhood to Adolescence

Background: This study aims to examine the longitudinal association of neighborhood socioeconomic deprivation (SED) with physical activity in youth during the transition from elementary to middle school, and to determine if access to physical activity facilities moderates this relationship. Methods: Data were obtained from the Transitions and Activity Changes in Kids (TRACK) study, which was a multilevel, longitudinal study designed to identify the factors that influence changes in physical activity as youth transition from elementary to middle school. The analytic sample for the current study included 660 youth with complete data in grades 5 (baseline) and 7 (follow-up). A repeated measures multilevel framework was employed to examine the relationship between SED and physical activity over time and the potential moderating role of elements of the built environment. Results: Decreases in physical activity varied by the degree of neighborhood SED with youth residing in the most deprived neighborhoods experiencing the greatest declines in physical activity. Access to supportive physical activity facilities did not moderate this relationship. Conclusion: Future research studies are needed to better understand how neighborhood SED influences youth physical activity over time.

Walkability, Overweight, and Obesity in Adults: A Systematic Review of Observational Studies

We conducted a systematic review to describe and summarize possible associations between the walkability index, overweight, and obesity. Systematic searches using seven electronic databases and reference lists were conducted to identify papers published until December 2017. Observational studies, describing associations using regression-based statistical methods, published in English and Portuguese, reporting markers of overweight and obesity, and involving adults (≥18 years) were included. Of the 2469 references initially retrieved, ten were used for the descriptive synthesis. Seven studies showed significant inverse associations between walkability and overweight and obesity, however, all were cross-sectional studies. High risk of bias scores were observed in “selection bias” and “withdrawals and dropouts”. All studies were published in high-income countries with sample sizes ranging among 75 to 649,513 participants. Weight and height as measures for determining BMI tended to be self-reported. Indicators of walkability, such as land-use mix, street connectivity and residential density were used as components of the indices. Based on this review, more studies should be conducted in low, middle, and middle-high income countries, using longitudinal designs that control neighborhood self-selection; other indicators of the neighborhood environment, such as food access, physical activity facilities, sidewalks, and safety and crime prevention should be considered.